La mediación de la lectura del libro-álbum para el potenciamiento del lenguaje oral en niños de Jardín

253 páginasLa lectura literaria es una actividad que favorece el desarrollo cognitivo, afectivo y social de los niños, especialmente cuando se realiza con una adecuada mediación por parte del docente o el adulto. La riqueza visual y narrativa de los libros-álbum los convierte en un instrumento poderoso para fomentar la imaginación, la creatividad y la expresión verbal. Las ilustraciones atractivas, las historias cautivadoras y la posibilidad de interactuar con el libro de diferentes maneras permiten a los niños explorar diversos mundos, personajes y emociones, ampliando su vocabulario y desarrollando su capacidad para expresarse de forma oral. Sin embargo, ¿cuál es el impacto de la mediación lectora a través del libro-álbum en el desarrollo del lenguaje oral en niños pertenecientes al nivel de jardín? Esta es la pregunta que orienta el presente Trabajo Final de Maestría (TFM), cuya intención es comprender la relación que existe entre la mediación de lectura literaria del libro-álbum y el potenciamiento del desarrollo del lenguaje oral de los niños y las niñas de jardín de la IED Nueva Delhi a partir del diseño e implementación de una propuesta pedagógica para tal fin.Maestría en Desarrollo InfantilMagíster en Desarrollo Infanti

La literatura en la educación inicial y el desarrollo del lenguaje oral: Una propuesta pedagógica dirigida a niños de nivel jardín de la I.E.D. Débora Arango Pérez

319 páginasEl presente trabajo de investigación tiene como propósito potenciar el desarrollo del lenguaje oral de los niños de 4 y 5 años de educación inicial, basados en el disfrute de la mediación de la lectura literatura infantil. Esta propuesta pedagógica surge ante la necesidad de fortalecer las competencias comunicativas de los niños del grado jardín, que se han visto influenciados por el uso frecuente de las pantallas, la falta de estimulación y el contexto de la pandemia. El estudio se basa en los siguientes ejes conceptuales: DESARROLLO DE LA ORALIDAD INFANTIL, RELACIÓN ENTRE LITERATURA INFANTIL Y ESTRATEGIAS DE MEDIACIÓN EN LA EDUCACIÓN INICIAL.Maestría en Desarrollo InfantilMagíster en Desarrollo Infanti

Microencapsulation of fat-removing Lactobacillales and polyphenols from Theobroma cacao L. as a combined strategy for intestinal removal of free fatty acids evaluated by simulated in vitro digestion

Cocoa polyphenols and Lactobacillales have shown promising effects in mitigating the adverse health effects associated with high-fat diets by removing free fatty acids from the gastrointestinal tract. However, the successful incorporation of these bioactive agents into functional foods requires a protective mechanism capable of withstanding the challenging conditions encountered during processing, storage, and gastrointestinal transit. This study explores the microencapsulation parameters of fat-removing Lactobacillales strains, previously isolated from human intestinal microbiota, and cocoa polyphenols, and their performance during simulated digestion. The findings revealed that microencapsulated Lactobacillus sp. A1, the strain with the best encapsulation results, effectively removed fatty acids from the simulated intestinal fluid during in vitro digestion, and the presence of cocoa polyphenols had no detrimental impact on their fatty acid removal capacity. These results hold promise for the potential development of innovative functional foods for the prevention of health conditions associated with excessive consumption of fatty acids. © 2024 The Author(s

Differences in Exercise Capacity, Ventilatory Efficiency, and Gas Exchange between Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension Residing at High Altitude

