Una respuesta ética en la atención a residencias de ancianos en la pandemia Covid-19 / An ethical response in the care of nursing homes in the covid-19 pandemic

La llegada de la pandemia COVID-19 puso en evidencia el riesgo de una posible falta de atención de los ancianos de las residencias de mayores. Aportamos la experiencia de un equipo multidisciplinar con profesionales voluntarios de diferentes especialidades que realizó una labor de apoyo a los profesionales sanitarios de las residencias. Este equipo se implementó desde las gerencias de atención primaria y de atención especializada. La sistemática de trabajo se inspiraba en el de hospitalización a domicilio e incluía la atención directa de los pacientes más complejos y el asesoramiento en las medidas de prevención, aislamiento e higiene dentro de la residencia. De este modo fue posible que los ancianos de las residencias con sospecha o diagnóstico de COVID-19 recibieran una atención adecuada por parte de un equipo interdisciplinar, que se descargara parte de la presión de los profesionales de las residencias y que los familiares percibieran que no existía abandono terapéutico. El compromiso desde diversos niveles asistenciales en una labor coordinada ha conseguido evitar que una población vulnerable pudiera quedar desatendido durante la pandemia

With the arrival of the COVID-19 pandemic, the risk of a possible lack of care for the elderly in nursing homes became evident. We summarize the experience of a multidisciplinary team with volunteer professionals from different specialties who carried out support for healthcare professionals in nursing homes. This team was implemented from both Primary and Specialty Care managements. Its work paradigm was proposed by our home hospitalization team, which included direct care of the most complex patients and general counselling on isolation, hygiene and preventive measures within the nursing homes. Thanks to this support, the elderly population placed there, with suspected or diagnosed COVID-19, received adequate care from an interdisciplinary team, which led part of the pressure to be released from their professional workers, and many family members were aware that there was no neglect of the elderly. Commitment from various levels of care in a coordinated effort has prevented a vulnerable population from being left unattended during the pandemic

Diversity of "Pedestrians on Wheels", New Challenges for Cities in 21st Century.

Traditionally, pedestrians were identified as singular entities with standard needs. Reality shows us that pedestrian diversity is a reality that is becoming increasingly complex. How does urban design face the changing reality of pedestrian typologies? In the same way that in the 20th century the car set aside horse carriages and pedestrians, in the 21st century pedestrians are returning to take centre stage with regard to motor vehicles, but with new formalizations that imply new considerations in the design of streets, many of they are still unsolved. Citizens strolling on scooters, skates, skateboard, segway, unicycles, are added to the already traditional baby strollers, wheelchairs, and suitcases with wheels … "pedestrians on wheels" that pose new challenges of coexistence and design. Own functional requirements to walk and maneuver, to see and be seen … functional requirements of coexistence with other pedestrians that make a different use of the street (people looking at shop windows, pedestrians with umbrellas, reading on the smartphone…) or changes of use of the same space when the conditions are different: snow, strong sun, fog, at night … These are considerations of Universal Accessibility and Design for all that we cannot leave out while our society progresses. This paper identifies some of these new needs and studies this new pedestrian mobility is carried out through a progressive analysis in three phases: 1 classification of the different user of the street, 2 study of the Personal Mobility Devices (PMD) and 3 the new accessibility barriers that arise with the use of PMD. As a result, some action strategies are pointed out to respond to the difficulties of accessibility derived from this new reality and to integrate them into the Universal Design of the urban public space.

[Results of the Spanish National Campaign of oral vaccination polio 1963-1964: virological and epidemiological study]. / Resultados de la Campaña Nacional de vacunación antipoliomielítica por vía oral en España: estudio virológico y epidemiológico.

