Perspectives on Communication Technology Use for Alleviating the Impact of COVID-19 on Hospitalized Patients' Well-Being and Transitions in Care.

BACKGROUND: The COVID-19 pandemic created many challenges for in-patient care including patient isolation and limitations on hospital visitation. Although communication technology, such as video calling or texting, can reduce social isolation, there are challenges for implementation, particularly for older adults. OBJECTIVE/METHODS: This study used a mixed methodology to understand the challenges faced by in-patients and to explore the perspectives of patients, family members, and health care providers (HCPs) regarding the use of communication technology. Surveys and focus groups were used. FINDINGS: Patients who had access to communication technology perceived the COVID-19 pandemic to have more adverse impact on their well-beings but less on hospitalization outcomes, compared to those without. Most HCPs perceived that technology could improve programs offered, connectedness of patients to others, and access to transitions of care supports. Focus groups highlighted challenges with technology infrastructure in hospitals. DISCUSSION: Our study findings may assist efforts in appropriately adopting communication technology to improve the quality of in-patient and transition care.

The Aging Care 5Ms Competencies: A Modified Delphi Study to Revise Medical Student Competencies for the Care of Older Adults.

PURPOSE: To revise the 2009 Canadian Geriatrics Society (CGS) Core Competencies in the Care of Older Persons for Canadian Medical Students by applying current frameworks and using a modified Delphi process. METHOD: The working group chose the Geriatric 5Ms model and CanMEDS framework to develop and structure the competencies. National (i.e., Canadian) Delphi participants were recruited, and 3 Delphi survey rounds were conducted from 2019 to 2021. Each survey round collected quantitative data using a 7-point Likert scale (LS) and qualitative data using free-text comments. The purpose of the first round was to establish the importance of the components of the proposed competencies (categorized into 13 subsections) and identify additional themes. The second round assessed agreement with 31 proposed competencies organized into 7 themes: aging, caring for older adults, mind, mobility, medications, multicomplexity, and matters the most. The third survey-rated agreement levels after further revisions to the competencies were applied. The final 33 competencies were shared with survey participants for feedback and other stakeholders for external validation. RESULTS: Mean LSs for the importance of the 13 competency component subsections on the first survey varied from 5.11 to 6.54, with an agreement level of 73%-93%. New themes emerged from the qualitative comments. Mean LSs for the 31 competencies on the second survey ranged from 5.57 to 6.81, with an agreement level of 80%-97%. Mean LSs for the revised competencies on the third survey ranged from 5.83 to 6.65, with an agreement level of 83%-95%. CONCLUSIONS: The authors developed the 33 Aging Care 5Ms Competencies for Canadian medical students using a consensus process. The competencies fulfill an important need in medical education, and ultimately, society. The authors strongly believe that the competencies can be woven into existing undergraduate medical curricula through purposeful integration and collaboration, including with other specialties.

Cell growth and detachment from protein-coated PNIPAAm-based copolymers.

The cultivation of cells requires the use of unfavorable proteolytic enzymes, which cause cell-surface modification and also need considerable optimization. Recently, with the development of smart polymers, research has looked to using thermoresponsive polymers as cell culture substrates. These novel surfaces allow the cultivation of cells without using enzymes by utilizing the thermoresponsive phase transition property of poly(N-isopropylacrylamide) (PNIPAAm). Copolymers of PNIPAAm and N-tert-butyl-acrylamide (NtBAm) with varying ratios were synthesized and solvent cast. The copolymer films are coated with cell adhesion promoters such as collagen, poly-L-lysine, and laminin to increase their cell adhesion and growth properties. Cell activity measured by the alamarBlue and PicoGreen assays is similar for coated copolymer films and standard tissue culture plastic controls. Deposition of cell adhesion promoters onto the copolymer films was characterized by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Cell detachment from the copolymer films is dependent on copolymer composition and is not affected by the surface coatings of extracellular matrix (ECM) proteins. The results demonstrate a versatile method for the cultivation of cells while eliminating the need for the use of digestive enzymes such as trypsin.

Intact endothelial cell sheet harvesting from thermoresponsive surfaces coated with cell adhesion promoters.

