The association between meat consumption and muscle strength index in young adults: the mediating role of total protein intake and lean mass percentage.

PURPOSE: The aim of this study was to analyse the associations between the consumption of different types of meat and the muscle strength index (MSI) and to examine whether this relationship is mediated by total protein intake (TPI) and lean mass percentage (LM%) in young adults. METHODS: We conducted a cross-sectional study with first-year university students from Castilla-La Mancha, Spain. Different types of meat consumption (total, red, processed, and white and fish) were separately evaluated using a Food-Frequency Questionnaire. MSI was determined from the handgrip and standing long jump tests. ANCOVA models were used to test the mean differences in MSI by categories of meat consumption. Serial multiple mediation models were used to explore the mediating role of TPI and LM% in the relationship between meat consumption and MSI. All analyses were adjusted for age, sex, and socioeconomic level, identified through a directed acyclic graph. Additional analyses were performed with a small subsample including alcohol intake, tobacco smoking, physical activity, cardiorespiratory fitness, and total energy intake as covariates in the multiple mediation models. RESULTS: A total of 230 students (mean age 21.1 ± 2.1 years, 66.5% women) were included in the analysis. Young adults with higher meat consumption (total, red, and white and fish) had higher MSI adjusted means than their peers with lower meat consumption (p < 0.05). These associations did not remain after controlling for TPI and LM%. In adjusted mediation analyses, a significant indirect effect was observed through TPI and LM% in the associations between each of the types of meat consumption and MSI. In the additional analyses, a greater effect of white and fish meat consumption on muscle strength through mediation of TPI and LM% was reported compared to red or processed meat consumption, and no significant effects were observed between processed meat consumption and MSI. CONCLUSION: Higher consumption of total, red, and white and fish meat was associated with increased MSI in young adults. TPI and LM% mediated this relationship.

Effectiveness of Microcurrent Therapy for Treating Pressure Ulcers in Older People: A Double-Blind, Controlled, Randomized Clinical Trial.

The aim of this study was to assess the effectiveness of microcurrent therapy for healing pressure ulcers in aged people. A multicentric, randomized clinical trial was designed with a sham stimulation control. The experimental group received an intervention following a standardized protocol for curing ulcers combined with 10 h of microcurrent therapy daily for 25 days. The sham group received the same curing protocol plus a sham microcurrent stimulation. The studied healing-related variables were the Pressure Ulcer Scale for Healing (PUSH) and the surface, depth, grade, and number of ulcers that healed completely. Three evaluations were conducted: pre-intervention (T1), 14 days following the start of the intervention (T2), and 1 day after the intervention was completed (T3). In total, 30 participants met the inclusion criteria (n = 15 in each group). The improvement in the PUSH at T2 and T3 was 16.8% (CI95% 0.5-33.1) and 25.3% (CI95% 7.6-43.0) greater in the experimental group versus the sham control, respectively. The reduction in the wound area at T2 and T3 was 20.1% (CI95% 5.2-35.0) and 28.6% (CI95% 11.9-45.3) greater in the experimental group versus the control, respectively. Microcurrent therapy improves the healing of pressure ulcers in older adults, both quantitatively and qualitatively.

Campañas de vacunación contra las enfermedades víricas en España durante el siglo XX: una visión desde la prensa (1951-1986) / Vaccination campaigns against viral diseases in Spain during the 20th Century: a view from the press (1951-1986)

