Gestión del proceso de desarrollo de simuladores virtuales educativos : Un enfoque transdisciplinario

Los esquemas interactivos de simulación, ampliamente difundidos en el ámbito industrial, constituyen una interesante interfaz educativa para representar situaciones y reproducir fenómenos difíciles de ver y hasta imposibles de imaginar. Así, la complejidad propia de los desarrollos de software en estos ambientes, se ve profundizada ante la carencia de metodologías y herramientas adecuadas para el tratamiento, gestión y control de la transdisciplinariedad involucrada; erigiéndose como una causal determinante en el fracaso de proyectos de desarrollo de software educativo. El abordaje desde esta perspectiva implica, necesariamente, la investigación y selección de las técnicas y métodos más aptos, desde un enfoque de calidad. De esta forma, la interdisciplinariedad existente, requiere para su tratamiento, de un modelo de proceso que permita captar, seleccionar, organizar, diseñar, desarrollar y controlar integralmente las actividades, estableciendo el marco de trabajo de las tareas que se requieren para construir software de calidad. El presente trabajo, sobre la base de la experiencia recogida en ámbitos altamente interactivos, pretende describir los caracteres más relevantes en la gestión del proceso interdisciplinario de desarrollo de simuladores virtuales y sus implicancias sobre la calidad de los productos software generados.Red de Universidades con Carreras en Informática (RedUNCI

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.

BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Objetos de aprendizaje 2.0, patrones de diseño de OA y recursos educativos abiertos. Una aproximación reflexiva en torno al desarrollo de materiales para la EAD

The massive and exponential development of Information and Communication Technology (ICT) which we see today has blurred and significantly transformed the ways we learn, teach, communicate, work, and therefore, how we live. From this perspective, planning, management and evaluation of educational projects in this field require a critical and reflective analysis to guide meaningful technology supported interventions in teaching, learning and communication. Therefore, the properly use of the technological means and the knowledge how to use them, are a core issue in the techno-educational process treated. According to this vision, technology and educational resources should be designed to be accessible, portable and maintainable and that way able to respond adequately to current needs. Focusing on these aspects, the philosophy of Learning Objects (LO) in conjunction with the Design Patterns of LO and the initiativeof Open Educational Resources, represents central pillars in the development of techno-pedagogical materials. This integrated approach enables the exploitation of the full potential of ICT and thereby increasing the benefits of their implementation in Distance Education.La masiva y vertiginosa irrupción de las Tecnologías de la Información y Comunicación a la que asistimos actualmente, ha desdibujado y transformado significativamente las formas en que aprendemos, enseñamos, nos comunicamos, trabajamos y, por ende, en cómo vivimos. Desde esta perspectiva, la planificación, gestión y evaluación de proyectos educativos en este ámbito requiere un análisis crítico y reflexivo profuso para encauzar intervenciones que resulten significativas en los procesos de enseñanza, aprendizaje y comunicación mediados tecnológicamente. Por ello, la correcta explotación de los medios tecnológicos y cómo aprender a utilizarlos con el máximo provecho constituye uno de los fundamentos medulares en el proceso tecno-educativo referido. A partir de esta visión, los recursos diseñados deben ser accesibles, portables y mantenibles, para dar respuestas asequibles a las necesidades actuales. Focalizando sobre estos aspectos, la filosofía de Objetos de Aprendizaje (OA) en conjunto a la de Patrones de Diseño de OA y Recursos Educativos Abiertos, se erigen como pilares fundamentales en el desarrollo de materiales tecno-pedagógico-comunicacionales libres; proponiendo un enfoque integral que posibilita emplear todo el potencial de las TIC y, por lo tanto, incrementar y extender los beneficios de aplicación en la Educación a Distancia

Objetos de aprendizaje 2.0, patrones de diseño de OA y recursos educativos abiertos. Una aproximación reflexiva en torno al desarrollo de materiales para la EAD

The massive and exponential development of Information and Communication Technology (ICT) which we see today has blurred and significantly transformed the ways we learn, teach, communicate, work, and therefore, how we live. From this perspective, planning, management and evaluation of educational projects in this field require a critical and reflective analysis to guide meaningful technology supported interventions in teaching, learning and communication. Therefore, the properly use of the technological means and the knowledge how to use them, are a core issue in the techno-educational process treated. According to this vision, technology and educational resources should be designed to be accessible, portable and maintainable and that way able to respond adequately to current needs. Focusing on these aspects, the philosophy of Learning Objects (LO) in conjunction with the Design Patterns of LO and the initiativeof Open Educational Resources, represents central pillars in the development of techno-pedagogical materials. This integrated approach enables the exploitation of the full potential of ICT and thereby increasing the benefits of their implementation in Distance Education.La masiva y vertiginosa irrupción de las Tecnologías de la Información y Comunicación a la que asistimos actualmente, ha desdibujado y transformado significativamente las formas en que aprendemos, enseñamos, nos comunicamos, trabajamos y, por ende, en cómo vivimos. Desde esta perspectiva, la planificación, gestión y evaluación de proyectos educativos en este ámbito requiere un análisis crítico y reflexivo profuso para encauzar intervenciones que resulten significativas en los procesos de enseñanza, aprendizaje y comunicación mediados tecnológicamente. Por ello, la correcta explotación de los medios tecnológicos y cómo aprender a utilizarlos con el máximo provecho constituye uno de los fundamentos medulares en el proceso tecno-educativo referido. A partir de esta visión, los recursos diseñados deben ser accesibles, portables y mantenibles, para dar respuestas asequibles a las necesidades actuales. Focalizando sobre estos aspectos, la filosofía de Objetos de Aprendizaje (OA) en conjunto a la de Patrones de Diseño de OA y Recursos Educativos Abiertos, se erigen como pilares fundamentales en el desarrollo de materiales tecno-pedagógico-comunicacionales libres; proponiendo un enfoque integral que posibilita emplear todo el potencial de las TIC y, por lo tanto, incrementar y extender los beneficios de aplicación en la Educación a Distancia