BACKGROUND: From the results of epidemiological studies in 1958 was decided to use oral vaccine Sabinl type. The aim of this work is to evaluate the impact of the national vaccination campaign of 1963 and 1964. METHODS: The national campaign offering it to all Spanish children between two months and seven years. In the first phase of the national campaign was employed polio virus type 1 and 4,400,000 children were vaccinated, ie 95% of the target population. In the second phase was trivalent vaccine types 1, 2 and 3 and covered 4,680,000 children, representing 98.8 per 100. RESULTS: In the first phase 26 polio cases occurred in vaccinated children, 18 had been produced by the virus type 3 and type 2. In phase 2 were confirmed virologically 27. From 1 June to 31 December 1964 14 cases were confirmed. 9 in unvaccinated people, 4 received a single dose of oral vaccine and one had received two doses of the campaign. From January 1 to October 1, 1965 were confirmed 18 cases, 8 children orally vaccinated and 7 had received only one dose of this vaccine, in 3 was unknown vaccination status. In children vaccinated with two doses of oral vaccine were 0 cases. CONCLUSION: The evolution of polio in our country changed radically since the introduction of oral polio vaccine. The annual numbers of cases dropped dramatically, disappearing completely seasonal rising incidence curve.

Resultados de la Campaña Nacional de vacunación antipoliomielítica por vía oral en España (estudio virológico y epidemiológico) / Results of the Spanish National Campaign of Oral Vaccination Polio 1963-1964 (Virological and Epidemiological Study)

Fundamentos. A partir de los resultados de los estudios epidemiológicos realizados en 1958 se decidió emplear la vacuna oral tipo Sabinl. El objetivo de este trabajo es evaluar el impacto de la campaña nacional de vacunación de 1963 y 1964. Métodos. La campaña nacional ofreciéndola a todos los niños españoles entre dos meses y 7 años. En la primera fase de la campaña nacional se empleó virus polio tipo 1 y fueron vacunados 4.400.000 niños, es decir, el 95% de la población de entre dos meses y 7 años. En la segunda fase la vacuna fue trivalente con los tipos 1, 2 y 3 y cubrió a 4.680.000 niños, lo que representó el 98,8 por 100. Resultados. En la primera fase ocurrieron 26 casos de poliomielitis en niños vacunados, 18 habían sido producidos por el virus tipo 3 y por el tipo 2. En la fase 2 se confirmaron virológicamente 27. Desde el 1 de junio hasta el 31 de diciembre de 1964 se confirmaron 14 casos: 9 en sujetos no vacunados, 4 recibieron una sola dosis de vacuna oral y 1 había recibido las dos dosis de la campaña. Desde el 1 de enero al 1 de octubre de 1965 se confirmaron 18 casos, 8 en sujetos no vacunados por vía oral y 7 sólo habían recibido una dosis de esta vacuna; en 3 se desconocía el estado de vacunación. En niños vacunado con dos dosis de vacuna oral hubo 0 casos. Conclusión. La evolución de la poliomielitis en nuestro país sufrió un cambio radical desde la introducción de la vacuna antipoliomielítica oral. Las cifras anuales de casos descendieron vertiginosamente, desapareciendo por completo la elevación estacional de la curva de incidencia (AU9

Background. From the results of epidemiological studies in 1958 was decided to use oral vaccine Sabinl type. The aim of this work is to evaluate the impact of the national vaccination campaign of 1963 and 1964. Methods. The national campaign offering it to all Spanish children between two months and seven years. In the first phase of the national campaign was employed polio virus type 1 and 4,400,000 children were vaccinated, ie 95% of the target population. In the second phase was trivalent vaccine types 1, 2 and 3 and covered 4,680,000 children, representing 98.8 per 100. Results. In the first phase 26 polio cases occurred in vaccinated children, 18 had been produced by the virus type 3 and type 2. In phase 2 were confirmed virologically 27. From 1 June to 31 December 1964 14 cases were confirmed. 9 in unvaccinated people, 4 received a single dose of oral vaccine and one had received two doses of the campaign. From January 1 to October 1, 1965 were confirmed 18 cases, 8 children orally vaccinated and 7 had received only one dose of this vaccine, in 3 was unknown vaccination status. In children vaccinated with two doses of oral vaccine were 0 cases. Conclusion. The evolution of polio in our country changed radically since the introduction of oral polio vaccine. The annual numbers of cases dropped dramatically, disappearing completely seasonal rising incidence curve (AU)