Desde finales del siglo XIX, fue posible luchar contra varias de las enfermedades víricas (rabia, viruela, gripe, polio, sarampión, rubéola y parotiditis), que, a lo largo del siglo XX, afectaron masivamente a la población adulta e infantil, a través de programas de vacunación que se establecieron una vez que estuvieron disponibles vacunas seguras para prevenirlas. España fue adoptando estas medidas preventivas progresivamente, especialmente a partir de su incorporación a la Organización Mundial de la Salud (OMS) en 1951. Cuando se promulgó la Ley General de Sanidad, en 1986, algunas de estas enfermedades habían podido controlarse y/o eliminarse mediante la vacunación sistemática. El tratamiento que ha realizado la prensa nacional de estos hechos ha sido escasamente estudiado. Este artículo tiene como objetivo analizar la repercusión en la prensa nacional de las campañas de vacunación contra estas enfermedades víricas hasta el año 1986 y comprobar si los medios de comunicación escritos reflejaron las medidas epidemiológicas globales adoptadas por la OMS para combatirlas. Junto a ello, estudiar su posible influencia, tanto en la puesta en marcha de políticas públicas de vacunación, como en el modo de transmitir dicha información a la población en los diferentes contextos sociopolíticos y científico-sanitarios cambiantes del periodo estudiado

Since the end of the 19th century, it has been possible to fight against several viral diseases (smallpox, rabies, influenza, polio, measles, rubella and mumps) that, during the 20th century, had a massive effect on the adult and child population through vaccination programmes established when safe vaccines were available to prevent such diseases. Spain progressively incorporated these preventive measures, especially after its incorporation into the World Health Organization (WHO) in 1951. By the time the General Health Law was enacted in 1986, it had been possible to control and/or eliminate some of these diseases through systematic vaccination. The treatment and monitoring that the Spanish national press has given to the implementation of the vaccination campaigns against these diseases has been little studied. Therefore, the objectives of this paper are to analyse the repercussions in the national press of the vaccination campaigns against these viral diseases between 1951 and 1986 and to check whether the written media reflected the global epidemiological measures adopted by WHO to combat them. Besides, to study its possible influence both in the development of public policies of vaccination and in the way how this information was transmitted to the population during the different socio-political and scientific contexts in the studied period

[SAFETY IN THE ELDERLY: HOME ACCIDENTS]. / Seguridad en personas mayores: accidentes en el hogar.

Home accidents are more common in the elderly and they can have serious consequences to the injured person's health. At home, chances to suffer accidents of any type are higher, because it's the place where old people spend most of their daily time. It is important to point out that a high percentage of domestic accidents could be easily avoided by taking some simple cautions. The main aim of this paper is to know how we can prevent most common domestic accidents in the aged population: falls, burnings, poisonings and fire prevention.

Análisis de la mortalidad expósita de la inclusa de Toledo y sus condicionantes (1900-1930) / Analysis of the mortality experience among the abandoned children in the foundling hospital of Toledo and its determinants (1900-1930)

El objetivo de este trabajo es analizar la mortalidad expósita y sus causas en una cohorte de niños abandonados en la inclusa toledana, aquellos que nacieron en la Maternidad aneja, como grupo homogéneo que partía de unas condiciones de alumbramiento similares y fueron institucionalizados al nacer. Ello permite comparar esta mortalidad expósita con la de otras inclusas españolas y con la mortalidad poblacional, a la vez que explica los distintos factores que pudieron condicionarla (AU)

The aim of this work is to analyze the mortality and its causes in the abandoned children of the Children’s home of Toledo, who were born in the Maternity House, because it was a homogeneous group which had the same conditions in their delivery and they were abandoned at the moment of their birth. It allows us to compare the mortality of this group of foundlings with the mortality of the general population and with the mortality of those abandoned in other Charity Institutions. This paper explains the different factors which could determine the mortality (AU)

[Elderly caregivers of elderly people].

The ageing of the population is a reality in our society nowadays. The aging process changes increase the probability that health problems occur. This fact involves that the needs of care demanded by the population increase too. The care for the elderly generally are provided in home environments, where often, the primary caregiver is another old person. In this sense, must be taken into account that this stage of life, the old age, although there has been important improvements in the quality of life and in the resolution of health problems, presents certain limitations refers to physical and mental declines that affect to the functional capacity of elderly caregivers. For this reason, it is necessary to carry out a comprehensive geriatric assessment to identify unresolved needs and establish care strategies required to attend their demands for care.

[What do we need to know about the burn injuries? Pathophysiology, aetiology and effects]. / ¿Que necestamos saber sobre las quemaduras? Fisiopatología, etiología y repercusiones.

Burn injuries are a major public health problem worldwide, because they are very common. They are usually produced in domestic or work environments, although it is not unusual that they might be caused by traffic accidents or intentionally (self-injured or assaults on the people). These injuries do not attract much attention but if they are not treated properly, they can lead to serious systemic complications which can sometimes cause the death of the patient. In the last few years, the therapeutic approach of the burned patient has significantly improved due to an early correct initial valuation, which is used to design an effective nursing care plan and it determines the prescription of a suitable medical treatment according to the characteristics and the severity of the burn. The aim of this chapter is to explain some general aspects about the aetiology and pathology of burn injuries and their systemic effects, because the medical and nursing staff should know these aspects to make an adequate initial valuation. They should recognize the aetiology of the burn, its depth and area, its severity and its systemic complications to act properly in the initial phase of the treatment, because these preliminary actions are essential in the prognosis and evolution of the burns.

[Local nursing care in burn injuries]. / Cuidados de enfermería locales en las quemaduras.

Burn injuries are tissue injuries originated as a result of a physical or chemical trauma. They can cause from a mild skin affectation to the total destruction of the affected tissues, depending on various levels of severity. Moreover, if the affected body surface is very large, patient life can be seriously compromised. An estimate 300 people for every 100,000 inhabitants are treated for burn injuries every year in hospitals or social-sanitary centers. In this chapter we aim at clarifying the nursing care for the affected area, once patient's life risk is stabilized and controlled.This care will be based on an adequate approach to local handling of burn injuries, after severity and prognosis have been stated.

[Therapeutic guide to local care of burn injuries]. / Guía terapéutica en el cuidado local de las quemaduras.

There is a large variety of topical application substances in the market for burnt areas treatment. This fact, far from being an advantage, turns into a serious problem when nursing staff has to choose the most adequate for each case. We think that, apart from a thorough knowledge of aspects such as indications and contraindications, application methods, combination with other substances and possible interactions, the formulation of a series of practical criteria can be of great help in order to select the right topical substance for the objectives pursued. This is the goal of this article.

[Therapeutic guide to critical burn patients]. / Guía terapéutica en el paciente quemado crítico.

Burn injuries are defined as the destruction of skin tissue under the effects of a thermal, electrical, chemical or radioactive agent. They can cause local injuries, with no systemic effect, but in certain cases, considered as "critical burn patients", they can produce severe and immediate systemic injuries, thus making it necessary to address care from a comprehensive perspective in order to achieve a satisfactory evolution. With this in mind, as nursing staff we must consider the need to review the treatments and nursing care we are applying to critical burn patients, in order to prevent the onset of complications that might lead to unwanted consequences or even the death of the patient, and eventually unifying criteria of nursing care. The main goal of this guide is to provide an efficient and easy to use working tool that is suitable for adult burn patients, thus making it easier for nurses to update knowledge and decision making.

[Sequelae in patients with severe burns]. / Secuelas en los pacientes con quemaduras graves.

Nowadays, the main aim with severe burned patients is the prevention and treatment of the complications associated to burn injuries, because the mortality caused by them has significantly declined due to the improvements in the treatments used. This fact has changed the focus of the care from a biomedical model which pay attention to the physical aspects, to other based on the holistic care of the patient in which physical, psychological and social aspects are considered. To minimize the development of these adverse complications and to prevent their severity in long term, it is essential to initiate an early rehabilitation at hospital and follow these patients by the Primary Care team when they return home. The adverse effects of the burns can invalidate the patient and they can affect several spheres of his life: physical, psychological and social. The goals of this article are to determine the most common complications in severe burns, describe the treatments more effective to combat them and explain the role of nurses in the prevention and rehabilitation of these injured.

