Socioeconomic differences in digital inequality among Chinese older adults: Results from a nationally representative sample.

The current study seeks to investigate digital inequality among older adults in China, specifically examining two socially defined age groups: young-old adults (aged 60-74) and old-old adults (aged 75+). Descriptive statistics and multiple regression were used to examine the prevalence of and identify the factors associated with Internet access, usage (frequency and breadth containing 11 activities), skills, and social support. The study used data from the 2018 China Longitudinal Ageing Social Survey (CLASS) which consisted of 11,419 respondents aged 60 years and older. We found that 40.22% of older adults had access to the Internet, and 18.27% used it regularly. Socioeconomic factors played a crucial role in determining Internet access and usage, with young-old adults with higher education using the Internet more frequently, deliberately, and competently. Those with higher economic status had greater social support to use it, and the old-old adults with higher socioeconomic status were more likely to have Internet access. This study has implications for prioritizing targeted policies and interventions aimed at supporting socioeconomically disadvantaged older adults and ensuring equal opportunities for all to access and benefit from the digital world.

Compliance with web content accessibility guidelines in ophthalmology social media posts.

This is a cross-sectional exploratory analysis of publicly available Internet data to examine compliance to web content accessibility guidelines (WCAG) on patient education social media posts in ophthalmology. WCAG ensures web content accessibility for those with disabilities (including visual impairment). A total of 100 social media posts were sampled from ten ophthalmology patient education social media pages and ten non-ophthalmology (cardiopulmonary) pages as the comparison group. Three independent graders evaluated the selected posts based on the WCAG 2 checklist by WebAIM, a non-profit affiliated with Utah State University, after its adaptation for social media posts. Validated accessibility standard labels: "0" for not meeting any standards, "1" or "A" for meeting bare minimum accessibility requirements, "2" or "AA" for meeting legal accessibility requirements, or "3" or "AAA" for exceeding accessibility requirements. There was not enough evidence to detect a difference in WCAG scores between ophthalmology and non-ophthalmology posts (p = 0.80). Forty-nine percent of scores for ophthalmology social media posts showed no compliance with any WCAG. The most common reasons that ophthalmology posts failed to meet criteria were due to color and contrast issues (39%). Most ophthalmology social media posts had low WCAG scores, indicating poor compliance to WCAG. Because social media is highly visual, reduced compliance to WCAG may create barriers for low vision individuals to successfully access patient education social media content.

Gestações e nascimentos em tempos de COVID-19 / Embarazos y nacimientos en tiempos de COVID-19 / Pregnancies and births in times of COVID-19

Resumo Objetivo Identificar o perfil de nascimentos das gestações de mulheres com acesso à internet que cursaram com a infecção pelo SARS-CoV-2 e seus desfechos. Métodos Estudo transversal integrado a uma coorte prospectiva, com coleta entre agosto de 2021 e fevereiro de 2022, baseado nas respostas de 304 mulheres que tiveram gestações e/ou partos durante o período pandêmico. Resultados Do total, 25,7% das entrevistadas tiveram COVID-19, com predomínio de diagnósticos no terceiro trimestre. Queixas de anosmia, fadiga e cefaleia prevaleceram como relacionados à infecção. As variáveis: utilizar o Sistema Único de Saúde para atendimento (p = 0,084); diabetes gestacional (p = 0,141); baixo peso de nascimento (p = 0,117); necessidade de internação em unidade neonatal (p = 0,120) foram inseridas no modelo de regressão por terem valores de p inferiores a 0,20. A variável referente ao tipo de parto (p=1,000) foi inserida no modelo por se tratar de uma variável de interesse e com descrição de relevância na literatura. A prematuridade foi a única variável que apresentou associação estatística com a infecção pelo SARS-CoV-2 durante a gestação (p = 0,008) na análise bivariada, explicando o desfecho da infecção na gestação (<0,001), comprovado no modelo de Regressão Robusta de Poisson. Conclusão Observou-se alta prevalência de COVID-19 na amostra, com variação de sintomas e predomínio de partos operatórios. No entanto, a infecção pelo SARS-CoV-2 explicou apenas a maior ocorrência de nascimentos prematuros.

