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1.
Am Soc Clin Oncol Educ Book ; 41: 1-11, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33793315

RESUMEN

The overwhelming majority of head and neck cancers and related deaths occur in low- and middle-income countries, which have challenges related to burden of disease versus access to care. Yet the additional health care burden of the COVID-19 pandemic has also impacted access to care for patients with head and neck cancer in the United States. This article focuses on challenges and innovation in prioritizing head and neck cancer care in Sub-Saharan Africa, the Indian experience of value-added head and neck cancer care in busy and densely populated regions, and strategies to optimize the management of head and neck cancer in the United States during the COVID-19 pandemic.


Asunto(s)
Neoplasias de Cabeza y Cuello/terapia , Accesibilidad a los Servicios de Salud , Oncología Médica , Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/mortalidad , Prioridades en Salud , Necesidades y Demandas de Servicios de Salud , Humanos , Evaluación de Necesidades , Resultado del Tratamiento
2.
BMC Pregnancy Childbirth ; 21(1): 208, 2021 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-33722198

RESUMEN

BACKGROUND: Pregnancy is a risk factor for coronavirus disease 2019 (COVID-19). Pregnant women suffer from varying levels of pregnancy-related anxiety (PRA) which can negatively affect pregnancy outcomes. The aim of this study was to assess PRA and its associated factors during the COVID-19 pandemic. METHODS: This web-based cross-sectional study was conducted in 2020 on 318 pregnant women purposively recruited from primary healthcare centers in Sari and Amol, Iran. Data were collected using questionnaires (PRAQ, Edinburg, KAP of COVID-19, CDA-Q and Demographic questionnaire), which were provided to participants through the social media or were completed for them over telephone. Data were analyzed with the linear regression and the logistic regression analysis, at the significance level of 0.05 using the SPSS software (v. 21). RESULTS: Around 21% of participants had PRA, 42.1% had depression, and 4.4% had COVID-19 anxiety. The significant predictors of PRA were number of pregnancies (P = 0.008), practice regarding COVID-19 (P < 0.001), COVID-19 anxiety (P < 0.001), depression (P < 0.001), and social support (P = 0.025) which explained 19% of the total variance. Depression and COVID-19 anxiety increased the odds of PRA by respectively four times and 13%, while good practice regarding COVID-19 decreased the odds by 62%. CONCLUSION: Around 21% of pregnant women suffer from PRA during the COVID-19 pandemic and the significant predictors of PRA during the pandemic include number of pregnancies, practice regarding COVID-19, COVID-19 anxiety, depression, and social support. These findings can be used to develop appropriate strategies for the management of mental health problems during pregnancy in the COVID-19 pandemic.


Asunto(s)
Ansiedad , Complicaciones del Embarazo , Atención Primaria de Salud , Apoyo Social , Adulto , Ansiedad/diagnóstico , Ansiedad/epidemiología , Ansiedad/prevención & control , /prevención & control , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Femenino , Humanos , Irán/epidemiología , Evaluación de Necesidades , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/epidemiología , Complicaciones del Embarazo/prevención & control , Complicaciones del Embarazo/psicología , Mujeres Embarazadas/psicología , Atención Primaria de Salud/métodos , Atención Primaria de Salud/normas , Atención Primaria de Salud/tendencias , Factores de Riesgo , Estrés Psicológico/diagnóstico , Estrés Psicológico/epidemiología
3.
J Nurs Adm ; 51(4): 227-231, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33734183

RESUMEN

This case study describes how an innovative, triple-win, academic-practice partnership model can be used to deepen the clinical expertise of advanced practice registered nurse (APRN) students and improve rural Americans' access to quality patient care. It features the experience and strategies used by a school of nursing and a local rural hospital system collaborating to provide clinical experiences for APRN students pursuing doctor of nursing practice degrees.


