Personas adultas mayores frente a la inclusión digital en América Latina: un estudio en red - Volumen 1

El presente libro es la culminación de un proyecto denominado Personas adultas mayores frente a la inclusión digital en América Latina – un estudio en red, desarrollado mediante una red de investigadores latinoamericanos. La idea de dicho proyecto surgió cuando la profesora Maria Consuelo Oliveira Santos finalizó su posdoctorado en la Facultad de Ciencias de la Comunicación de la Universidad Autónoma deNuevo León (UANL), en la ciudad de Monterrey, estado de Nuevo León, México. En cierto modo, es la continuación de la investigación sobre las nuevas tecnologías y los adultos mayores en Monterrey, iniciada en dicha institución. Se constató que era una temática que suscitaba estudios más verticalizados y que sería oportuno poder establecer una red de investigadores y así obtener una visión más amplia sobre la inclusión digital, en la realidad latinoamericana. El propósito del estudio fue conocer, contrastar y comprender las relaciones de las personas adultas mayores con las nuevas tecnologías y la repercusión de dichas relaciones en sus vidas. Igualmente observar la importancia de las condiciones sociales, políticas y culturales que repercuten en el acceso o no a las nuevas tecnologías. La implicación de investigadores integrantes de diferentes instituciones académicas, pertenecientes a diversas áreas del conocimiento fue consecuencia de invitaciones formuladas directamente por diferentes medios de comunicación, explicándoles la idea del proyecto en red para estudiar dicha temática a partir de sus realidades.El presente libro es la culminación de un proyecto denominado Personas adultas mayores frente a la inclusión digital en América Latina – un estudio en red, desarrollado mediante una red de investigadores latinoamericanos. La idea de dicho proyecto surgió cuando la profesora Maria Consuelo Oliveira Santos finalizó su posdoctorado en la Facultad de Ciencias de la Comunicación de la Universidad Autónoma deNuevo León (UANL), en la ciudad de Monterrey, estado de Nuevo León, México. En cierto modo, es la continuación de la investigación sobre las nuevas tecnologías y los adultos mayores en Monterrey, iniciada en dicha institución. Se constató que era una temática que suscitaba estudios más verticalizados y que sería oportuno poder establecer una red de investigadores y así obtener una visión más amplia sobre la inclusión digital, en la realidad latinoamericana. El propósito del estudio fue conocer, contrastar y comprender las relaciones de las personas adultas mayores con las nuevas tecnologías y la repercusión de dichas relaciones en sus vidas. Igualmente observar la importancia de las condiciones sociales, políticas y culturales que repercuten en el acceso o no a las nuevas tecnologías. La implicación de investigadores integrantes de diferentes instituciones académicas, pertenecientes a diversas áreas del conocimiento fue consecuencia de invitaciones formuladas directamente por diferentes medios de comunicación, explicándoles la idea del proyecto en red para estudiar dicha temática a partir de sus realidades

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

La enseñanza de las ciencias naturales y la educación ambiental en los grados octavo y noveno de la Institución Educativa Robert Mario Bischoff