Resumen Objetivo Identificar el perfil de nacimientos de los embarazos de mujeres con acceso a internet que lo cursaron con la infección por SARS-CoV-2 y sus desenlaces. Métodos Estudio transversal integrado a una cohorte prospectiva, con recopilación entre agosto de 2021 y febrero de 2022, basado en las respuestas de 304 mujeres que tuvieron embarazos o partos durante el período pandémico. Resultados Del total, el 25,7 % de las entrevistadas tuvieron COVID-19, con predominio de diagnósticos en el tercer trimestre. Prevalecieron quejas de anosmia, fatiga y cefalea como relacionadas a la infección. Las variables utilización del Sistema Único de Salud para atención (p = 0,084), diabetes gestacional (p = 0,141), bajo peso de nacimiento (p = 0,117), necesidad de internación en unidad neonatal (p = 0,120) se introdujeron en el modelo de regresión por tener valores de p inferiores a 0,20. Se introdujo la variable relacionada al tipo de parto (p = 1,000) en el modelo por tratarse de una variable de interés y con descripción de relevancia en la literatura. La prematuridad fue la única variable que presentó asociación estadística con la infección por SARS-CoV-2 durante el embarazo (p = 0,008) en el análisis bivariado, lo que explica el desenlace de la infección en el embarazo (>0,001), comprobado en el modelo de regresión robusta de Poisson. Conclusión Se observó alta prevalencia de COVID-19 en la muestra, con variación de síntomas y predominio de partos operatorios. Sin embargo, la infección por SARS-CoV-2 explicó solamente la mayor incidencia de nacimientos prematuros.

Abstract Objective Identify the profile of births of pregnancies of women with internet access who were infected with SARS-CoV-2 and their outcomes. Methods Cross-sectional study integrated into a prospective cohort, with collection between August 2021 and February 2022, based on the responses of 304 women who had pregnancies and/or deliveries during the pandemic period. Results Of the total, 25.7% of the interviewees had COVID-19, with a predominance of diagnoses in the third quarter. Complaints of anosmia, fatigue and headache prevailed as related to the infection. The variables using the Unified Health System for care (p = 0.084); gestational diabetes (p = 0.141); low birth weight (p = 0.117); need for admission to a neonatal unit (p = 0.120) were included in the regression model because they had p values lower than 0.20. The variable referring to the type of delivery (p=1.000) was inserted in the model because it is a variable of interest and with a description of relevance in the literature. Prematurity was the only variable that was statistically associated with SARS-CoV-2 infection during pregnancy (p = 0.008) in the bivariate analysis, explaining the outcome of infection during pregnancy (<0.001), confirmed in the Poisson Robust Regression model. Conclusion There was a high prevalence of COVID-19 in the sample, with varying symptoms and a predominance of operative deliveries. However, SARS-CoV-2 infection only explained the higher occurrence of premature births.

Cambio de la atención psicológica presencial a modalidad remota: facilitadores y obstáculos en la pandemia de COVID-19 / Changing face-to-face psychological care to remote mode: facilitators and obstacles in the COVID-19 pandemic / Mudança do atendimento psicológico presencial para modalidade remota: facilitadores e dificultadores na pandemia de COVID-19

Objetivo: verificar asociaciones entre variables sociodemográficas y factores que facilitan y dificultan la transición de la atención psicológica presencial a la modalidad remota en el primer año de la pandemia de COVID-19. Método: se trata de un estudio analítico, cuantitativo y de corte transversal. Después de la aprobación del Comité de Ética en Investigación, la recolección de datos se realizó mediante la aplicación de un formulario en línea que consta de 55 preguntas. Los datos fueron analizados utilizando técnicas de estadística descriptiva e inferencial. Resultados: la muestra de conveniencia estuvo compuesta por 385 psicólogos brasileños, en su mayoría mujeres (67,01%), jóvenes profesionales con hasta cinco años de actuación después de la graduación (44,16%) y predominio de actividades en la clínica privada. Se encontró que el tiempo de formación entre cinco y 10 años se asoció con una mayor percepción de dificultades y que la experiencia previa con la atención a distancia facilitó la adaptación en la transición de una modalidad a otra. Conclusión: considerando que la teleasistencia puede ser una poderosa herramienta en el escenario de la salud, se sugiere que los temas de la teleasistencia sean incluidos en la agenda de investigación y los contenidos programáticos en los currículos de los cursos de formación en salud.