Asunto(s)
Enfermería de Práctica Avanzada/educación , Bachillerato en Enfermería/organización & administración , Relaciones Interinstitucionales , Área sin Atención Médica , Población Rural/estadística & datos numéricos , Conducta Cooperativa , Humanos , Maryland , Evaluación de Necesidades , Investigación en Educación de Enfermería , Estudiantes de Enfermería/estadística & datos numéricos
6.
BMC Pregnancy Childbirth ; 21(1): 171, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33648450

RESUMEN

BACKGROUND: Psychological stress and coping experienced during pregnancy can have important effects on maternal and infant health, which can also vary by race, ethnicity, and socioeconomic status. Therefore, we assessed stressors, coping behaviors, and resources needed in relation to the COVID-19 pandemic in a sample of 162 perinatal (125 pregnant and 37 postpartum) women in the United States. METHODS: A mixed-methods study captured quantitative responses regarding stressors and coping, along with qualitative responses to open-ended questions regarding stress and resources needed during the COVID-19 pandemic. Logistic and linear regression models were used to analyze differences between pregnant and postpartum participants, as well as differences across key demographic variables. Qualitative content analysis was used to analyze open-ended questions. RESULTS: During the COVID-pandemic, food scarcity and shelter-in-place restrictions made it difficult for pregnant women to find healthy foods. Participants also reported missing prenatal appointments, though many reported using telemedicine to obtain these services. Financial issues were prevalent in our sample and participants had difficulty obtaining childcare. After controlling for demographic variables, pregnant women were less likely to engage in healthy stress-coping behaviors than postpartum women. Lastly, we were able to detect signals of increased stressors induced by the COVID-19 pandemic, and less social support, in perinatal women of racial and ethnic minority, and lower-income status. Qualitative results support our survey findings as participants expressed concerns about their baby contracting COVID-19 while in the hospital, significant others missing the delivery or key obstetric appointments, and wanting support from friends, family, and birthing classes. Financial resources, COVID-19 information and research as it relates to maternal-infant health outcomes, access to safe healthcare, and access to baby supplies (formula, diapers, etc.) emerged as the primary resources needed by participants. CONCLUSIONS: To better support perinatal women's mental health during the COVID-19 pandemic, healthcare providers should engage in conversations regarding access to resources needed to care for newborns, refer patients to counseling services (which can be delivered online/via telephone) and virtual support groups, and consistently screen pregnant women for stressors.


Asunto(s)
Adaptación Psicológica , Recursos en Salud/organización & administración , Accesibilidad a los Servicios de Salud , Responsabilidad Parental/psicología , Atención Perinatal , Educación Prenatal/métodos , /epidemiología , /psicología , Femenino , Asignación de Recursos para la Atención de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/normas , Accesibilidad a los Servicios de Salud/tendencias , Humanos , Recién Nacido , Salud Mental/normas , Evaluación de Necesidades , Atención Perinatal/métodos , Atención Perinatal/organización & administración , Atención Perinatal/tendencias , Embarazo , Estrés Psicológico/etiología , Estrés Psicológico/prevención & control , Telemedicina/métodos , Telemedicina/organización & administración , Estados Unidos
8.
Medicine (Baltimore) ; 100(12): e25245, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761719

RESUMEN

ABSTRACT: We compared the knowledge of attention-deficit hyperactivity disorder (ADHD) among the general public, parents of children with ADHD, and primary school teachers and identified factors associated with ADHD knowledge in each group, separately.Secondary data analysis was made on the pre-lecture data from those (122 from the general public, 64 parents of children with ADHD, and 515 primary school teachers) attending education lectures by the Department of Public Health, New Taipei City Government, Taiwan, 2014.ADHD onset age was least known in these 3 groups. Knowledge of ADHD was significantly better among teachers (test score, 75.3%) than among parents (65.5%) and the general public (59.2%). Among the general public, the test score significantly decreased with age and was worst in those who did not know their friends or relatives with ADHD. Among parents, service workers, and retired/unemployed knew significantly less about ADHD than housewife did. Among teachers, men knew significantly less than women; those who taught children with ADHD knew significantly more than those who did not.Primary school teachers knew more about ADHD than parents and the general public. Factors associated with ADHD knowledge varied among the 3 groups.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Conocimientos, Actitudes y Práctica en Salud , Padres , Maestros , Percepción Social , Adulto , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Actitud Frente a la Salud , Niño , Conducta Infantil , Estudios Transversales , Femenino , Humanos , Masculino , Evaluación de Necesidades , Padres/educación , Padres/psicología , Opinión Pública , Maestros/psicología , Maestros/normas , Instituciones Académicas/estadística & datos numéricos , Taiwán/epidemiología
9.
BMJ Open ; 11(1): e045794, 2021 01 31.
Artículo en Inglés | MEDLINE | ID: mdl-33518530

