School performance: New multimedia resources versus traditional notes // El rendimiento escolar: Nuevos recursos multimedia frente a los apuntes tradicionales

With the increasing adoption of information and communication technologies among youngsters, it has become common for high school students to incorporate the use of multiple devices and digital platforms in their study habits. Although these digital resources support and motivate them to learn, these are also a source of continuous distraction. This research analyzes the impact of studying with handwritten notes, WhatsApp, YouTube and searching the Internet in academic performance, through a mixed method that combines 31 focus groups and a survey of 7,217 students from 12 to 18 years of age in Chile. The results of the focus groups show that the positive impact of technologies in learning would depend on the students’ motivation for learning, their ability to efficiently control and manage the available digital resources, and their capacity to search and evaluate information on the Internet. The survey concludes that those who study with their notes more frequently have better academic performance, whereas those who frequently study with YouTube and WhatsApp have a lower GPA, with no significant differences when it comes to internet browsing. These results reinforce the need raised by scholars to generate policies that promote digital literacy both inside and outside the school

School performance: New multimedia resources versus traditional notes

Con la creciente masificación de las tecnologías de información y comunicación entre los jóvenes, es cada vez más común que los estudiantes de secundaria incorporen el uso de múltiples dispositivos y plataformas en sus hábitos de estudio, lo que sería una fuente de apoyo y motivación, pero también de constante distracción. Esta investigación compara el impacto que tiene estudiar con apuntes escritos a mano, WhatsApp, YouTube y navegando por Internet, en el rendimiento académico, a través de un método mixto que combina 31 grupos focales y una encuesta a 7.217 estudiantes de 12 a 18 años en Chile. El análisis de los grupos focales muestra que el buen uso de tecnologías al estudiar dependería de la capacidad de los estudiantes para controlar y hacer un uso eficiente de los recursos digitales disponibles, de sus motivaciones individuales y de la habilidad que tienen para buscar y evaluar la información en Internet. Por su parte, los resultados de la encuesta concluyen que aquellos jóvenes que estudian con mayor frecuencia con sus apuntes presentan un promedio de calificaciones más alto y los que estudian frecuentemente con YouTube y WhatsApp, un promedio de calificaciones más bajo, sin encontrar diferencias significativas en el caso de los navegadores de Internet. Esto reforzaría la necesidad observada por académicos de generar políticas que promuevan la alfabetización digital tanto dentro como fuera del colegioWith the increasing adoption of information and communication technologies among youngsters, it has become common for high school students to incorporate the use of multiple devices and digital platforms in their study habits. Although these digital resources support and motivate them to learn, these are also a source of continuous distraction. This research analyzes the impact of studying with handwritten notes, WhatsApp, YouTube and searching the Internet in academic performance, through a mixed method that combines 31 focus groups and a survey of 7,217 students from 12 to 18 years of age in Chile. The results of the focus groups show that the positive impact of technologies in learning would depend on the students’ motivation for learning, their ability to efficiently control and manage the available digital resources, and their capacity to search and evaluate information on the Internet. The survey concludes that those who study with their notes more frequently have better academic performance, whereas those who frequently study with YouTube and WhatsApp have a lower GPA, with no significant differences when it comes to internet browsing. These results reinforce the need raised by scholars to generate policies that promote digital literacy both inside and outside the schoo

Mediación parental y escolar: uso de tecnologías para potenciar el rendimiento escolar

Con la asimilación masiva de las nuevas plataformas digitales en el mundoeducacional, en que diversos usuarios pueden generar contenido de formasimultánea, colaborar integrando distintas fuentes y consumir esta informaciónsegún sus propias preferencias y necesidades, el saber cómo controlar y escogerlos canales indicados para sus procesos de aprendizaje se ha vuelto cada vez más relevante. En este contexto, y haciendo caso al llamado de diversos expertos en el área educacional a enseñar sobre el uso de las tecnologías en el hogar y la escuela, esta investigación presenta tres grandes objetivos: 1) identifica el impacto de la mediación parental y escolar en el rendimiento académico, 2) observa la relación entre las herramientas de estudio y el rendimiento escolar, y 3) explica los motivos que hay tras los resultados obtenidos. Para ello se desarrolló una investigación mixta, aplicando un cuestionario a más de 7000 estudiantes chilenos de 12 a 18 años y entrevistas a 14 especialistas en el área de educación. El estudio arrojó tres grandes resultados: en primer lugar, mostró que la mediación que realizan los padres en el hogar tiene un impacto mucho mayor –en el uso de tecnologías y en el rendimiento académico– que la mediación realizada en los colegios.En segundo lugar, se observó que los estudiantes que utilizan YouTube comoherramienta de estudio tienen un rendimiento menor que los estudiantes queutilizan el cuaderno. Y, en tercer lugar, se identificaron dificultades y desafíos enla implementación de TIC en clases. Así, este trabajo adquiere especial relevancia al aportar sobre cómo se puede influir en las prácticas del uso de TIC de un sistema educativo que ha tenido que adaptarse a la modalidad online

Impact of Empagliflozin in Heart Failure With Reduced Ejection Fraction in Patients With Ischemic Versus Nonischemic Cause

