Inclusión digital como opción aportante al envejecimiento activo / Digital Inclusion as a contributory alternative to active aging

Resumen Introducción: Actualmente, suceden dos fenómenos el crecimiento de la población adulta mayor y la incorporación creciente y masiva de las TIC en la sociedad, que si bien se supone se mueven en paralelo, a cada momento interactúan más, al punto de integrarse. Objetivo: Abordar la inclusión digital como alternativa aportante en el proceso de envejecimiento activo. Proposición: La inclusión digital se convierte en una opción que aporta al envejecimiento activo, al proporcionar alternativas para la incorporación del adulto mayor a la(s) sociedad(es) de la información y el conocimiento. Argumentos para la discusión: El envejecimiento, a pesar de ser un proceso biológico, no implica que deba asumirse como una situación de incapacidad o pérdida de condición humana, sino como un ambiente con nuevas demandas, relaciones e intereses, donde las TIC podrán aportar en la calidad de vida, si se consideran aspectos específicos en los procesos de inclusión digital. A manera de aporte, se plantean unas recomendaciones con miras a iniciativas de inclusión digital con adultos mayores residentes de hogares geriátricos. Conclusiones: La inclusión digital se convierte en estrategia relevante, para favorecer procesos de envejecimiento activo, dentro de un marco de equidad y respeto a la diversidad.

Abstract Introduction: In the current world two phenomena are happening (incremental of the elderly population and growing and massive adult implementation of ICTs in society), although they are supposed to move in parallel, they are interact more and more, to the point of integration. Objective: To address digital inclusion as an alternative contributor to the active aging process. Proposition: Digital inclusion is an option that contributes to active aging by providing alternatives for the incorporation of the elderly into the information and knowledge society(s). Arguments for discussion: Aging, even though it is a biological process, it does not imply that the process should be assumed as a cause of a situation of disability or a loss of human condition. Instead, it is an environment with new demands, relationships and interests, where ICTs can contribute to have a better life quality, if specific aspects are considered in the processes of digital inclusion. As a contribution, recommendations are made for e-inclusion initiatives with elderly residents of geriatric homes. Final thoughts: Digital inclusion is becoming a relevant strategy to promote active aging process, within a framework of equity and respect for diversity.

Progressive reduction of hospital length of stay following minimally invasive repair of pectus excavatum: A retrospective comparison of three analgesia modalities, the role of addressing patient anxiety, and reframing patient expectations.

PURPOSE: Management of postoperative pain is a significant challenge following the Nuss procedure. Epidurals, PCAs, and newer analgesia modalities have been used elsewhere without demonstrating consistent improvement in the reported length of hospital stays (LOS). We reviewed a large single surgeon experience identifying three different methods of analgesia used over time to highlight marked improvement in patient LOS. METHODS: IRB approval was obtained and patient clinical information was retrospectively reviewed from 2001 to 2017. The primary outcome variable was length of hospital stay. An expanded preoperative consultation reviews the issue of pain, the negative impact of anxiety on recovery, and our current success of shortened hospital stays with our patients. RESULTS: One hundred and seventy-three patients representing three different analgesia approaches had a LOS of 4.4 days (epidural); 2.2 days (PCA/intercostal nerve block); and 1.6 days (scheduled oral pain meds/intercostal nerve blocks). The current LOS for patients is 1.0 day. Patients successfully stop using narcotics by the end of the first week postoperatively. CONCLUSIONS: Intraoperative intercostal nerve blocks, scheduled postoperative pain medications, and enhanced preoperative consultation aimed to educate patients about anxiety and reframe patient pain expectations have collectively decreased LOS, and reduced postoperative narcotic usage. TYPE OF STUDY: Clinical research LEVEL OF EVIDENCE: Level III.