RESUMEN

SETTING: The State of Qatar has had one of the highest COVID-19 infection rates globally and has used state-managed quarantine and isolation centres to limit the spread of infection. Quarantine and isolation have been shown to negatively affect the mental health of individuals. Qatar has a unique population, with around 90% of the population being economic migrants and a majority being blue-collar workers and labourers. OBJECTIVES: This study was carried out to evaluate the psychological impact of institutional isolation and quarantine during the COVID-19 pandemic outbreak in Qatar. The study also explored the sociodemographic correlates of this psychological impact. DESIGN, PARTICIPANTS AND INTERVENTION: A cross-sectional study involving 748 consenting individuals in institutional quarantine and isolation in Qatar during the months of June and July 2020 was carried out. Relevant sociodemographic data along with depressive and anxiety symptomatology scores were collected from consenting adults at these facilities. RESULTS: 37.4% (n=270) of respondents reported depressive symptoms and 25.9% (n=189) reported anxiety symptoms. The scores were higher for individuals in isolation facilities and higher for migrants from poor socioeconomic group (p<0.001 for both). Within this group, although worries about infection were widely reported, lack of contact with the family was cited as one of the most important sources of distress. Respondents reported that contact with the family and reliable information were important factors that helped during the duration of isolation and quarantine. CONCLUSIONS: Our study reported significantly elevated scores for depression and anxiety during institutional quarantine, which is in keeping with emerging evidence. However, in contrast to other studies reporting mostly from native populations, this study of a population with an overwhelming majority of immigrants highlights the special mental health needs of this specific group and can inform future healthcare policies.


Asunto(s)
Ansiedad , Control de Enfermedades Transmisibles , Depresión , Distrés Psicológico , Cuarentena/psicología , Adulto , Ansiedad/epidemiología , Ansiedad/etiología , /prevención & control , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/estadística & datos numéricos , Estudios Transversales , Demografía , Depresión/epidemiología , Depresión/etiología , Femenino , Humanos , Masculino , Salud Mental/estadística & datos numéricos , Evaluación de Necesidades , Qatar/epidemiología , Factores Socioeconómicos , Migrantes/psicología
10.
Medicine (Baltimore) ; 100(5): e24270, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33592869

RESUMEN

ABSTRACT: The study aimed to explore the association between family functioning and quality of life (QOL) in family caregivers of patients with schizophrenia.Totally 121 family caregivers were surveyed in the cross-sectional study by the self-administration questionnaires about sociodemographic characteristics, family functioning and QOL. Family functioning was evaluated in terms of the family assessment device and the Family Adaptability and Cohesion Evaluation Scale II China Version. QOL was evaluated in terms of TSDHE short-form 12-item health survey, version 2. Multiple regression models were built to explore the association between QOL and family functioning.A regression analysis showed that poorer physical health of family caregivers was significantly associated with the lower educational level of caregivers, the closer kinship with patients and the multiple episodes schizophrenia. The other regression analysis showed that better family adaptability and affective responsiveness were significantly associated with the better mental health of family caregivers.Family functioning is associated with mental health rather than the physical health of family caregivers. Psychoeducational intervention could focus on family caregivers with a lower educational level and closer kinship, and those who look after patients with multiple episodes schizophrenia. Further family intervention could focus on family adaptability and affective expression in family caregivers of patients with schizophrenia.