Objective: to verify associations between sociodemographic variables and factors that facilitate and hinder the transition from face-to-face psychological care to remote mode in the first year of the COVID-19 pandemic. Method: this is an analytical, quantitative, cross-sectional study. After approval by the Research Ethics Committee, data collection was performed by applying an online form consisting of 55 questions. Data were analyzed using descriptive and inferential statistics techniques. Results: the intentional sampling consisted of a total of 385 Brazilian psychologists, mostly women (67.01%), young professionals with up to five years of graduation (44.16%) most of activities in the private clinic. It was found that training time between five and 10 years was associated with a greater perception of difficulties and that previous experience with remote care facilitated adaptation in the transition from one modality to another. Conclusion: considering that call center can be a powerful tool in the health scenario, it is suggested the inclusion of remote care issues in the research agenda and syllabus in the curricula of health training courses.

Objetivo: verificar associações entre variáveis sociodemográficas e fatores facilitadores e dificultadores da transição do atendimento psicológico presencial para a modalidade remota no primeiro ano da pandemia de COVID-19. Método: trata-se de um estudo analítico, quantitativo, de corte transversal. Após aprovação do Comitê de Ética em Pesquisa, a coleta foi realizada mediante aplicação de um formulário online composto por 55 questões. Os dados foram analisados por meio de técnicas de estatística descritiva e inferencial. Resultados: a amostra de conveniência foi composta por 385 psicólogos brasileiros, majoritariamente mulheres (67,01%), jovens profissionais com até cinco anos de ofício após a graduação (44,16%) e com predomínio de atividades na clínica privada. Constatou-se que o tempo de formação entre cinco e 10 anos foi associado com uma maior percepção de dificuldades e que a experiência prévia com atendimento remoto foi facilitadora da adaptação na transição de uma modalidade à outra. Conclusão: considerando que o teleatendimento pode ser uma ferramenta potente no cenário da saúde, sugere-se a inclusão das questões do atendimento remoto na agenda de pesquisa e conteúdos programáticos das grades curriculares dos cursos de formação em saúde.

¿Cómo usan el teléfono móvil los niños de Castilla y León? / How do children in Castilla y León use their mobile phones?

Introducción: los teléfonos móviles suponen una gran herramienta de comunicación entre iguales, pero un uso inapropiado puede repercutir en las relaciones familiares, sociales y en el rendimiento escolar. Objetivos: el objetivo principal del trabajo fue estudiar el uso del teléfono móvil en la población pediátrica de varias áreas de salud de Castilla y León. Material y métodos: estudio multicéntrico prospectivo en varios centros de salud y un hospital comarcal. Se pasó una encuesta a padres de niños que acudían a consulta y a los adolescentes que lo desearon, quienes también respondieron a un test de dependencia (TDM). Resultados: el móvil es el dispositivo electrónico que más usaban los niños para navegar por Internet. La media de edad en la que tuvieron el primer móvil propio fue de 10,35 años; la mayoría, con acceso a Internet. El 68% de ellos accedía sin ningún control parental. El 70% de padres establecieron unas normas al proporcionárselo. Un tercio reconocían que estas no se cumplían. El número de horas diarias de uso aumentaba según la edad de los niños. De los adolescentes, más del 50% lo usaba más de dos horas al día. Los más pequeños lo utilizaban para ver vídeos y los mayores para chatear y redes sociales. El uso del móvil se relacionaba con el uso de gafas, pero no con el rendimiento académico, problemas de sueño ni práctica de deporte. En el TDM se observaron muchas respuestas positivas en los ítems de los cuatro apartados en los que se divide el test, especialmente en el de falta de control. Conclusiones: la media de edad de adquisición del primer teléfono móvil propio es menor de la recomendada. Su abuso puede generar conductas con rasgos de adicción (AU)