¿Qué necesitamos saber sobre las quemaduras? Fisiopatología, etiología y repercusiones / What do we need to know about the burn injuries? pathophysiology, aetiology and effects

Las quemaduras constituyen un importante problema de salud a nivel mundial, ya que se dan con mucha frecuencia. Tienen su origen, sobre todo, en el ámbito doméstico y en el laboral, sin ser infrecuentes las generadas en accidentes de tráfico o las que son intencionadas (autolesión o agresión a terceros). Son lesiones poco llamativas en apariencia, que si no se tratan correctamente pueden conducir a graves complicaciones sistémicas que, en ocasiones, causan la muerte. En los últimos años, el abordaje terapéutico de un paciente con quemaduras ha mejorado de manera significativa gracias a una valoración inicial precoz y correcta, que determina la planificación de unos cuidados de enfermería eficaces y la instauración de un tratamiento médico adecuado a las características y la gravedad del quemado. El objetivo de este artículo es presentar algunos aspectos generales relacionados con la fisiopatología de las quemaduras y con la afectación sistémica que causan, porque la valoración inicial solo será adecuada si el personal sanitario es capaz de reconocer la etiología de la quemadura, su extensión, su profundidad, la gravedad y la afectación sistémica, para poder actuar de modo adecuado en los estadios iniciales del tratamiento, ya que estas intervenciones resultan clave en el pronóstico y evolución de los afectados (AU)

Burn injuries are a major public health problem worldwide, because they are very common. They are usually produced in domestic or work environments, although it is not unusual that they might be caused by traffic accidents or intentionally (self-injured or assaults on the people). These injuries do not attract much attention but if they are not treated properly, they can lead to serious systemic complications which can sometimes cause the death of the patient. In the last few years, the therapeutic approach of the burned patient has significantly improved due to an early correct initial valuation, which is used to design an effective nursing care plan and it determines the prescription of a suitable medical treatment according to the characteristics and the severity of the burn. The aim of this chapter is to explain some general aspects about the aetiology and pathology of burn injuries and their systemic effects, because the medical and nursing staff should know these aspects to make an adequate initial valuation. They should recognize the aetiology of the burn, its depth and area, its severity and its systemic complications to act properly in the initial phase of the treatment, because these preliminary actions are essential in the prognosis and evolution of the burns (AU)

Cuidados de enfermería locales en las quemaduras / Local nursing care in burn injuries

Las quemaduras son lesiones tisulares originadas como resultado de un traumatismo físico o químico. En sus distintos grados, pueden producir desde una leve afectación de la piel hasta la destrucción total de los tejidos implicados. Además, si la superficie corporal quemada es muy extensa, puede verse seriamente comprometida la vida de la persona que las sufre. Se estima que, por cada 100 000 habitantes, alrededor de 300 personas son atendidas cada año en centros hospitalarios o sociosanitarios por este tipo de lesiones. Con este capítulo se pretende clarificar los cuidados enfermeros en el área lesionada, una vez estabilizado y controlado el riesgo vital de la víctima. Estos cuidados se basan en el planteamiento de un correcto manejo local de las quemaduras, conocidas ya la gravedad y el pronóstico de las mismas (AU)

Burn injuries are tissue injuries originated as a result of a physical or chemical trauma. They can cause from a mild skin affectation to the total destruction of the affected tissues, depending on various levels of severity. Moreover, if the affected body surface is very large, patient life can be seriously compromised. An estimate 300 people for every 100,000 inhabitants are treated for burn injuries every year in hospitals or social-sanitary centers. In this chapter we aim at clarifying the nursing care for the affected area, once patient’s life risk is stabilized and controlled.This carewill be based on an adequate approach to local handling of burn injuries, after severity and prognosis have been stated (AU)

Guía terapéutica en el cuidado local de las quemaduras / Therapeutic guide to local care of burn injuries