Asunto(s)
Cuidadores/psicología , Costo de Enfermedad , Salud de la Familia , Salud Mental , Calidad de Vida , Esquizofrenia/epidemiología , Psicología del Esquizofrénico , Adaptación Psicológica , Adulto , China/epidemiología , Estudios Transversales , Demografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Factores Socioeconómicos
11.
Int J Palliat Nurs ; 27(1): 37-45, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33629909

RESUMEN

BACKGROUND: Occupancy is commonly used to measure bed management in hospices. However, the increasing complexity of children and young people and growing dependence on technology mean that this is no longer effective. AIM: To develop a dependency tool that enables the hospice to safely and effectively manage the use of beds for planned short breaks (respite care), preserving capacity for children requiring symptom management and end-of-life care. METHODS: A comprehensive literature review and existing tools were used to inform the development of the Martin House Dependency Tool Framework. Training was provided to staff and the tool was piloted before applying it across the hospice caseload. FINDINGS: The tool has been used on 431 children (93.1% of caseload). The tool enabled consistency of assessment and more effective management of resources, due to a contemporaneous understanding of the clinical needs of those on the caseload. CONCLUSION: The tool has enabled consistent and transparent assessment of children, improving safety, effectiveness and responsiveness, and the management of the workforce and resources.


Asunto(s)
Cuidados Paliativos al Final de la Vida/organización & administración , Enfermería de Cuidados Paliativos al Final de la Vida , Modelos de Enfermería , Cuidados Paliativos/organización & administración , Ocupación de Camas , Inglaterra , Hospitales para Enfermos Terminales , Humanos , Evaluación de Necesidades , Asignación de Recursos , Cuidados Intermitentes/organización & administración
12.
Int J Palliat Nurs ; 27(1): 30-36, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33629911

RESUMEN

BACKGROUND: The demand for hospice-at-home (HH) nurses is increasing due to an ageing global population and many people preferring to die at home. Therefore, the retention of existing HH nurses is vital. AIMS: This paper explores HH nurses' experiences of caring for dying patients to discover the factors that enable them to maintain their enthusiasm for their work, and cope with the challenges of working in a patient's home. METHODS: This qualitative study consisted of multiple unstructured interviews with 16 HH nurses conducted in England. FINDINGS: The interviews show that HH nurses: use a broad range of coping mechanisms; encounter intense, complex, unpredictable and ethically unclear challenges; identify a need for more support; and love their job. CONCLUSION: In order for nurses to continue to enjoy their job, extra support to incorporate protected time for debriefing at the end of an HH nurse's shift is needed. Nurses also need training to develop positive coping skills, external supervision on a one-to-one basis as needed, and have their value demonstrated, by their employers and managers recognising and acknowledging them. These factors are likely to facilitate in the retention of employment of HH nurses.


Asunto(s)
Actitud del Personal de Salud , Servicios de Atención de Salud a Domicilio , Enfermería de Cuidados Paliativos al Final de la Vida , Adaptación Psicológica , Inglaterra , Humanos , Entrevistas como Asunto , Satisfacción en el Trabajo , Evaluación de Necesidades , Estrés Laboral , Muestreo
14.
Am J Phys Med Rehabil ; 100(3): 288-291, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33595942

