La atención en salud bucal para personas con discapacidad. Un desafío en tiempos de pandemia por la COVID-19 / Oral health care for people with disabilities. A challenging issue in times of the COVID-19 pandemic

La pandemia por la COVID-19 ocasionó que los Estados promulgaran normas específicas para mitigar el riesgo de contagio y preservar la salud de la población; se establecieron e implementaron estrategias para disminuir la vulnerabilidad y cuidar los factores económicos y sociales. En este proceso, las personas con discapacidad (PcD) agudizaron su vulnerabilidad, pues desde que se decretaron las medidas para mitigar la condición de crisis social, se han identificado varios grupos con dificultades socioeconómicas. En general, muchas de las PcD se encuentran en estos grupos, pues su condición por sí misma los sitúa en circunstancias vulnerables, como efecto de las brechas de comunicación, acceso y oportunidad para los servicios de salud bucal. Así, el objetivo de este ensayo es analizar críticamente la situación de esta población en tiempos de pandemia. Se realizó una revisión de la literatura nacional e internacional alrededor de los conceptos discapacidad y COVID-19. Se concluye que la crisis agudizó la vulnerabilidad de las PcD generada por las escasas estrategias que se han implementado para cubrir esta población de acuerdo a sus necesidades, por lo que se incrementaron las barreras físicas y comunicativas y, con ello, limitado el goce efectivo del derecho a la atención de salud en los servicios odontológicos

The COVID-19 pandemic promulgated States to enact specific regulations to mitigate the risk of contagion and preserve the health of the population; strategies were established and implemented to reduce vulnerability and take care of economic and social factors. In this process, people with disabilities (PwD) increased their vulnerability, since the measures to mitigate the condition of social crisis were decreed; several groups with socioeconomic difficulties have been identified. In general, many of the PwD are found in these groups, since their condition by itself places them in vulnerable circumstances, as a result of gaps in communication, access and opportunity for oral health services. Thus, the objective of this essay is to critically analyze the situation of this population in times of pandemic. A review of the national and international literature around the concepts of disability and COVID-19 was carried out. It is concluded that the crisis exacerbated the vulnerability of PwD generated by the few strategies that have been implemented to cover this population according to their needs, thus increasing physical and communication barriers and, with it, limited the effective enjoyment of the right to health care in dental services

Behaviourally designed treatments that increase willingness to treatment from families with children suffering from autism spectrum disorder.

BACKGROUND: Autism spectrum disorder is a lifelong disability that is not well known by the general population and tends to be associated with social stigma; also, because it involves children, it may get highly emotionally charged. These stylised facts engender a number of possible heuristics and biases at the moment of deciding on following a treatment or looking for a diagnosis, which should be considered in the presentation of information. Using insights from Behavioural Economics, three treatments are designed to present the information regarding possible therapies. METHODS: Between-subjects design with one level of variation. Interviews were performed with a convenience sample of 154 households from the metropolitan area of Bogotá (Colombia). The treatments include: use of default option, use of professional interviewer to illustrate the therapy and emotionally charged presentation. RESULTS: Kruskal-Wallis test of the intention to be treated rejects the null hypothesis (χ(2)=22.14, p=0.00). The cognitive processing of the information is not a determinant, supporting the claim that genuine framing effects shape the choice. The strongest effect of the treatment with a professional suggests a key role for asymmetry of the information, which is confirmed indirectly through the postexperiment questionnaire. CONCLUSIONS: Bad healthcare decisions are not necessarily driven by lack of information. Asymmetric information (eg, delegating the decision to a professional) improves choices, especially when social stigma is involved. Cognitive processing of information seems to be less relevant than the framing effect.