Existen gran variedad de sustancias en el mercado de aplicación tópica para el tratamiento de áreas quemadas. Este hecho, lejos de ser una ventaja, se convierte en un serio inconveniente a la hora de elegir el más adecuado en cada caso por parte del personal de enfermería. Creemos que, además del conocimiento exhaustivo de sus indicaciones, contraindicaciones, formas de aplicación, posibilidad de combinación con otras sustancias o sus interacciones, la formulación de una serie de criterios prácticos puede ser de gran ayuda para seleccionar el tópico más adecuado en relación con los objetivos que se persigan. Este es el objetivo de este artículo (AU)

There is a large variety of topical application substances in the market for burnt areas treatment. This fact, far from being an advantage, turns into a serious problem when nursing staff has to choose the most adequate for each case. We think that, apart from a thorough knowledge of aspects such as indications and contraindications, application methods, combination with other substances and possible interactions, the formulation of a series of practical criteria can be of great help in order to select the right topical substance for the objectives pursued. This is the goal of this article (AU)

Secuelas en los pacientes con quemaduras graves / Sequelae in patients with severe burns

La prevención y el tratamiento de las secuelas en los pacientes quemados es uno de los objetivos principales de la atención sanitaria a estos heridos en la actualidad, ya que una vez mejoradas sus tasas de supervivencia, gracias a los grandes avances en la medicina, el foco de atención se ha desplazado desde un modelo biomédico, con atención prioritaria a las alteraciones físicas del individuo, a otro de cuidado integral, en el que se tienen en cuenta los factores físicos, psicológicos y sociales que le afectan. Para minimizar la aparición de secuelas y evitar sus consecuencias a largo plazo, se considera necesario iniciar la rehabilitación de manera precoz y continuar su seguimiento en la consulta de Atención Primaria, cuando es dado de alta. Estas secuelas pueden ser invalidantes para la persona y afectar a varias esferas de su vida: la física, la psicológica y la social. El objetivo de este artículo es determinar los tipos de secuelas más frecuentes en el paciente quemado grave, exponer los tratamientos con los que se pueden combatir y explicar el papel de la enfermera tanto en su prevención como en la rehabilitación de estos pacientes (AU)

Nowadays, the main aim with severe burned patients is the prevention and treatment of the complications associated to burn injuries, because the mortality caused by them has significantly declined due to the improvements in the treatments used. This fact has changed the focus of the care from a biomedical model, which pay attention to the physical aspects, to other based on the holistic care of the patient in which physical, psychological and social aspects are considered. To minimize the development of these adverse complications and to prevent their severity in long term, it is essential to initiate an early rehabilitation at hospital and follow these patients by the Primary Care team when they return home. The adverse effects of the burns can invalidate the patient and they can affect several spheres of his life: physical, psychological and social. The goals of this article are to determine the most common complications in severe burns, describe the treatments more effective to combat them and explain the role of nurses in the prevention and rehabilitation of these injured (AU)

Guía terapéutica en el paciente quemado crítico / Therapeutic guide to critical burn patients

Las quemaduras se definen como la destrucción de los tejidos bajo el efecto de un agente térmico, eléctrico, químico o radiactivo. Pueden causar lesiones locales, sin afectación sistémica, pero, en determinados pacientes, que consideramos «quemados críticos», pueden originar lesiones sistémicas graves e inmediatas para el afectado, lo que hace necesario abordar su atención desde una perspectiva integral para su buena evolución. Partiendo de esta idea, como personal de enfermería, debemos plantearnos la necesidad de revisar qué tratamientos y cuidados realizamos a los pacientes quemados críticos, para prevenir la aparición de complicaciones que pudieran ocasionarles secuelas o incluso la muerte, con el fin de unificar criterios de actuación enfermera. El objetivo principal de esta guía es realizar una herramienta de trabajo ágil, de fácil manejo y adecuada para pacientes quemados adultos, que facilite a los profesionales de enfermería la actualización de conocimientos y la toma de decisiones (AU)