Introduction: mobile phones are a great communication tool between equals, but inappropriate use can affect family and social relationships and school performance.Objectives: the main objective of this work was to study the use of mobile phones in the pediatric population of several health areas in Castilla y León.Material and methods: prospective multicenter study in several health centers and a regional hospital.A survey was passed to parents of children who attended the consultation, and to adolescents who wished to, who also responded to a dependency test (TDM).Results: the mobile is the electronic device that children used the most to surf the Internet. The average age at which they had their first mobile phone was 10.35 years, most of them with Internet access.68% of them accessed without any parental control. 70% of parents established rules of operating. A third recognized that these rules were not fulfilled.The number of hours per day of use increased with the age of the children. More than 50% of the adolescents used it for more than two hours a day. The little ones used it to watch videos and the older ones to chat and social networks.The use of the mobile phone was related to the use of glasses, but not with academic performance, sleep problems or sports practice.In the TDM many positive responses were observed in the items of the four sections into which the test is divided, especially in the lack of control.Conclusions: the average age for acquiring their first mobile phone is lower than the recommended age. Its abuse can generate behaviors with traits of addiction. (AU)

Inclusion4EU: Co-Designing a Framework for Inclusive Software Design and Development.

Digital technology is now pervasive, however, not all groups have uniformly benefitted from technological changes and some groups have been left behind or digitally excluded. Comprehensive data from the 2017 Current Population Survey shows that older people and persons with disabilities still lag behind in computer and internet access. Furthermore unique ethical, privacy and safety implications exist for the use of technology for older persons and people with disabilities and careful reflection is required to incorporate these aspects, which are not always part of a traditional software lifecycle. In this paper we present the Inclusion4EU project that aims to co-design a new framework, guidelines and checklists for inclusive software design and development with end-users from excluded categories, academics with expertise in human-computer interaction and industry practitioners from software engineering.

The Digital Divide in Brazil and Barriers to Telehealth and Equal Digital Health Care: Analysis of Internet Access Using Publicly Available Data.

BACKGROUND: The COVID-19 pandemic has increased the use of digital solutions in medical care, especially for patients in remote areas and those requiring regular medical care. However, internet access is essential for the implementation of digital health care. The digital divide is the unequal distribution of access to digital technology, and the first level digital divide encompasses structural barriers. Brazil, a country with economic inequality and uneven population distribution, faces challenges in achieving internet access for all. OBJECTIVE: This study aims to provide a comprehensive overview of the first-level digital divide in Brazil, estimate the relationship between variables, and identify the challenges and opportunities for digital health care implementation. METHODS: Data were retrieved from the Brazilian Institute of Geography and Statistics National Continuous House survey database, including demographic, health, and internet-related variables. Statistical analysis included 2-tailed t tests, chi-square, and multivariate logistic regression to assess associations between variables. RESULTS: Our analysis included 279,382 interviews throughout Brazil. The sample included more houses from the northeast (n=99,553) and fewer houses from the central west (n=30,804). A total of 223,386 (80.13%) of the interviewed population used the internet, with urban areas having higher internet access (187,671/212,109, 88.48%) than rural areas (35,715/67,077, 53.24%). Among the internet users, those interviewed who lived in urban houses, were women, were younger, and had higher income had a statistically higher prevalence (P<.001). Cell phones were the most common device used to access the internet (141,874/143,836, 98.63%). Reasons for not using the internet included lack of interest, knowledge, availability, and cost, with regional variations. The prevalence of internet access also varied among races, with 84,747 of 98,968 (85.63%) White respondents having access, compared to 22,234 of 28,272 (78.64%) Black respondents, 113,518 of 148,191 (76.6%) multiracial respondents, and 2887 of 3755 (76.88%) other respondents. In the southeast, central west, and south regions, the numbers of people with internet access were 49,790 of 56,298 (88.44%), 27,209 of 30,782 (88.39%), and 27,035 of 31,226 (86.58%), respectively, and in the north and northeast, 45,038 of 61,404 (73.35%) and 74,314 of 99,476 (74.7%). The income of internet users was twice the income of internet nonusers. Among those with diabetes-related limitations in daily activities, 945 of 2377 (39.75%) did not have internet access, and among those with daily activity restrictions, 1381 of 3644 (37.89%) did not have access. In a multivariate logistic regression analysis, women (odds ratio [OR] 1.147, 95% CI 0.118-0.156; P<.001), urban households (OR 6.743, 95% CI 1.888-1.929; P<.001), and those earning more than the minimum wage (OR 2.087, 95% CI 0.716-0.756; P<.01) had a positive association with internet access. CONCLUSIONS: Brazil's diverse regions have different demographic distributions, house characteristics, and internet access levels, requiring targeted measures to address the first-level digital divide in rural areas and reduce inequalities in digital health solutions. Older people, poor, and rural populations face the greatest challenges in the first level digital divide in Brazil, highlighting the need to tackle the digital divide in order to promote equitable access to digital health care.