RESUMEN

ABSTRACT: This study characterizes the demographics and durable medical equipment needs of persons with disabilities to improve utilization and management of resources at a philanthropic rehabilitation clinic. Paper charts from all encounters between 2013 and 2018 were reviewed. Data collected include sex, age, ethnicity, insurance status, diagnoses, and durable medical equipment requested/received. Paper charts that were incomplete or illegible were excluded. Among 763 individuals, there were 1157 encounters for durable medical equipment requests. Forty-six percent of individuals were uninsured. Thirty-seven percent had federal insurance such as Medicare or Medicaid, and 6% private insurance. Fifty-five percent of individuals were Hispanic, 28% African American, and 14% White. Fifty-six percent of encounters were with individuals with a neurological diagnosis, 18% medical diagnosis, 17% musculoskeletal/autoimmune diagnosis, 6% amputation diagnosis, and 3% cancer diagnosis. Of the 2680 items distributed, 34% were wheelchair parts and repair, 30% personal hygiene/incontinence supplies, 25% mobility equipment, and 11% bathroom equipment. Of the 513 unmet items requested, 49% were mobility equipment, 24% wheelchair parts and repair, 17% personal hygiene/incontinence supplies, and 11% bathroom equipment. More than a third (43%) of durable medical equipment requests were from individuals with either private insurance or federal payers, which implies lack of adequate coverage on durable medical equipment to maintain mobility and independence.


Asunto(s)
Personas con Discapacidad/rehabilitación , Personas con Discapacidad/estadística & datos numéricos , Equipo Médico Durable/provisión & distribución , Necesidades y Demandas de Servicios de Salud , Seguro de Salud/estadística & datos numéricos , Evaluación de Necesidades , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Centros de Rehabilitación , Adulto Joven
15.
Neurology ; 96(13): e1701-e1710, 2021 03 30.
Artículo en Inglés | MEDLINE | ID: mdl-33568545

RESUMEN

OBJECTIVE: To determine how young stroke survivors want their unmet needs to be addressed, we undertook an international online survey of people living with stroke. METHODS: Participants self-selected to complete an online survey that included a questionnaire on demographics and stroke-related characteristics, the Young Stroke Needs Screening Tool, and a questionnaire on how they wanted their needs to be met. RESULTS: One hundred seventy-one responses were received (68% female respondents, mean age 45 years, interquartile range 36-51 years). Preferences for methods of meeting needs varied depending on the domain of need and participants' demographic and stroke-related characteristics. Face-to-face contact with a health care professional was a popular means of meeting needs, but methods outside of a traditional health care setting such as a succinct list of tips or peer support were widely acceptable and sometimes preferred. CONCLUSION: This work provides the impetus for developing alternative methods of meeting young stroke survivors' needs, many of which are not resource intensive or do not require an appointment with a health care professional.


Asunto(s)
Evaluación de Necesidades , Prioridad del Paciente , Distrés Psicológico , Accidente Cerebrovascular/fisiopatología , Sobrevivientes , Adulto , Estudios Transversales , Femenino , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Grupo Paritario , Relaciones Profesional-Paciente , Reinserción al Trabajo , Apoyo Social , Accidente Cerebrovascular/psicología , Encuestas y Cuestionarios , Telemedicina
17.
Res Dev Disabil ; 111: 103873, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33540358

RESUMEN

BACKGROUND: COVID-19 pandemic has generated anxiety and mental health issues in the common population. In general, anxiety and poor health are higher in parents of children with Autism Spectrum Disorder (ASD) than parents of children without ASD. However, the symptoms of anxiety, depression and poor mental health are likely to be more escalated in parents of children with ASD during COVID-19, possibly due to the emergency measures involving suspension of essential services, closure of schools, work-from-home policy and lack of professional support, etc. AIM: This empirical research aimed to explore the attitude, anxiety and perceived mental health care of parents of children with ASD in the COVID-19 pandemic. METHOD: A total of 211 participants, including mothers and fathers of children with ASD from the Kingdom of Saudi Arabia, participated in this online study. Along with demographic details, data on attitude, anxiety, mental health status and perceived mental health care were obtained using both self-reported questionnaire and reference standard questionnaire. The collected data were analysed using t-test, Pearson correlation analysis and linear regression analysis. The responses to open-ended questions were also collected and analysed qualitatively. RESULTS: The study revealed that attitudes towards taking care of children with ASD were affected by parents' age and child's age, and mothers were more affected. Further, the anxiety of parents during COVID-19 was significantly higher than before the COVID-19 situation. It was found that parents' mental status during COVID-19 mediated the interaction between anxiety and perceived mental health care. Finally, the open-ended questions indicated that parents sought support from teachers, family members and therapists to deal with children with ASD during the pandemic outbreak. In the context of perceived mental health care, besides psychological and financial support, other measures like training sessions, online classes, etc., were recommended. CONCLUSIONS: The findings of this study insisted on the importance of support from government and local health authorities to introduce interventions for parents and children with ASD to improve the overall mental health.


Asunto(s)
Ansiedad , Trastorno del Espectro Autista , Salud Mental , Responsabilidad Parental/psicología , Padres/psicología , Apoyo Social , Adaptación Psicológica , Adulto , Ansiedad/diagnóstico , Ansiedad/epidemiología , Ansiedad/etiología , Actitud Frente a la Salud , Trastorno del Espectro Autista/epidemiología , Trastorno del Espectro Autista/psicología , /prevención & control , Niño , Conducta Infantil , Educación no Profesional/organización & administración , Femenino , Humanos , Masculino , Evaluación de Necesidades , Arabia Saudita/epidemiología
18.
Res Dev Disabil ; 111: 103884, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33556700

RESUMEN

BACKGROUND: Autism Spectrum Disorder (ASD) is a life-long condition which affects the individual and their family system. Little research understands the impact of an ASD upon families, how this may change over time and how COVID-19 has impacted these dynamics. AIMS: To explore the impact of an ASD on the lived experiences of parents and neurotypical adult siblings, including during the UK COVID-19 lockdown. METHODS: Eight parent-sibling dyads (16 individuals) completed semi-structured interviews discussing their family before, during and after receiving the ASD diagnosis, and in relation to the first UK lockdown. Interview transcripts were analysed using Interpretative Phenomenological Analysis. RESULTS: Three super-ordinate themes were identified: Dominated by ASD; Family Cohesion; and the Need for Support. CONCLUSIONS: The data suggested a closeness within the families and an adoration towards the individual with ASD (IWA). Dyads were, to an extent, consumed by the diagnosis both presently and in the future, implicating the need for a stretch in services to support parents and neurotypical siblings. In terms of the first UK lockdown, the IWA added an extra layer of difficulty to the dyads work-life balance yet there was an essence of family cohesion. Future research should consider longitudinal methods and explore the impact of ASD co-morbidities upon family dynamics.


Asunto(s)
Trastorno del Espectro Autista , Control de Enfermedades Transmisibles/métodos , Relaciones Familiares/psicología , Padres/psicología , Hermanos/psicología , Adulto , Trastorno del Espectro Autista/epidemiología , Trastorno del Espectro Autista/psicología , Trastorno del Espectro Autista/rehabilitación , /prevención & control , Niño , Salud de la Familia/tendencias , Femenino , Humanos , Masculino , Evaluación de Necesidades , Relaciones entre Hermanos , Apoyo Social , Reino Unido/epidemiología , Equilibrio entre Vida Personal y Laboral
20.
Psychiatry Res ; 296: 113700, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33422845

RESUMEN

COVID-19 has transformed day-to-day functioning and exacerbated mental health concerns. The current study examines preliminary feasibility and acceptability of a VA CONNECT - a novel 10-session, manualized telehealth group intervention integrating skills training and social support to develop a Safety & Resilience Plan for Veterans experiencing COVID-related stress. Data from the first 20 participants support the intervention's feasibility and acceptability. Strengths, limitations, and suggestions for improvement of the intervention are noted. Collaboration with other VA researchers would aid in protocol dissemination and evaluation of VA CONNECT's utility for reducing COVID-19-related stress, loneliness, and mental health symptoms.


Asunto(s)
/terapia , Evaluación de Necesidades , Aceptación de la Atención de Salud , Telemedicina , Adulto , Estudios de Factibilidad , Humanos , Soledad/psicología , Masculino , Salud Mental , Apoyo Social , Veteranos
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