Burn injuries are defined as the destruction of skin tissue under the effects of a thermal, electrical, chemical or radioactive agent. They can cause local injuries, with no systemic effect, but in certain cases, considered as «critical burn patients», they can produce severe and immediate systemic injuries, thus making it necessary to address care from a comprehensive perspective in order to achieve a satisfactory evolution. With this in mind, as nursing staff we must consider the need to review the treatments and nursing care we are applying to critical burn patients, in order to prevent the onset of complications that might lead to unwanted consequences or even the death of the patient, and eventually unifying criteria of nursing care. The main goal of this guide is to provide an efficient and easy to use working tool that is suitable for adult burn patients, thus making it easier for nurses to update knowledge and decision making (AU)

[Nursing care in males with spinal cord injury and sexual dysfunction]. / Cuidados enfermeros en el varón con lesión medular y disfunción sexual.

The impact of spinal cord injury and its sequels requires important efforts of adaptation. In several studies, people with spinal cord injury claim to have covered most of their needs at physical, emotional and social level, but they are not yet fully satisfied with their sexual life. Sexual function is usually impaired in men with spinal cord injuries, and is sometimes related to problems of erection, ejaculation and/or orgasm. This issue is not a priority in the first phase, but it appears over the subsequent periods when patients often ask for a solution to this problem. A case-study is presented of a 25 year old male with chronic complete spinal cord injury (ASIA A), L4-L5 level, who reported sexual dysfunction and attended an annual review in the National Hospital for Paraplegics. After performing a nursing assessment using the functional health patterns of Gordon, the team proposed a nursing care plan according to the taxonomy of NANDA (North American Nursing Association), NOC (Nursing Outcome Classification) and NIC (Nursing Intervention Classification). Nurses are the healthcare professionals who have more direct and continuous contact with these patients. Specific programs need to be designed to provide them with the sexual education, which should contain adequate emotional and sexual information. We believe that an appropriate and systematic assessment of patient's sexuality, as well as the application of the (NANDA, NOC, NIC) nurse methodology, may be very helpful in improving the outcomes of these specific interventions.

Cuidados enfermeros en el varón con lesión medular y disfunción sexual / Nursing care in males with spinal cord injury and sexual dysfunction

El impacto de la lesión medular y sus secuelas suponen grandes esfuerzos de adaptación. En distintos estudios las personas con lesión medular tienen cubierta la mayoría de sus necesidades, tanto físicas como afectivas y sociales. Sin embargo, manifiestan carencias en todo lo relacionado con el ámbito sexual. La función sexual en hombres con lesión medular suele estar alterada, pudiendo existir problemas en la erección, en la eyaculación y/o en la percepción orgásmica. Durante la fase aguda no se suele abordar, pero es después, en las etapas más tardías, cuando se demanda solución a este problema. Se presenta el caso de un varón de 25 años con lesión medular crónica completa (ASIA A), nivel L4-L5, que refiere tener disfunción sexual y acude a su revisión anual en el Hospital Nacional de Parapléjicos. Tras realizar la valoración enfermera por patrones funcionales de salud de Gordon, se propone un plan de cuidados enfermeros según taxonomía de la North American Nursing Association (NANDA), Nursing Outcome Classification (NOC) y Nursing Intervention Classification (NIC).Las enfermeras son los profesionales de la salud que más contacto directo y continuado tienen con estos pacientes, por lo que sería necesario diseñar programas de educación sexual que incluyeran información afectiva y sexual. Tras la realización de este trabajo pensamos que la valoración sistemática y adecuada de la sexualidad del paciente, y además la aplicación de la taxonomía enfermera (NANDA, NOC, NIC), puede resultar de gran ayuda para mejorar los resultados de las intervenciones en estos pacientes (AU)