Background: Cardiopulmonary exercise testing (CPET) assesses exercise capacity and causes of exercise limitation in patients with pulmonary hypertension (PH). At altitude, changes occur in the ventilatory pattern and a decrease in arterial oxygen pressure in healthy; these changes are increased in patients with cardiopulmonary disease. Our objective was to compare the response to exercise and gas exchange between patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) residing at the altitude of Bogotá (2640 m). Methods: All patients performed an incremental CPET with measurement of oxygen consumption (VO2), dead space (VD/VT), ventilatory equivalents (VE/VCO2), and alveolar–arterial oxygen gradient (PA-aO2). X2 test and one-way analysis of variance were used for comparisons between PAH and CTEPH. Results: We included 53 patients, 29 with PAH, 24 with CTEPH, and 102 controls as a reference of the normal response to exercise at altitude. CTEPH patients had a higher New York Health Association (NYHA) functional class than PAH (p = 0.037). There were no differences between patients with PAH and CTEPH in hemodynamics and VO2% of predicted (67.8 ± 18.7 vs. 66.0 ± 19.8, p < 0.05), but those with CTEPH had higher dyspnea, VD/VT (0.36 ± 0.09 vs. 0.23 ± 0.9, p < 0.001), VE/VCO2 (45.8 ± 7.1 vs. 39.3 ± 5.6, p < 0.001), and PA-aO2 (19.9 ± 7.6 vs. 13.5 ± 7.6, p < 0.001) than PAH patients. Conclusions: At altitude, patients with PH present severe alterations in gas exchange during exercise. There were no differences in exercise capacity between PAH and CTEPH, but patients with CTEPH had more dyspnea and greater alterations in gas exchange during exercise. CPET made it possible to identify alterations related to the pathophysiology of CTEPH that could explain the functional class and dyspnea in these patients. Copyright: © 2024 The Author(s)

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Accessibility to palliative care services in Colombia: an analysis of geographic disparities

Objectives: Due to the increase in the prevalence of non-communicable diseases and the Colombian demographic transition, the necessity of palliative care has arisen. This study used accessibility and coverage indicators to measure the geographic barriers to palliative care. Methods: Population-based observational study focused on urban areas and adult population from Colombia, which uses three measurements of geographic accessibility to services: a) density of palliative care services per 100,000 inhabitants, b) analysis of geographic distribution by territorial nodes of the country, and c) spatial analysis of palliative care services using Voronoi diagrams. ArcGIS Pro software was used to map services’ locations and identify geographic disparities. Results: A total of 504 palliative care services were identified, of which 77% were primary health care services. The density of palliative care services in Colombia is 1.8 primary care services per 100,000 inhabitants and 0.4 specialized services per 100,000 inhabitants. The average palliative care coverage is 41%, two regions of the country have a coverage below 30%. Twenty-eight percent of the services provide care for a population greater than 50,000 inhabitants within their coverage area, exceeding the acceptable limit by international standards. Conclusions: Palliative care services are concentrated in three main regions (Bogotá D.C., the Center, and the Caribbean) and are limited in the Orinoquia and Amazonia nodes. Density of specialized palliative care services is extremely low and there are regions without palliative services for adults with palliative needs. © The Author(s) 2024

Implementación de estrategias socioemocionales para favorecer la convivencia escolar de los jóvenes del grado noveno de la Institución Educativa Cerveleón Padilla Lascarr

139 páginasIn my work as a teacher, this research is carried out in the area of ethics and values of the Cerveleón Padilla Lascarro Educational Institution of Chimichagua, cesar, concerned about the contribution of a healthy school climate, I have given myself the task of researching how to implement emotional strategies, to promote the school coexistence of 9th grade students. I began by making an initial diagnosis, in the classroom, observing the behavior of each student and their relationship with their classmates, trying to discover coexistence problems, all of this affected by a negative school climate.Como docente, la presente investigación se realiza en el área de ética y valores de la Institución Educativa Cerveleón Padilla Lascarro de Chimichangas, cesar, preocupada por la contribución de un clima escolar sano, me he dado la tarea de investigar sobre cómo implementar estrategias emocionales, para favorecer la convivencia escolar de los estudiantes del grado 9º. Comencé por realizar un diagnóstico inicial, en el salón de clases, observando, el comportamiento de cada estudiante y su relación con los compañeros, tratando descubrir problemas de convivencia, todo esto afectado por un clima escolar negativo.Maestría en Pedagogía e Investigación en el AulaMagíster en Pedagogía e Investigación en el Aul

Evaluando el ambiente de aprendizaje en medicina: validez y confiabilidad de Jhons Hopkins Learning Enviroment Scale en una población de estudiantes colombianos