Background Outcomes and treatment effects of therapy may vary according to the cause of heart failure (HF). Methods and Results In this post hoc analysis of the EMPEROR-Reduced (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction) trial, the effect of empagliflozin on cardiovascular and renal outcomes was assessed according to the cause of HF. The cause of HF was investigator reported and stratified as ischemic or nonischemic. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% CIs. Of the 3730 patients enrolled, 1929 (51.7%) had ischemic cause. In the placebo arm, patients with ischemic cause of HF did not have a significantly higher risk of cardiovascular mortality (HR, 1.21 [95% CI, 0.90-1.63]) and hospitalization for HF (HR, 0.90 [95% CI, 0.72-1.12]) compared with nonischemic cause. Empagliflozin compared with placebo significantly reduced the risk of cardiovascular death or hospitalization for HF in patients with ischemic and nonischemic cause (HR, 0.82 [95% CI, 0.68-0.99] for ischemic and HR, 0.67 [95% CI, 0.55-0.82] for nonischemic cause; P interaction=0.15). The benefit of empagliflozin on HF hospitalization, the renal composite end point, estimated glomerular filtration slope changes, and health status scores were also consistent in both groups without treatment by cause modification. Conclusions Empagliflozin offers cardiovascular and renal benefits in patients with heart failure with reduced ejection fraction regardless of the cause of HF. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03057977

Health status across major subgroups of patients with heart failure and preserved ejection fraction

AIMS: There are limited data on health status and changes in it over time across major subgroups of patients with heart failure and preserved ejection fraction (HFpEF), including ejection fraction spectrum, age, sex, region, body mass index (BMI), and comorbidities including diabetes, chronic kidney disease (CKD), anaemia, and atrial fibrillation/flutter. METHODS AND RESULTS: In the EMPEROR-Preserved trial, the Kansas City Cardiomyopathy Questionnaire (KCCQ) was assessed at baseline, 12, 32 and 52 weeks. Determinants of baseline KCCQ score and change over time, and the impact of empagliflozin on KCCQ scores were studied in specified subgroups. A Cox model was used to assess the association between 5- and 10-point increase and 5-point decrease in KCCQ score from baseline to week 12 and later outcomes. Among 2979 participants in the placebo arm, mean KCCQ clinical summary score (CSS) was 70.7 (20.8). Older age, female sex, BMI, anaemia, and a history of diabetes, and CKD were associated with worse scores. KCCQ-CSS score improved during follow-up; patients with atrial fibrillation/flutter at enrollment (p trend = 0.014) and CKD (p trend < 0.001) had less improvement. A 5-point increase in KCCQ-CSS at week 12 was associated with lower risk of cardiovascular death or heart failure hospitalization (5%), cardiovascular death (8%), and first heart failure hospitalization (4%) subsequently. A similar trend was seen with KCCQ total symptom score (TSS) and overall summary score (OSS). Empagliflozin improved KCCQ-CSS, -TSS and -OSS scores similarly across subgroups studied except for greater improvement in patients with the highest BMI (p trend = 0.153, 0.08 and 0.078, respectively). CONCLUSION: Health status in patients with HFpEF is impaired, especially in elderly, women, and those with obesity and comorbidities. Empagliflozin improved health status among all key subgroups studied with a greater effect in obese patients

Baseline characteristics of patients with heart failure with preserved ejection fraction in the EMPEROR-Preserved trial.

AIMS: EMPEROR-Preserved is an ongoing trial evaluating the effect of empagliflozin in patients with heart failure with preserved ejection fraction (HFpEF). This report describes the baseline characteristics of the EMPEROR-Preserved cohort and compares them with patients enrolled in prior HFpEF trials. METHODS AND RESULTS: EMPEROR-Preserved is a phase III randomized, international, double-blind, parallel-group, placebo-controlled trial in which 5988 symptomatic HFpEF patients [left ventricular ejection fraction (LVEF) >40%] with and without type 2 diabetes mellitus (T2DM) have been enrolled. Patients were required to have elevated N-terminal pro B-type natriuretic peptide (NT-proBNP) concentrations (i.e. >300?pg/mL in patients without and >900?pg/mL in patients with atrial fibrillation) along with evidence of structural changes in the heart or documented history of heart failure hospitalization. Among patients enrolled from various regions (45% Europe, 11% Asia, 25% Latin America, 12% North America), the mean age was 72?±?9?years, 45% were women. Almost all patients had New York Heart Association class II or III symptoms (99.6%), and 23% had prior heart failure hospitalization within 12?months. Thirty-three percent of the patients had baseline LVEF of 41-50%. The mean LVEF (54?±?9%) was slightly lower while the median NT-proBNP [974 (499-1731) pg/mL] was higher compared with previous HFpEF trials. Presence of comorbidities such as diabetes (49%) and chronic kidney disease (50%) were common. The majority of the patients were on angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitors (80%) and beta-blockers (86%), and 37% of patients were on mineralocorticoid receptor antagonists. CONCLUSION: When compared with prior trials in HFpEF, the EMPEROR-Preserved cohort has a somewhat higher burden of comorbidities, lower LVEF, higher median NT-proBNP and greater use of mineralocorticoid receptor antagonists at baseline. Results of the EMPEROR-Preserved trial will be available in 2021

Empagliflozin in Heart Failure with a Preserved Ejection Fraction.