Inteligencia artificial y administración de justicia: desafíos derivados del contexto latinoamericano / ntel·ligència artificial i administració de justícia: desafiaments derivats del context llatinoamericà / Artificial Intelligence and Justice Administration: Challenges derived from the Latin American context

El surgimiento de la Inteligencia Artificial(IA), en el marco de la Cuarta Revolución Industrial, obliga a reflexionar acerca de su impacto en la administración de justicia desde la óptica plural, interdisciplinaria y social que caracteriza a la bioética. Esto se torna imprescindible no sólo para garantizar una aplicación ética de la IA en la administración de justicia; sino, además, para asegurar el respeto de la persona humana y sus manifestaciones culturales -como el derecho-frente a las innovaciones tecnológicas. Por consiguiente, para lograr ese objetivo resulta clave, por un lado, entender cómo funcionan los sistemas de IA en el campo del derecho, y cuáles son las dificultades que se plantean desde las diversas aristas (ética, de razonamiento y jurídica). Y, por otro lado, mirar con atención las particularidades presenta el contexto latinoamericano signado por la desigualdad; la volatilidad social, política e institucional; y una atávica caracterización de la justicia. La justicia impartida con IA tiene la potencialidad de hacer realidad valores tan preciados como la celeridad y la seguridad jurídica. Y, al mismo tiempo, de amenazar la libertad, la privacidad y la igualdad de los individuos, sobre todo en sociedades atravesadas por diferencias estructurales como la latinoamericana.(AU)

El sorgiment de la Intel·ligència Artificial (IA), en el marc de la Quarta Revolució Industrial, obliga a reflexionar sobre el seu impacte a l'administració de justícia des de l'òptica plural, interdisciplinària i social que caracteritza la bioètica. Això esdevé imprescindible no només per garantir una aplicació ètica de la IA a l'administració de justícia; sinó, a més, per assegurar el respecte de la persona humana i les seves manifestacions culturals –com el dret–davant les innovacions tecnològiques. Per tant, per assolir aquest objectiu resulta clau, per una banda, entendre com funcionen els sistemes d'IA en el camp del dret, i quines són les dificultats que es plantegen des de les diverses arestes (ètica, de raonament i jurídica). I, per altra banda, mirar amb atenció lesparticularitats presenta el context llatinoamericà signat per la desigualtat; la volatilitat social, política i institucional; i una atàvica caracterització de la justícia. La justícia impartida amb IA té la potencialitat de fer realitat valors tan preatscom la celeritat i la seguretat jurídica. I, alhora, d'amenaçar la llibertat, la privadesa i la igualtat dels individus, sobretot en societats travessades per diferències estructurals com la llatinoamericana.(AU)

The emergence of Artificial Intelligence (AI), in the framework of the Fourth Industrial Revolution, forces us to reflect on its impact on the administration of justice from the plural, interdisciplinary and social perspective that characterizes bioethics.This becomes essential not only to guarantee an ethical application of AI in the administration of justice; but also, to ensure respect for the human person and its cultural manifestations -such as law-in the face of technological innovations. Therefore,to achieve this objective, it is key, on the one hand, to understand how AI systems work in the field of law, and what are the difficulties that arise from various angles (ethical, legal and reasoning).And, on the other hand, looking carefully at the particularities presents the Latin American context marked by inequality; social, political and institutional volatility; and an atavistic characterization of justice.The justice imparted with AI has the potential to make values as precious as speed and legalcertainty a reality. And, at the same time, to threaten the freedom, privacy and equality of individuals, especially in societies crossed by structural differences such as Latin America.(AU)

Nutrição em rede: um relato de experiência de lives produzidas por um Grupo de Educação Tutorial durante a pandemia de covid-19 / Network nutrition: an experience report of lives produced by a Tutorial Education Group during the covid-19 pandemic / Nutrición en red: un relato de experiencia de directos producidos por un Grupo de Educación Tutorial durante la pandemia del covid-19

Devido às complexidades do período de pandemia de covid-19, houve um aumento do acesso às redes sociais para a busca de informações científicas. Este trabalho visa apresentar as adaptações de uma atividade de ensino, através de relato de experiência, promovido pelo Grupo de Educação Tutorial (GET) do Curso de Nutrição da Universidade Federal de Juiz de Fora (UFJF). Foram ciclos de palestras com atualizações científicas e vivência prática, utilizando a rede social Instagram em formato de lives, sendo o conteúdo transmitido como entrevista, em dois blocos, totalizando seis lives com aproximadamente 55 minutos cada. O público interagiu com o palestrante, ao expressar opinião e encaminhar dúvidas através do recurso de comentários. Houve sucesso na participação dos alunos, fato confirmado pelo número de visualizações, uma vez que o total foi superior quando comparado às edições presenciais. A internet viabilizou encontros de pessoas, mesmo distantes, possibilitando o acesso a profissionais de outras cidades e transmitindo informações através da rede social

Due to the complexities of the covid-19 pandemic period, there has been an increase in access to social net-works to search for scientific information. This work aims to present the adaptations of a teaching activity, through an experience report, promoted by the Tutorial Education Group, of the Nutrition Course from the Federal University of Juiz de Fora. There were lecture cycles with scientific updates and practical experience, using the social network Instagram in the format of lives, with the content being transmitted as an interview, in two blocks, totaling six lives with approximately 55 minutes each. The audience interacted with the speaker, expressing their opinion and doubts through the comment section. There was success in student participation, which can be confirmed by the number of online views, since this was higher when compared to the face-to-face editions. The internet made it possible for people to meet, even if they were far away, allowing access to professionals from other cities and transmitting information through the social network

Debido a las complejidades del período de la pandemia de covid-19, se ha incrementado el acceso a las redes sociales para buscar información científica. Este trabajo tiene como objetivo presentar las adaptaciones de una actividad docente, a través de un relato de experiencia, promovida por el Grupo de Educación Tutorial (GET) del Curso de Nutrición de la Universidad Federal de Juiz de Fora. Se realizaron ciclos de conferencias con actualización científica y experiencia práctica, utilizando la red social Instagram en formato de directos, siendo el contenido transmitido como entrevista, en dos bloques que suman seis directos con aproximada-mente 55 minutos cada una. El público interactuó con el ponente, expresando su opinión y dudas a través de la función de comentarios. Hubo éxito en la participación de los estudiantes, lo que se puede confirmar con el número de visualizaciones en línea, ya que fue mayor en comparación con las ediciones presenciales. Internet hizo posible que las personas se encontraran, aunque estuvieran lejos, permitiendo el acceso a profesionales de otras ciudades y transmitiendo información a través de la red social

La influencia de los entornos en el envejecimiento saludable. El desarrollo de la Red Mundial de la OMS de Ciudades y Comunidades Amigables con las Personas Mayores / The influence of environments on healthy aging. The development of the WHO Global Network of Age-Friendly Cities and Communities

Asegurar que las comunidades fomenten las capacidades de las personas mayores es uno de los cuatros ámbitos de acción de la Década del Envejecimiento Saludable 2021-2030, y la Red Mundial de la OMS de Ciudades y Comunidades Amigables con las Personas Mayores constituye una herramienta clave para intervenir en esta dimensión. Con el objetivo de perfilar el conocimiento actual disponible sobre la situación de la salud y la influencia de los entornos en el bienestar de las personas mayores en la Región de las Américas al comienzo de la década, así como de orientar las acciones políticas hacia el desarrollo pleno de las personas a lo largo de todo el curso de vida, en esta publicación se presenta el crecimiento de la Red Mundial de Ciudades y Comunidades Amigables con las Personas Mayores en las Américas y los logros obtenidos. La evolución de la red en la Región se analiza tomando como base la información que las propias ciudades y comunidades activas cargan en la plataforma disponible a tal efecto. Además, se exponen los desafíos presentes y futuros y se invita a fortalecer la red en el continente y en el mundo

Arquitectura de salud pública / Public Health Architecture

Uno de los ocho principios rectores para la transformación digital del sector de la salud promovidos por la Organización Panamericana de la Salud (OPS) es la arquitectura de salud pública. Este documento de política presenta conceptos clave, líneas de acción recomendadas e indicadores para su monitoreo con el objetivo de avanzar en la arquitectura de salud pública. De acuerdo con la definición de la OPS, este principio rector se propone diseñar la arquitectura de salud pública en la era de la interdependencia digital. "La arquitectura de salud pública, en la era de la interdependencia digital, debe enmarcarse en la agenda digital del gobierno. Debe ser transversal, para articular las distintas vertientes de gobernanza y optimizar la planificación estratégica y la gestión de los recursos. Debe basarse en el aprovechamiento de normas y procedimientos a favor de múltiples áreas, no solo de la esfera de la salud; este es el caso de la conectividad y el ancho de banda, que influyen indistintamente en salud, en educación y en todos los sectores". La mayoría de los avances en salud digital se dan como aplicaciones y sistemas de información individuales que funcionan independientemente. Esto genera islas de información, con grandes desafíos para alcanzar la eficiencia y mejorar los resultados de salud. La propuesta es lograr una arquitectura de salud como plataforma que sirva de base para que los diversos sistemas de información interoperen y trabajen juntos de manera integrada. Existen diferentes formas de alcanzar este intercambio de datos, y todos ellos implican establecer la gobernanza, un marco de confianza (dado por normativas y su cumplimiento) y de arquitectura tecnológica de interoperabilidad

Digital economy development and the urban-rural income gap: Evidence from Chinese cities.

The growth of the digital economy has created new forms of inequality of opportunity. This paper studies whether the development of the digital economy expands the income gap between urban and rural areas from theoretical and empirical. The research based on the panel data of 202 cities from 2011 to 2019 in China shows that: (1) Although the digital economy can promote the improvement of both urban and rural absolute income levels, it has a greater positive impact on urban residents' income levels than on rural residents', resulting in a widening of the urban-rural income gap. (2) The analysis of the action mechanism reveals that employment in the information service industry and the depth of digital finance use are two crucial mechanisms for the digital economy to widen the income gap between urban and rural areas. (3) The spatial Durbin model(SDM) and the spatial error model(SEM) based on three spatial weight matrices show that the impact of the digital economy on the urban-rural income gap is also characterized by spatial spillover, and the development of the digital economy will also have a negative impact on the urban-rural income gap in neighboring regions as well. (4) The main conclusions still hold after the robustness of quasi-natural experiments based on the strategy of "Broadband China" and the selection of historical data as instrumental variables. This research is helpful to understand the effects, mechanisms and spatial characteristics of digital economy on urban-rural income gap.