6 páginasIntroducción: la disponibilidad de instrumentos para la medición del ambiente de aprendizaje en las escuelas de Medicina en español es limitada. El Dundy ready environment Educational Measure (DREEM) es el único disponible. El objetivo de este estudio fue determinar la validez del constructo y consistencia interna del instrumento Johns Hopkins Learning Environment Scale (JHLES) en español. Métodos: el instrumento JHLES fue traducido al español siguiendo las recomendaciones del proyecto IQola. Posteriormente, fue aplicado en una cohorte de 364 estudiantes de Medicina de tercero a séptimo año durante el ciclo de formación clínica. Sobre las respuestas obtenidas se realizó un análisis factorial exploratorio. La retención de factores fue determinada por los criterios de valor propio, así como el criterio de los investigadores. Finalmente se realizó un análisis factorial confirmatorio para la evaluación de los criterios de ajuste del modelo a los datos obtenidos.Especialización en Cirugía GeneralEspecialista en Cirugía Genera

Action Research Project para la apropiación y socialización del cambio, soportado en los principios fundacionales: caso Universidad de La Sabana

112 páginasDiscovering how a prestigious and institutionally accredited higher education institution, the University of La Sabana, reinvents itself while protecting and consolidating its foundational principles is quite important. This research reveals how the forces of change and accelerated evolution are reshaping the landscape of higher education, challenging institutions to embrace innovation while preserving their identity and core values. Through Puccio's Creative Problem Solving (CPS) methodology, two significant challenges are addressed: creative leadership and change management. The results are very interesting: empowered leaders who blend tradition with transformation and a culture of innovation rooted in foundational principles. This research offers creative solutions on how a university can adapt and thrive in a constantly changing world, maintaining its core values while embracing innovation and technological progress.Descubrir como una institución de educación superior de prestigio y acreditada institucionalmente, la Universidad de La Sabana, se reinventa mientras protege y consolida sus principios fundacionales, es bien importante. Esta investigación revela como las fuerzas del cambio y la evolución acelerada están modificando el panorama de la educación superior, desafiando a las instituciones a abrazar la innovación preservando su identidad y sus valores fundamentales. A través de la metodología de Solución Creativa de Problemas (CPS) de Puccio, se abordan dos desafíos importantes: el liderazgo creativo y la gestión del cambio. Los resultados son bien interesantes: lideres empoderados que fusionan la tradición con la transformación y una cultura de innovación arraigada en los principios fundacionales. Esta investigación ofrece soluciones creativas de cómo una universidad puede adaptarse y prosperar en un mundo en constante cambio, manteniendo firmes sus valores esenciales mientras adoptan la innovación y el progreso tecnológico.Maestría en Gerencia de la InnovaciónMagíster en Gerencia de la Innovació

Evaluation of post-surgical complications between “Rendez-vous” technique vs. standard care in patients with choledocholithiasis [Evaluación de complicaciones posquirúrgicas de la técnica «Rendez-vous» vs. el manejo estándar en pacientes con coledocolitiasis]

Background: “Rendez-vous” (RV) technique is a mixed-technique which uses both laparoscopic and endoscopic skills; however, the evidence is contradictory regarding the implementation of this technique or the 2-step sequential technique (endoscopic retrograde cholangiopancreatography [ERCP] followed by laparoscopic cholecystectomy [LC]) in the management of cholecysto-choledocholitiasis. Objective: To estimate the association between the implementation of RV technique and the presence of post-surgical complications as primary outcome, using as comparator the 2-step sequential technique. Method: An observational, analytical, retrospective study was conducted, using as exposed cohort the medical records from patients with a diagnosis of cholelithiasis, cholecystitis, or mild biliary pancreatitis. The exposed cohort underwent RV technique, while the unexposed cohort were those which underwent two step technique. Results: There was a lower post-surgical complication rate in the RV group (0%) compared with the 10.1% (p = 0.3617) in the control group. Also, RV technique showed a lesser hospitalization time (p = 0.0377) and a lesser post-surgical hospitalization time (p < 0.0001) Conclusions: RV technique is superior when compared with the 2-step sequential technique (ERCP followed by LC), based on a better surgical success rate, a fewer complications rate and less hospitalization time. © 2021 Academia Mexicana de Cirugía