The impact of spinal cord injury and its sequels requires important efforts of adaptation. In several studies, people with spinal cord injury claim to have covered most of their needs at physical, emotional and social level, but they are not yet fully satisfied with their sexual life. Sexual function is usually impaired in men with spinal cord injuries, and is sometimes related to problems of erection, ejaculation and/or orgasm. This issue is not a priority in the first phase, but it appears over the subsequent periods when patients often ask for a solution to this problem. A case-study is presented of a 25 year old male with chronic complete spinal cord injury (ASIA A), L4-L5 level, who reported sexual dysfunction and attended an annual review in the National Hospital for Paraplegics. After performing a nursing assessment using the functional health patterns of Gordon, the team proposed a nursing care plan according to the taxonomy of NANDA (North American Nursing Association), NOC (Nursing Outcome Classification) and NIC (Nursing Intervention Classification).Nurses are the healthcare professionals who have more direct and continuous contact with these patients. Specific programs need to be designed to provide them with the sexual education, which should contain adequate emotional and sexual information. We believe that an appropriate and systematic assessment of patient's sexuality, as well as the application of the (NANDA, NOC, NIC) nurse methodology, may be very helpful in improving the outcomes of these specific interventions (AU)

La mortalidad infantil y sus causas en la inclusa de Toledo entre 1900-1910 / Mortalidade infantil e suas causas em crianças abandonados em um orfanato em Toledo (Espanha) entre 1900 e 1910 / The infant mortality and its causes in the foundling of Toledo between 1900-1910

La asistencia sanitaria se vinculaba a acciones benéficas hacia los pobres. Hasta el siglo XX fue frecuente el abandono de niños en inclusas, donde las cifras de mortalidad eran catastróficas. El objetivo de esta investigación es estudiar la mortalidad infantil y sus causas en los niños abandonados en la inclusa de Toledo entre 1900 y 1910. Es un trabajo histórico que analiza las fuentes primarias (libros de lactancias y destetes, con datos sobre el momento de la muerte y su causa) a partir de los presupuestos teóricos de la historia social y cultural. Excluidas las muertes perinatales, la tasa de mortalidad fue de 587 por mil. El 39 % murió antes de cumplir un año. La mortalidad en el grupo entre 1 y 5 años es la mitad de la que se da hasta el año de vida. Las causas de esta mortalidad fueron las enfermedades infecciosas, falta de desarrollo físico, eclampsia y atrepsia. La mortalidad infantil de estos niños era muy superior a la que tenía la provincia de Toledo en la misma fecha. La causalidad de los fallecimientos aparece vinculada a la falta de salubridad y de higiene tanto de la institución como de las familias de acogida (AU)

The study of the medical care is closely connected to the charitable actions with poor people. It was very common the abandonment of the children in the foundlings until the first decades of the 20th century. In them, the rates of infant mortality were catastrophic. The aim of this research is the study of the infant mortality and its causes in the abandoned children in the foundling of Toledo between 1910 and 1910. It is a historical research that analyses the primary sources (the books of breastfeeding and weaning of the institution have been used to collect the data because in them there are some references about the moment of the death and its etiology) using the principles of Social and Cultural History. If we exclude the perinatal deaths, the infant mortality rate was 537 per thousand. The39% died before being one year old. The mortality rate between one and five years is the half than in the other group of age. This mortality was caused by infections, rickets, «eclampsia and atrepsia». The mortality of these children was higher than the mortality of the kids who live in the county of Toledo in the same date. The causes of the death are related to the lack of healthiness and hygiene both in the institution and in the foster families (AU)

