Limitación auditiva y fragilidad social en hombres y mujeres mayores

ObjectiveTo explore the association between hearing loss and social frailty in a sample of Spanish older adults recruited from primary health care network.MethodCross-sectional study on a sample of 445 non-institutionalized adults aged 65 or more years (190 men and 255 women), recruited from primary care centers in Spain. Three self-reported hearing impairment questions were used to assess hearing loss. Social frailty was deemed to exist when the person presented two or more of the following conditions: living alone, absence of a person to provide help, infrequent contact with family, infrequent contact with friends, lack of confident and lack of help for daily activities in the last 3 months. To study the association between hearing loss and social frailty we used logistic regression models adjusted for potential confounders, including physical frailty.ResultsThe mean age of participants was 76.2 years (77.5 years for women). More than half of the participants (54.4%) reported hearing loss and the frequency of social frailty was 23.2%. Hearing loss was associated with social frailty (adjusted odds ratio [aOR] = 1.78; 95% confidence interval [95%CI]: 1.04-3.06). However, the association was sex-dependent (p for interaction = 0.041). In stratified analysis, the association was only found in women (aOR = 3.21; 95%CI: 1.44-7.17).ConclusionsHearing loss was associated with social frailty in women, but not in men. Longitudinal studies are needed to confirm this association and to understand the differential effect of gender.     

Influence of unfused cranial bones on magnetoencephalography signals in human infants

ObjectiveTo clarify the effects of unfused cranial bones on magnetoencephalography (MEG) signals during early development.MethodsIn a simulation study, we compared the MEG signals over a spherical head model with a circular hole mimicking the anterior fontanel to those over the same head model without the fontanel for different head and fontanel sizes with varying skull thickness and conductivity.ResultsThe fontanel had small effects according to three indices. The sum of differences in signal over a sensor array due to a fontanel, for example, was < 6% of the sum without the fontanel. However, the fontanel effects were extensive for dipole sources deep in the brain or outside the fontanel for larger fontanels. The effects were comparable in magnitude for tangential and radial sources. Skull thickness significantly increased the effect, while skull conductivity had minor effects.ConclusionMEG signal is weakly affected by a fontanel. However, the effects can be extensive and significant for radial sources, thicker skull and large fontanels. The fontanel effects can be intuitively explained by the concept of secondary sources at the fontanel wall.SignificanceThe minor influence of unfused cranial bones simplifies MEG analysis, but it should be considered for quantitative analysis.     

Mapeo de activos comunitario para la salud en un asentamiento informal de Medellín (Colombia)

ObjectiveTo describe how the community from El Faro neighborhood identifies its community assets, uses them to face life's challenges through the capacity of collective agency; and by generating community development processes, applying the salutogenic theory that considers people as active subjects, with the capacity to conserve and generate health and well-being, through the use of their own resources called health assets.MethodsA map of community assets was made in 2018 in el Faro neighborhood, an informal settlement of Medellín, Colombia, following the phases recommended by other authors and from a qualitative, participatory approach that delves into the health situation of the community.ResultsIn this process were identified 12 individual community assets, 12 collective, 13 institutional and 10 in the environment. The main community asset among the 47 described was community participation, from the agency capacity, mainly of its leaders who participating in their own organizations encourage development, identity construction and well-being.ConclusionAsset mapping has served to identify intangible assets for the community and, in turn, this recognition has been useful in strengthening the agency's capacity for community development. This is a territory transformed by community reflection processes allowing to understand situations of exclusion and poverty, seeking to create a more livable place and developing a community capacity to solve their own problems, through solidarity and community support.     

Social media use and the not-so-imaginary audience: Behavioral and neural mechanisms underlying the influence on self-concept

We investigated behavioral and neural mechanisms in the relation between social media use (SMU) and self-concept, as well as longitudinal developmental outcomes. Adolescents and young adults (N = 150, 11–21 years old at T1) rated themselves on 60 traits in the academic, physical and prosocial domain, and also indicated how they thought peers would judge them (reflected-peer-judgements). Longitudinal questionnaires (1- and 2-year follow-up) were collected to assess positive (prosocial behavior, self-concept clarity) and negative (clinical symptoms) long-term outcomes.Results indicated that heavier self-reported SMU was linked with lower difference scores between self-judgements and reflected-peer-judgements. Lower SMU was related to more positive ratings from self-judgements vs. reflected-peer-judgements. SMU was also associated with less positive self-concept, particularly in the academic domain (boys and girls) and physical domain (girls). Neurally, increased SMU was linked to heightened mPFC-activity during self-judgements compared to reflected-peer-judgements, and increased activity during physical compared to academic and prosocial self-judgements. Longitudinal analyses indicated no evidence for long-term effects of social media use, self/reflected-peer-difference scores and mPFC-activity on clinical symptoms, prosocial behavior or self-concept clarity. This study highlights the complex relationship between social media use and wellbeing and future research is needed to confirm the lack of long-term effects.     