Medir la situación digital académica: una acción de la gestión del conocimiento / Measuring the academic digital situation: a knowledge management action

Resumen La Sociedad(es) de la Información y del Conocimiento se caracterizan por la omnipresencia de las Tecnologías de la Información y de la Comunicación (TIC) y el uso intensivo de la información y el conocimiento en los diferentes sectores; sin embargo, es indiscutible la manera en cómo las comunidades se incorporan a ese entorno globalizado y cambiante, aflorando inequidades socioeconómicas y la misma brecha digital. En tales circunstancias, la institución educativa realza su importancia al ser productora de conocimiento y formadora de ciudadanos, exigiéndole identificar sus fortalezas y falencias en su actuar coherente con las exigencias sociales, donde su preparación y aporte, desde los procesos de inclusión digital, son fundamentales. En vista de lo anterior, el presente documento es un aporte a la gestión del conocimiento en el campo académico, mediante dos experiencias de medición de la situación digital en sendas poblaciones, esto es, jóvenes estudiantes de educación media y docentes de educación superior, con el diseño y la aplicación de índices compuestos, que recogen aspectos genéricos del sector TIC y específicos de los grupos poblacionales, útiles para el diseño y la evaluación de iniciativas de inclusión digital.

[Association between depression and hearing loss in patients with type 2 diabetes]. / Asociación entre depresión e hipoacusia en pacientes con diabetes tipo 2.

BACKGROUND: The association between diabetes, hearing loss and depression is unknown, and needs to be understood clearly and precisely. Our objective was to estimate the association between depression and hearing loss in patients with type 2 diabetes. METHODS: Cross-sectional analytical study. Patients of 40 years or older with type 2 diabetes were studied. Anthropometric measurements and biochemical parameters were recorded. The Beck Depression Inventory and a pure tone audiometry were applied. Groups were compared with chi squared test and logistic regression for confounders. RESULTS: 150 patients were included (76 % women). Average age was 56 ± 9.3 years, with 12.4 ± 6.5 years of progression of diabetes, weight 67.4 ± 11.6 kg; 31 % were obese; 25.5 % hypertensive (126.3 ± 19.3 / 79.4 ± 19.7 mm Hg) and 80.7 % had poor metabolic control (HbA1c ≥ 7 %). Of all the patients, 45.3 % presented hearing loss and 32.4 % depression. Diagnosis of depression in patients with hearing loss remained significant after adjusting for confounders (odds ratio [OR] = 2.3; 95 % confidence interval [CI] = 1.051-5.333, p = 0.037). Women had greater risk of depression, difference that remained significant (OR = 3.2; 95 % CI = 1.268-8.584, p = 0.014) after adjustment. CONCLUSIONS: Almost half of the patients with diabetes presented hearing loss and more than three times the risk of depression. Subjects with depression and diabetes presented more hearing loss (> 20 dB) than those without diabetes and/or without depression.

Introducción: se desconoce y es necesario entender con mayor claridad y precisión cuál es la asociación entre la diabetes, la hipoacusia y la depresión. Nuestro objetivo fue estimar la asociación entre depresión e hipoacusia en pacientes con diabetes tipo 2 (DT2). Métodos: estudio transversal analítico. Se estudiaron pacientes con DT2 mayores de 40 años. Se registraron medidas antropométricas y parámetros bioquímicos. Se aplicó el cuestionario de depresión de Beck y un estudio audiológico tonal. Se compararon los grupos con chi cuadrada y regresión logística. Resultados: se incluyeron 150 pacientes (76 % mujeres). El promedio de edad fue de 56 ± 9.3 años, con 12.4 ± 6.5 años de evolución de diabetes, con peso de 67.4 ± 11.6kg; fueron obesos el 31 %; 25.5 % hipertensos (126.3 ± 19.3/79.4 ± 19.7 mm Hg) y el 80.7 % presentó descontrol metabólico (HbA1c ≥ 7 %). El 45.3 % presentó hipoacusia y el 32.4 % depresión. El diagnóstico de depresión en pacientes con hipoacusia permaneció significativo después de ajustar para conseguir confusores (razón de momios [RM] = 2.3; intervalo de confianza [IC] al 95 % 1.051-5.333, p = 0.037). Las mujeres tuvieron mayor riesgo de padecer depresión, diferencia que permaneció significativa al ajustarse (RM = 3.2; IC 95 % 1.268-8.584, p = 0.014). Conclusiones: casi la mitad de los pacientes con diabetes presentaron hipoacusia y más de tres veces el riesgo de depresión. Los sujetos con depresión y diabetes mostraron mayor hipoacusia (> 20 dB) que aquellos sin diabetes o sin depresión.