Recently, with the development of smart polymers, research has looked to using thermoresponsive polymers as cell culture substrates. These novel surfaces allow the cultivation of cells without enzymes using the thermoresponsive phase transition property of poly(N-isopropylacrylamide) (PNIPAAm). However, this requires expensive techniques to generate a sufficiently thin film that allows cell adhesion. In this study, we looked at simple solvent cast films which normally show poor cell adhesion, but here the films are coated with cell adhesion promoters (CAPs) to improve cell growth without altering the copolymer thermoresponsive behaviour.A copolymer of PNIPAAm and N-tert-butylacrylamide (NtBAm) with a ratio of 85:15, respectively, was synthesized and solvent cast. The copolymer films were coated with CAPs, such as collagen, fibronectin and laminin, to increase their cell adhesion and growth properties. Cell activity measured by the alamarBlue assay showed similar results for coated copolymer films and standard tissue culture plastic controls. Deposition of CAPs on to the copolymer films was characterized by scanning electron microscopy and atomic force microscopy. Cell detachment from the copolymer films is not affected by the surface coatings of CAPs, and endothelial cells are recovered as an intact sheet, which has great potential for uses in tissue engineering applications. The results demonstrate a versatile method for the cultivation of cells while eliminating the need for the use of digestive enzymes such as trypsin. This study shows that cultivation on physically bonded PNIPAAm copolymers is viable and achievable by relatively simple methods.

Manifestaciones oftalmológicas compatibles con el síndrome de Waardenburg / Ophthalmological manifestations compatible with Waardenburg syndrome

RESUMEN El síndrome de Waardenburg es una enfermedad genética, con criterios diagnósticos como la distopia cantorum, las anomalías pigmentarias del iris, el hipertelorismo y la conjunción de las cejas. Se presentan dos casos de una misma familia quienes asistieron a la consulta de Oftalmología con manifestaciones compatibles con el síndrome de Waardenburg. Paciente de 12 años con asociación típica que inclu ye conjunción de las cejas, alteraciones en la pigmentación del iris (iris azul zafiro) y distopia cantorum, a los que se le une el antecedente de hipoacusia. Su madre, paciente de 37 años de edad, quien presenta la asociación típica, inclu ye alteraciones en la pigmentación del cabello (mechón de canas) y del iris (iris azul zafiro), distopia cantorum y antecedente de hipoacusia. El propósito de este estudio fue dar a conocer dos casos de la misma familia con una entidad infrecuente en la especialidad. No obstante, se pueden encontrar manifestaciones oftalmológicas que son compatibles con su diagnóstico, por lo que es elemental dirigir nuestra acción hacia una aten ción en forma interdisciplinaria y una remisión oportuna(AU)

ABSTRACT Waardenburg syndrome is a genetic disorder with diagnostic criteria such as dystopia canthorum, iris pigmentary abnormalities, hypertelorism and synophrys. A case is presented of two members of the same family who attend the ophthalmology service for manifestations compatible with Waardenburg syndrome. The two patients are a 12-year-old girl with a typical association, which includes synophrys, iris pigmentary alterations (brilliant blue iris) and dystopia canthorum, as well as a history of hypoacusis, and her 37-year-old mother, who presents the typical association, which includes alterations in the pigmentation of her hair (a forelock of white hair) and iris (brilliant blue iris), dystopia canthorum and a history of hypoacusis. The purpose of the study is to present two cases from the same family with a condition which is infrequent in the specialty. However, ophthalmological manifestations may be found which are compatible with its diagnosis, which should obviously enough lead to actions aimed at interdisciplinary care and timely referral(AU)

Síndrome de ojo seco / Dry eye syndrome

Se realizó una revisión bibliográfica sobre el síndrome de ojo seco, que abarcó su clasificación, diagnóstico y tratamiento. Se tuvo en cuenta que constituye una entidad frecuente en la Oftalmología; se presenta con la finalidad de mostrar el síndrome de manera actualizada y con el objetivo de facilitar su manejo.

A bibliographic review of the dry eye syndrome that included its classification, diagnosis and treatment is made. Taking into account that it is a frequent entity in Ophthalmology, it is presented in order to provide an updating of the syndrome and to facilitate its management.