Héctor Abad-Gómez (1921-1987): médico,educador y defensor de los derechos humanos

Héctor Abad-Gómez, Colombian physician, university professor, journalist and human rights defender, was murdered in Medellín in 1987. He was a pioneer public health activist engaged in various fields. While being student his restless and dissatisfied mind, led him to fight for a better and safer water and food. He specialized in the University of Minnesota (USA), at his return to the country he led the establishment of the Rural Medical Service. Forced to exile for several years he was WHO consultant to several countries in the Americas and Asia. In 1956 he founded the Preventive Medicine and Public Health Department of the University of Antioquia. He carried out the first recorded mass community vaccination against polio in the world. He initiated a community health agents program known as “Rural health promoters” that later would be implemented nationally. In 1962 he first proposed the application of epidemiological methods to study violence; he was visiting professor at the University of California; he coined the term “polyiatry” for a specialty dedicated to the health populations; he was director of the Colombian National School of Public Health that currently bears his name. Héctor Abad-Gómez ventured into political life, in accordance with Virchow dictum that “politics is medicine on a large scale”. The lives of both have interesting similarities except for the tragic and premature death of the former that still receives rejection today in social, political and academic levels, both in Colombia and abroad.     

KIF2A regulates ovarian development via modulating cell cycle progression and vitollogenin levels

The kinesin superfamily of proteins (KIFs) are microtubule motor proteins that use the hydrolysis of ATP to power directional movement along microtubules. KIFs induce microtubule depolymerization to regulate the length and dynamics of microtubules in a variety of cell processes and structures, including the mitotic and meiotic spindles and centriole and interphase microtubules. KIF plays a significant role in the transport of organelles, protein complexes and mRNAs. The brown planthopper (Nilaparvata lugens) is a major insect pest in rice paddy fields. Ovarian development is regulated by multiple factors, including endocrine factors. The role of KIFs in brown planthopper ovarian development remains unknown. We found that downregulation of KIF2A significantly compromised the development and eclosion of the brown planthopper, delayed ovarian cell cycle progression, disrupted ovarian development, reduced the expression of MCM genes required for DNA replication and significantly reduced the number of nuclei in the follicles. We also found a significant reduction in Vg mRNA and protein levels. We conclude that downregulation of KIF2A disrupts the cell cycle progression of cells. Alternatively, the ovarian phenotype could be an indirect effect of a compromised trophic cord. In summary, KIF2A regulates ovarian development via modulating cell cycle progression and/or vitollogenin transportation.     

Development of white matter microstructure and executive functions during childhood and adolescence: a review of diffusion MRI studies

Diffusion magnetic resonance imaging (dMRI) provides indirect measures of white matter microstructure that can be used to make inferences about structural connectivity within the brain. Over the last decade, a growing literature of cross-sectional and longitudinal studies have documented relationships between dMRI indices and cognitive development. In this review, we provide a brief overview of dMRI methods and how they can be used to study white matter and connectivity and review the extant literature examining the links between dMRI indices and executive functions during development. We explore the links between white matter microstructure and specific executive functions: inhibition, working memory and cognitive shifting, as well as performance on complex executive function tasks. Concordance in findings across studies are highlighted, and potential explanations for discrepancies between results, together with challenges with using dMRI in child and adolescent populations, are discussed. Finally, we explore future directions that are necessary to better understand the links between child and adolescent development of structural connectivity of the brain and executive functions.     

标准引领下医学人才培养过程规范建构与实践

近年来,我国职业教育办学规模已实现跨越式发展。进一步加强内涵建设,提升育人质量将成为职业教育可持续发展的基本路径。标准建设是检验学校人才培养质量的重要依据。文章通过构建标准建设基本路径,基于健康产业发展需求,分析医学人才过程中的重要环节,完善专业人才培养方案,优化课程体系,制定包括课程、课堂教学、实践教学、临床教学等各环节在内的一系列教学相关标准,梳理教学管理制度,成立专门的质量管理组织,通过质量管理部门、校系二级督导、学生、教师等多途径收集质量信息,依据标准开展教学诊断与分析,加强信息反馈及改进监督,形成了标准建设-组织保证-诊断分析-反馈改进的保证体系,可持续提升育人质量。