BACKGROUND: Sodium-glucose cotransporter 2 inhibitors reduce the risk of hospitalization for heart failure in patients with heart failure and a reduced ejection fraction, but their effects in patients with heart failure and a preserved ejection fraction are uncertain. METHODS: In this double-blind trial, we randomly assigned 5988 patients with class II-IV heart failure and an ejection fraction of more than 40% to receive empagliflozin (10 mg once daily) or placebo, in addition to usual therapy. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure. RESULTS: Over a median of 26.2 months, a primary outcome event occurred in 415 of 2997 patients (13.8%) in the empagliflozin group and in 511 of 2991 patients (17.1%) in the placebo group (hazard ratio, 0.79; 95% confidence interval [CI], 0.69 to 0.90; P<0.001). This effect was mainly related to a lower risk of hospitalization for heart failure in the empagliflozin group. The effects of empagliflozin appeared consistent in patients with or without diabetes. The total number of hospitalizations for heart failure was lower in the empagliflozin group than in the placebo group (407 with empagliflozin and 541 with placebo; hazard ratio, 0.73; 95% CI, 0.61 to 0.88; P<0.001). Uncomplicated genital and urinary tract infections and hypotension were reported more frequently with empagliflozin. CONCLUSIONS: Empagliflozin reduced the combined risk of cardiovascular death or hospitalization for heart failure in patients with heart failure and a preserved ejection fraction, regardless of the presence or absence of diabetes. (Funded by Boehringer Ingelheim and Eli Lilly; EMPEROR-Preserved ClinicalTrials.gov number, NCT03057951)

El rendimiento escolar: Nuevos recursos multimedia frente a los apuntes tradicionales

With the increasing adoption of information and communication technologies among youngsters, it has become common for high school students to incorporate the use of multiple devices and digital platforms in their study habits. Although these digital resources support and motivate them to learn, these are also a source of continuous distraction. This research analyzes the impact of studying with handwritten notes, WhatsApp, YouTube and searching the Internet in academic performance, through a mixed method that combines 31 focus groups and a survey of 7,217 students from 12 to 18 years of age in Chile. The results of the focus groups show that the positive impact of technologies in learning would depend on the students’ motivation for learning, their ability to efficiently control and manage the available digital resources, and their capacity to search and evaluate information on the Internet. The survey concludes that those who study with their notes more frequently have better academic performance, whereas those who frequently study with YouTube and WhatsApp have a lower GPA, with no significant differences when it comes to internet browsing. These results reinforce the need raised by scholars to generate policies that promote digital literacy both inside and outside the schoolCon la creciente masificación de las tecnologías de información y comunicación entre los jóvenes, es cada vez más común que los estudiantes de secundaria incorporen el uso de múltiples dispositivos y plataformas en sus hábitos de estudio, lo que sería una fuente de apoyo y motivación, pero también de constante distracción. Esta investigación compara el impacto que tiene estudiar con apuntes escritos a mano, WhatsApp, YouTube y navegando por Internet, en el rendimiento académico, a través de un método mixto que combina 31 grupos focales y una encuesta a 7.217 estudiantes de 12 a 18 años en Chile. El análisis de los grupos focales muestra que el buen uso de tecnologías al estudiar dependería de la capacidad de los estudiantes para controlar y hacer un uso eficiente de los recursos digitales disponibles, de sus motivaciones individuales y de la habilidad que tienen para buscar y evaluar la información en Internet. Por su parte, los resultados de la encuesta concluyen que aquellos jóvenes que estudian con mayor frecuencia con sus apuntes presentan un promedio de calificaciones más alto y los que estudian frecuentemente con YouTube y WhatsApp, un promedio de calificaciones más bajo, sin encontrar diferencias significativas en el caso de los navegadores de Internet. Esto reforzaría la necesidad observada por académicos de generar políticas que promuevan la alfabetización digital tanto dentro como fuera del colegio

Dietary patterns, nutritional profile, and body mass index in Mexican schoolchildren : A cross-sectional study

Childhood obesity is a serious public health problem in Mexico. In this study, childhoodspecific dietary patterns and their relationship with overweight-obesity prevalence, nutrient profiles and types of foods consumed were studied. A descriptive cross-sectional study of 724 randomly selected schoolchildren between 9 to 12 years old from Nayarit State, Mexico was performed. Data on anthropometric characteristics and food intake were recorded. Seven dietary patterns and three specific diets were identified by multivariate analysis. A dietary pattern characterized by high legume, snack and low beverage intake was negatively associated with weight and body mass index. The overall overweight and obesity prevalence was 20.2% and 20.6%, respectively. Diet type significantly influenced (p<0.05) protein, carbohydrates and fat intake but did not show correlation with the overweightobesity status. Simple sugars, candies, pastries and sweetened beverages appeared in all dietary patterns. Dietary patterns in countries with a wide gastronomic diversity should be considered to design preventive nutrition intervention programs