La presente investigación nace de la necesidad de reconocer la realidad de la enseñanza de las Ciencias Naturales y Educación Ambiental en todas las instituciones educativas del Departamento de Nariño que además de cumplir con los requerimientos legales satisfagan las expectativas e imaginarios que al respecto tengan los docentes y estudiantes de las mismas. La finalidad que subyace detrás de este esfuerzo investigativo es estructurar nuevos planes y enfoques, encontrar y aplicar alternativas que mejoren los procesos de enseñanza, aprendizaje y aplicación de las Ciencias Naturales en las instituciones educativas del Departamento y particularmente en la Institución Educativa Robert Mario Bischoff. La investigación se genera en las distintas problemáticas presentes en la enseñanza de las Ciencias Naturales y Educación Ambiental en las instituciones educativas del departamento de Nariño y de las cuales se pretende hacer una cuidadosa auscultación con la participación de los docentes del área y los estudiantes de los grados 8o y 9o, con una muestra de 14 y 16 estudiantes respectivamente, quienes se destacaron por su colaboración y participación directa en las distintas actividades. Esta se desarrolla dentro del enfoque crítico social en la línea de la Investigación Acción toda vez que permite la movilización de los protagonistas en búsqueda de sus propias soluciones. La información requerida se obtuvo a través de técnicas como entrevistas cualitativas, observación directa, revisión de fuentes bibliográficas y encuestas. Para dar respuesta a la solución de la problemática fue necesario indagar alrededor de cinco objetivos fundamentales y básicos para la enseñanza de las ciencias y se refieren a: Concepciones y referentes teóricos en el imaginario de los estudiantes y profesores, contenidos temáticos desarrollados en las asignaturas del área, logros, estándares y competencias. Los resultados más significativos se derivan del análisis de la información, entre los que se pueden citar: 1. Los contenidos temáticos del área están sin estructurar dado que los correspondientes a las asignaturas de Medio Ambiente, Física y Química están parcialmente elaborados. 2. Los lineamientos curriculares no están integrados en razón a que los docentes no han elaborado sus respectivos proyectos de área causando traumatismos en el avance institucional y en el desarrollo intelectual de los estudiantes. 3. No hay Plan de Estudio y faltan docentes con el perfil específico para la asignatura de Física y Química. Con las alternativas presentadas el grupo investigador espera un cambio de actitud por parte de todos los actores que participan, intervienen en el proceso y tienen relación estrecha con la vida de la institución educativ

Health- and Vision-Related Quality of Life in a Randomized Controlled Trial Comparing Methotrexate and Mycophenolate Mofetil for&nbsp;Uveitis

PurposeTo evaluate changes in health-related and vision-related quality of life (VRQoL) among patients with noninfectious uveitis who were treated with antimetabolites.DesignSecondary analysis of a randomized controlled trial.ParticipantsPatients with noninfectious uveitis from India, the United States, Australia, Saudi Arabia, and Mexico.MethodsFrom 2013 through 2017, 216 participants were randomized to receive 25 mg weekly oral methotrexate or 1.5 g twice daily oral mycophenolate mofetil. Median changes in quality of life (QoL) were measured using Wilcoxon signed-rank tests, and differences between treatment groups were measured using linear mixed models, adjusting for baseline QoL score, age, gender, and site. Among Indian patients, VRQoL scores from a general scale (the National Eye Institute Visual Function Questionnaire [NEI-VFQ]) and a culturally specific scale (the Indian Visual Function Questionnaire [IND-VFQ]) were compared using Pearson correlation tests.Main outcome measuresVision-related QoL (NEI-VFQ and IND-VFQ) and health-related QoL (HRQoL; physical component score [PCS] and mental component score [MCS] of the Medical Outcomes Study 36-Item Short Form Survey [SF-36v2]) were measured at baseline, the primary end point (6 months or treatment failure before 6 months), and the secondary end point (12 months or treatment failure between 6 and 12 months).ResultsAmong 193 participants who reached the primary end point, VRQoL increased from baseline by a median of 12.0 points (interquartile range [IQR], 1.0-26.1, NEI-VFQ scale), physical HRQoL increased by a median of 3.6 points (IQR, -1.4 to 14.9, PCS SF-36v2), and mental HRQoL increased by a median of 3.0 points (IQR, -3.7 to 11.9, MCS SF-36v2). These improvements in NEI-VFQ, SF-36v2 PCS, and SF-36v2 MCS scores all were significant (P &lt; 0.01). The linear mixed models showed that QoL did not differ between treatment groups for each QoL assessment (NEI-VFQ, IND-VFQ, PCS SF-36v2, and MCS SF-36v2; P &gt; 0.05 for all). The NEI-VFQ and IND-VFQ scores for Indian participants were correlated highly at baseline and the primary and secondary end points (correlation coefficients, 0.87, 0.80, and 0.90, respectively).ConclusionsAmong patients treated with methotrexate or mycophenolate mofetil for uveitis, VRQoL and HRQoL improved significantly over the course of 1 year and did not differ by treatment allocation. These findings suggest that antimetabolites could improve overall patient well-being and daily functioning

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures

Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted

Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

BACKGROUND The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation