Aportaciones innovadoras de la pedagogía al tratamiento del autismo.

El siguiente documento expone un proyecto de innovación que ofrece, desde mi punto de vista, nuevas alternativas pedagógicas . C oncretamente, este proyecto se enfoca en el CEE Hermano Pedro, ya que hay gran cantidad de alumnado que presenta el trastorno del espectro autista (TEA). Hay que destacar que este trabajo se ha enfocado hacia ese sector no solo por ser un trastorno muy com ún en nuestra sociedad sino , también, porque he tenido la oportunidad de realizar el prácticum en un centro destinado a la educación especial , lo cual, me ha permitido tener una visión más cercana sobre este trastorno y el tipo de metodología utilizada por el profesorado. Por tanto, el fin de este proyecto consiste en innovar realizando metodologías y actividades centradas en las necesidades de estos alumnos/as . Es decir, con este proyecto de innovación lo que se pretende es ofrecer actividades como guía, p ara llevarlas a cabo con todo tipo de alumnado que presente diferentes grados de autismo sin necesidad de adaptarlas a cada uno/a de ellos/as, sino que todos/as puedan realizarla sin ningún tipo de impedimento. Por consiguiente, este proyecto debería poner se en marcha pues, el autismo es importante tanto en nuestra sociedad como en el sistema educativoThe following document presents an innovation project that offers, from my point of view, new pedagogical alternatives. Specifically, this project focuses on the CEE Hermano Pedro, since there is a large number of students with autism spectrum disorder (ASD). It should be noted that this work has focused on this sector not only because it is a very common disorder in our society but also because I a lso had the opportunity to do the exercise in a center dedicated to special education, which has given me a vision closer to this disorder and the type of methodology used by the teaching staff. Therefore, the purpose of this project is to innovate by carr ying out activities and methodologies focused on the needs of these students. That is, with this innovation project, which means that it can be carried out as a guide, to carry out a type of work with all the students that present different degrees of auti sm without having to adapt them to each one of them. , but all / if you have to do it without any kind of impediment. Therefore, this project should be launched, autism is important both in our society and in the education syste

Eventos adversos de enfermería en el cuidado directo al paciente del área de medicina interna del Hospital Delfina Torres de Concha- Esmeraldas, 2016

Determinar los eventos adversos de enfermería en el cuidado directo al paciente que asiste al área de medicina interna del Hospital Delfina Torres de Concha- Esmeraldas, 2016.Cada día suceden eventos adversos en distintos lugares del mundo, tanto en países desarrollados como en países subdesarrollados afectando el mejoramiento de la calidad de atención en salud. La presente investigación tiene como objetivo determinar los eventos adversos de enfermería en el cuidado directo, nivel de cumplimiento de notificación y registro de evento adverso y el conocimiento de enfermería sobre seguridad. Siendo un estudio observacional, descriptivo con un enfoque cuantitativo, se aplica un check list y una encuesta a 20 profesionales de enfermería del servicio de medicina interna. Se pudo apreciar que el mayor porcentaje del personal de enfermería conoce sobre el manual de Seguridad del Paciente del MSP; más de la mitad del profesional de enfermería considera que es importante implementar una cultura institucional para el reporte de evento adverso; en un nivel medio el profesional de enfermería notifica y registra los eventos adversos, hecho comprobado mediante el check list, el cual permitió también definir que la flebitis, caídas, ulceras por presión son los eventos más frecuentes. La cultura de notificación y registro de evento adverso de los profesionales de enfermería en este servicio no es adecuada es necesario que se cumpla con la normativa, es aún un problema que la cultura institucional sobre seguridad del paciente este en un nivel medio ya que la estrategia clave para aprender de los errores y evitar su recurrencia es evidenciarlos

Dementia research in the Caribbean Hispanic islands: Present findings and future trends

During the last decade, the Caribbean Hispanic islands experienced accelerated demographic aging, representing the fastest aging region within Latin America. Age-related non-communicable diseases, including dementia, are now reported at high prevalence. The Caribbean islands share similar genetic ancestry, culture, migration patterns, and risk profiles, providing a unique setting to understand dementia in the Caribbean-Hispanics. This perspective article aimed to describe the impact of dementia in the Caribbean, at a local and regional level and reflect on research strategies to address dementia. We report on 10/66 project findings, described research projects and regional plans for the region. According to our results, the prevalence of dementia in the Caribbean is the highest in Latin America, with 11.7% in Dominican Republic, 11.6% in Puerto Rico, and 10.8% in Cuba. Preliminary data from new waves of the 10/66 study shows increasing numbers of dementia cases. Furthermore, dementia is expected to be one of the most serious medical and social issues confronted by Caribbean health systems. However, there is a scarcity of knowledge, awareness, and health services to deal with this public health crisis. In light of the new evidence, local and regional strategies are underway to better understand dementia trends for the region and develop policies aimed to decrease the impact of dementia. Implementation of our national plans is critical to deal with an aging population with high dementia rates. Current recommendations include emphasizing public health prevention campaigns to address modifiable risk factors and expand support to caregiver and family interventions

Exploring the natural history of intrinsic capacity impairments: Longitudinal patterns in the 10/66 study

BACKGROUND: intrinsic capacity (IC) is a construct encompassing people\u27s physical and mental abilities. There is an implicit link amongst IC domains: cognition, locomotion, nutrition, sensory and psychological. However, little is known about the integration of the domains. OBJECTIVES: to investigate patterns in the presentation and evolution of IC domain impairments in low-and-middle-income countries and if such patterns were associated with adverse outcomes. METHODS: secondary analyses of the first two waves of the 10/66 study (population-based surveys conducted in eight urban and four rural catchment areas in Cuba, Dominican Republic, Puerto Rico, Venezuela, Peru, Mexico and China). We applied latent transition analysis on IC to find latent statuses (latent clusters) of IC domain impairments. We evaluated the longitudinal association of the latent statuses with the risk of frailty, disability and mortality, and tested concurrent and predictive validity. RESULTS: amongst 14,923 participants included, the four latent statuses were: high IC (43%), low deterioration with impaired locomotion (17%), high deterioration without cognitive impairment (22%), and high deterioration with cognitive impairment (18%). A total of 61% of the participants worsened over time, 35% were stable, and 3% improved to a healthier status.Participants with deteriorated IC had a significantly higher risk of frailty, disability and dementia than people with high IC. There was strong concurrent and predictive validity. (Mortality Hazard Ratio = 4.60, 95%CI 4.16; 5.09; Harrel\u27s C = 0.73 (95%CI 0.72;0.74)). CONCLUSIONS: half of the study population had high IC at baseline, and most participants followed a worsening trend. Four qualitatively different IC statuses or statuses were characterised by low and high levels of deterioration associated with their risk of disability and frailty. Locomotion and cognition impairments showed other trends than psychological and nutrition domains across the latent statuses

Juntos y Saludables: Outcomes of a peer led approach to obesity prevention for Head Start

Purpose: The purpose of this study was to evaluate Juntos y Saludables (Get Healthy Together), a multi-component obesity prevention pilot tailored for Mexican American Head Start children (ages 3-5). For the parent education component, researchers trained seven peer parent educators to deliver health information via afterschool parent education sessions. When parents attended the sessions, they received a take-home bag with a book and family activity to promote physical activity in the home. Method: Parent intercept interviews, focus groups, and questionnaires were collected (average 80% participation rate). Results: Average participation rate at the parent education sessions was 46% and rates varied between 34% (61 parents) and 53% (94 parents). More parents in the intervention school reported that their child ate fruit at least 3 times (83.5% versus 79.17%), ate in front of the television less than three times (70.87% versus 49.38%) during the typical week and more parents reported that their child watched 2 hours or less of television each day (73.79% versus 13.19%), compared to the comparison school. 81% of parents interviewed correctly identified the program name. On average, parents could recall almost 3 (M=2.94, SD=1.92) of the 8 key messages without a prompt and about 6 (M=5.91, SD=1.88) when prompted. Messages recalled the most, without a prompt, included (1) preschoolers need 60 minutes of physical activity each day, and (2) children who get all five servings of fruits and vegetables each day are more likely to get the nutrients they need. In the focus group, parents reported that they enjoyed the peer-led session format and session scheduled time. Conclusion: Results suggest that peer-led approaches can be highly effective with parents, especially when addressing childhood obesity prevention

Lessons Learned from Juntos Y Saludables Peer-Led Parent Education

Purpose: The objective of this study was to assess the quality of training received by peer educators in the Juntos y Saludables (Get Healthy Together) program. Juntos y Saludables is a multi-component childhood obesity prevention program for Head Start. Method: This study applied the peer led education approach to provide parents with education regarding healthy growth among their children. Seven parents were recruited through teachers, other parents, and the Parent Leadership Institute at a local Head Start center. Faculty and graduate assistants from local universities provided training to the parent educators in both English and Spanish. Training sessions were conducted the week of each new parent education session, with one booster training after spring break (7 training sessions in total). The parent educators were trained to: (1) encourage the Head Start parents to participate in the sessions, (2) explain the health messages, and (3) answer any questions the parents had. A focus group was conducted at the end of the program, with all seven parent educators, to assess their feedback about the training they received. Results: The peer parent educators reported that they became educators to improve children’s health. They were satisfied with the training methods and felt that they learned a lot of information regarding nutrition and physical activity recommendations for their children. They also reported feeling comfortable delivering health information to other parents. Parent educators appreciated that they could work together (e.g., in bilingual pairs) to provide the health education to parents in both English and Spanish. The peer parent education training session attendance was high-71% and greater. Conclusions: Most peer parent educators felt comfortable and confident delivering the material as the program progressed. Earlier training might assist the parent educators to have greater familiarity with content prior to the first session. Educators also created strategies to deal with situations that arose during the sessions (e.g. crowd control, parents requesting extra bags). Future training can include suggested strategies to handle similar situations

Information and communication technologies (TIC) as a strategy to prevent environmental pollution

El uso de las Tecnologías de la Información y la Comunicación (TIC), se ha expandido a nivel mundial y por lo tanto se encuentra presente en cada una de los ámbitos en los que se desempeña el ser humano. Por tal motivo, se consideró la estrategia a emplear en este proyecto, con el objetivo de mitigar y prevenir la contaminación ambiental con ayuda de los estudiantes de la Institución Educativa Departamental (IED) San Martín de Porres y de la Comunidad de Fundación, Magdalena. La metodología utilizada fue un estudio cualitativo y descriptivo, utilizando el modelo de investigación acción-participativa entre estudiantes, la comunidad y los docentes. Para recoger los datos, se utilizaron relatorías individuales, institucionales y el diario de campo. Se evidenció durante el desarrollo del proyecto, una problemática de malas prácticas en los criaderos que se encuentran alrededor de la institución, lo cual ocasiona contaminación ambiental y daños en la salud de las personas.The use of Information and Communication Technologies (ICT) has expanded worldwide and therefore is present in each of the areas in which the human being performs. For this reason, they were considered as the strategy to be used in this project, with the aim of mitigating and preventing environmental contamination with the help of the IED students San Martín de Porres and the community of Fundación, Magdalena. The methodology used was a qualitative and descriptive study, using the action-participatory research model among students, community and teachers. In order to collect the data, individual, institutional and field diary reports were used. During the development of the project, a problem of bad practices was shown in the breeding sites that are located around the institution, which causes environmental contamination and damage to the health of the people

Prediction of dementia risk in low-income and middle-income countries (the 10/66 Study): an independent external validation of existing models

BackgroundTo date, dementia prediction models have been exclusively developed and tested in high-income countries (HICs). However, most people with dementia live in low-income and middle-income countries (LMICs), where dementia risk prediction research is almost non-existent and the ability of current models to predict dementia is unknown. This study investigated whether dementia prediction models developed in HICs are applicable to LMICs.MethodsData were from the 10/66 Study. Individuals aged 65 years or older and without dementia at baseline were selected from China, Cuba, the Dominican Republic, Mexico, Peru, Puerto Rico, and Venezuela. Dementia incidence was assessed over 3–5 years, with diagnosis according to the 10/66 Study diagnostic algorithm. Discrimination and calibration were tested for five models: the Cardiovascular Risk Factors, Aging and Dementia risk score (CAIDE); the Study on Aging, Cognition and Dementia (AgeCoDe) model; the Australian National University Alzheimer's Disease Risk Index (ANU-ADRI); the Brief Dementia Screening Indicator (BDSI); and the Rotterdam Study Basic Dementia Risk Model (BDRM). Models were tested with use of Cox regression. The discriminative accuracy of each model was assessed using Harrell's concordance (c)-statistic, with a value of 0·70 or higher considered to indicate acceptable discriminative ability. Calibration (model fit) was assessed statistically using the Grønnesby and Borgan test.Findings11 143 individuals without baseline dementia and with available follow-up data were included in the analysis. During follow-up (mean 3·8 years [SD 1·3]), 1069 people progressed to dementia across all sites (incidence rate 24·9 cases per 1000 person-years). Performance of the models varied. Across countries, the discriminative ability of the CAIDE (0·52≤c≤0·63) and AgeCoDe (0·57≤c≤0·74) models was poor. By contrast, the ANU-ADRI (0·66≤c≤0·78), BDSI (0·62≤c≤0·78), and BDRM (0·66≤c≤0·78) models showed similar levels of discriminative ability to those of the development cohorts. All models showed good calibration, especially at low and intermediate levels of predicted risk. The models validated best in Peru and poorest in the Dominican Republic and China.InterpretationNot all dementia prediction models developed in HICs can be simply extrapolated to LMICs. Further work defining what number and which combination of risk variables works best for predicting risk of dementia in LMICs is needed. However, models that transport well could be used immediately for dementia prevention research and targeted risk reduction in LMICs

Associations between education and dementia in the Caribbean and the United States: An international comparison

Introduction: Despite high dementia prevalence in Hispanic populations globally, especially Caribbean Hispanics, no study has comparatively examined the association between education and dementia among Hispanics living in the Caribbean Islands and older adults in the United States. Methods: We used data on 6107 respondents aged 65 and older in the baseline wave of the population-based and harmonized 10/66 survey from Cuba, the Dominican Republic, and Puerto Rico, collected between 2003 and 2008, and 11,032 respondents aged 65 and older from the U.S.-based Health and Retirement Study data in 2014, a total of 17,139 individuals. We estimated multivariable logistic regression models examining the association between education and dementia, adjusted for age, income, assets, and occupation. The models were estimated separately for the Caribbean population (pooled and by setting) and the U.S. population by race/ethnicity (Hispanic, Black, and White), followed by pooled models across all populations. Results: In the Caribbean population, the relative risk of dementia among low versus high educated adults was 1.45 for women (95% confidence interval [CI] 1.17, 1.74) and 1.92 (95% CI 1.35, 2.49) for men, smaller compared to those in the United States, especially among non-Hispanic Whites (women: 2.78, 95% CI 1.94, 3.61; men: 5.98, 95% CI 4.02, 7.95). Discussion: The differential associations between education and dementia across the Caribbean and US settings may be explained by greater disparities in social conditions in the United States compared to the Caribbean, such as access to health care, healthy behaviors, and social stressors, which serve as potentially important mediators

Neighbourhood environment and dementia in older people from high-, middle- and low-income countries: results from two population-based cohort studies

Abstract: Background: A growing number of studies have explored how features of the neighbourhood environment can be related to cognitive health in later life. Yet few have focused on low- and middle-income countries and compared the results across different settings. The aim of this study is to investigate the cross-sectional associations between neighbourhood amenities and dementia in older people from high-, middle- and low-income countries. Methods: This study was based on two population-based cohort studies of people aged≥65: the Cognitive Function and Ageing Study II (CFAS II) in UK (N = 4955) and a subset of the 10/66 study in China, Dominican Republic and Mexico (N = 3386). In both cohorts, dementia was assessed using the Geriatric Mental State−Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) algorithm. The 10/66 dementia diagnostic algorithm was also used as an additional criterion in the 10/66 study. Publicly accessible databases, Google Maps and Open Street Map, were used to obtain geographic information system data on distance to neighbourhood amenities, including lifestyle (cafés, libraries, movie theatres, parks), daily life (post offices, convenience stores), healthcare (hospitals, pharmacies) and percentages of local green and blue spaces within 400 and 800 m of participants’ residences. Multilevel logistic regression was used to investigate the associations between these environmental features and dementia adjusting for sociodemographic factors and self-rated health. Results: Living far from daily life amenities was associated with higher odds of dementia in both CFAS II (1.47; 95% CI: 0.96, 2.24) and the 10/66 study (1.53; 95% CI: 1.15, 2.04), while living far from lifestyle (1.50; 95% CI: 1.13, 1.99) and healthcare amenities (1.32; 95% CI: 0.93, 1.87) was associated with higher odds of dementia only in the 10/66 study. A high availability of local green and blue spaces was not associated with dementia in either cohort yet living far from public parks was associated with lower odds of dementia in CFAS II (0.64; 95% CI: 0.41, 1.00). Conclusions: The different relationships across cohorts may indicate a varying role for local amenities in diverse settings. Future research may investigate mechanisms related to these differences and social, cultural and historical influences on the interaction between neighbourhood amenities and older people