Nanoscale fabrication of the ferroelectric polymer poly(vinylidene fluoride with trifluoroethylene) P(VDF-TrFE) 75:25 thin films by atomic force microscope nanolithography.

Thin films of an organic ferroelectric system, poly(vinylidene fluoride with trifluoroethylene) P(VDF-TrFE, Kureha Corporation, Tokyo, Japan) 75:25 layers, have been deposited on highly ordered pyrolytic graphite and silicon dioxide by the horizontal Schaefer method of Langmuir-Blodgett techniques. It is possible to "shave" or mechanically displace small regions of the polymer film by using atomic force microscope nanolithography techniques such as nanoshaving, leaving swaths of the surface cut to a depth of 4 nm and 12 nm exposing the substrate. The results of fabricating stripes by nanoshaving two holes close to each other show a limit to the material "stripe" widths of an average of 153.29 nm and 177.67 nm that can be produced. Due to the lack of adhesion between the substrates and the polymer P(VDF-TrFE) film, smaller "stripes" of P(VDF-TrFE) cannot be produced, and it can be shown by the sequencing of nanoshaved regions that "stripes" of thin films can be removed.

Approaching an organic semimetal: Electron pockets at the Fermi level for a p-benzoquinonemonoimine zwitterion.

There is compelling evidence of electron pockets, at the Fermi level, in the band structure for an organic zwitterion molecule of the p-benzoquinonemonoimine type. The electronic structure of the zwitterion molecular film has a definite, although small, density of states evident at the Fermi level as well as a nonzero inner potential and thus is very different from a true insulator. In spite of a small Brillouin zone, significant band width is observed in the intermolecular band dispersion. The results demonstrate that Bloch's theorem applies to the wave vector dependence of the electronic band structure formed from the molecular orbitals of adjacent molecules in a molecular thin film of a p-benzoquinonemonoimine type zwitterion.

A new device for alveolar bone transportation.

We present a retrospective review of a new technique for the transportation of alveolar bone using a Hyrax device modified by the principal author (O.A.V.). There were seven patients (five males and two females), including five patients with cleft palate and lip diagnosis, one patient with a high-speed gunshot wound, and one patient with facial trauma sequel due to mandibular fracture. They were all treated with an alveolar bone transportation technique (ABT) through the use of the modified Hyrax device (VEGAX). Before surgery, distraction osteogenesis of the bifocal type was performed on four patients, and the trifocal type was performed on the other three patients. However, in one case, direct dental anchorage was not used, only orthodontic appliances. In all the cases, new bone formation and gingival tissue around the defect were obtained, posterior to the alveolar distraction process; no complications were observed in any patient. In one case, two teeth involved in the disk of the ABT were extracted, due to a previous condition of periodontal disease. The alveolar bone transport with the VEGAX device is an accessible technique for almost every patient with alveolar defects due to diverse causes. In all the presented cases, predictability and success were demonstrated.

Distraction osteogenesis for craniomaxillofacial problems.

Distraction osteogenesis (DO) is a biological process involving the formation of new bone between viable bone segments that are gradually separated by incremental traction. This technology has proved useful in several craniomaxillofacial applications where conventional techniques were previously used. This article describes DO and demonstrates three disparate uses for this technology.