O estudo dos cuidados de saúde deve estar vinculado à acções benéficas dos pobres. Foi frequente até o século XX o abandono de crianças em orfanatos, onde as taxas de mortalidade infantil era muito altas. O objectivo desta pesquisa é estudar a mortalidade infantil e suas causas em crianças abandonados em um orfanato em Toledo (Espanha) entre 1900 e 1910. É um trabalho histórico que analisa as fontes primárias (livros de lactancias e desmame da instituição, porque recolher dados sobre o tempo de morte e sua etiologia) usando dos fundamentos teóricos da história social e cultural. Excluídas as mortes perinatais, a taxa de mortalidade foi de 587 por mil. O 39 % morreram no primeiro ano. A mortalidade no grupo entre 1 e 5 anos é metade do que no primeiro ano do vida. As causas de morte foram doenças infecciosas, a falta de desenvolvimento físico, eclampsia e atrepsia. A mortalidade infantil dessas crianças foi muito maior do que à mortalidade de crianças em Toledo na mesma data. As causas da morte parecem estar asociadas à falta de saneamento e higiene da instituição assim como das famílias de acolhimento (AU)

Calidad de vida del varón con lesión medular traumática y disfunción sexual / Quality of life of males with spinal cord injury and sexual dysfunction

Objetivos Valorar la calidad de vida (CDV) del varón con lesión medular (LM). Conocer el estado de salud sexual del varón con LM. Analizar la relación de las variables clínicas, sociodemográficas y estado de salud sexual del varón con LM con la CDV. Método Se trata de un estudio observacional y transversal, realizado en el Hospital Nacional de Parapléjicos de Toledo con 45 varones con LM y disfunción sexual. Para la recogida de datos se utilizaron la escala de satisfacción con la Vida (LISAT-8) y la escala de valoración de la salud sexual. Resultados El 97,8% de los participantes del estudio tienen interés para mantener relaciones sexuales; el 70% tiene pareja sexual estable; el 51% mantiene relaciones sexuales con regularidad. El 86% de la muestra refiere tener disfunción eréctil (DE) y el 71% an aeyaculación. El grupo que tiene DE puntúa significativamente menos en CDV sexual (p-valor t de Student 0,000) y en CDV general (p-valor t de Student 0,001). La muestra obtuvo en CDV general una media de 34,27 (DT: 2,8), en CDV social 20,16 (DT: 2,7), en CDV sexual 7,62 (DT: 2,7) y en CDV económica 7,71 (DT: 2,6). No existe relación significativa entre la CDV y la etiología, el grado, el tiempo de la LM. Conclusiones Los participantes perciben una CDV general buena, siendo la vida sexual el aspecto con el que refieren estar menos satisfechos. De hecho los que tienen disfunción eréctil están menos satisfechos en su vida general y en su vida sexual (AU)

Aims: the aims of this study are to assess the quality of life (QOL) of males with spinal cordinjury (SCI) and to know their sexual health. We also analyze the links among clinic and sociodemographic variables, the sexual health of males with SCI and their QOL. Method: This is a transversal cross-sectional study that was made in the hospital of Paraplegics of Toledo. The sample included 45 men presenting SCI and sexual dysfunction. Life Satisfaction Checklist and Sexual Health Measurement Scale were used to gather data. Results: The 97, 8% of all participants are interested in having sexual relationships; the 70% of all participants have a steady sexual couple while the 51% often maintain sexual relations. The 86% of the sample admit to suffer from erectile dysfunction and the 71% can’t ejaculate. The score of the group which has erectile dysfunction are significantly low in sexual QOL(p t-Student 0.000) and in general QOL (p t-Student 0.001).The sample had an average in general QOL of 34,27 (standard deviation: 2,8), in social QOL20,16 (SD:2,7), in sexual QOL 7,62 (SD:2,7) and in economic QOL 7,71 (SD:2,6). There isn’t a signifi cant relationship among the QOL and the etiology, the degree and the time of evolution of the SCI. Conclusions: The individuals who have participated in this study generally experienced a good general QOL, but their sexual life is the aspect which causes them a greater dissatisfaction. Infact, those who suffer from erectile dysfunction show less satisfaction with their general and sexual QOL (AU)