Homogeneidad y heterogeneidad en la escuela rural. An?lisis del contexto para determinar la incidencia que tiene el discurso pedag?gico en la poblaci?n estudiantil del programa escuela nueva de la instituci?n educativa t?cnica Gabriela Mistral sede Inali y el Quebrad?n sede La Conquista

110 P?ginasRecursos Electr?nicosHomogeneidad y heterogeneidad en la escuela rural, gira en torno a la incidencia del discurso pedag?gico a trav?s de las pol?ticas educativas en la homogenizaci?n estudiantil. Fomenta una educaci?n para la diversidad y plantea el problema de investigaci?n as?:?C?mo determinar y articular la incidencia del discurso pedag?gico, en la poblaci?n estudiantil del programa escuela nueva en la Instituci?n educativa T?cnica Gabriela Mistral sede Inali y el Quebrad?n sede ?la Conquista? para promover la producci?n escrita, favoreciendo as?, procesos de heterogeneidad? La poblaci?n objeto de estudio son estudiantes del modelo escuela nueva de dichas instituciones, ubicadas en los municipios de R?oblanco y Melgar respectivamente, en el Tolima. Presentan caracter?sticas espec?ficas que influyen en su formaci?n. Sus edades oscilan entre 7 y 13 a?os, reciben clases en jornada de la ma?ana. Pertenecen al estrato socioecon?mico uno. Viven en las veredas y alrededores de las escuelas. Est? cimentado en la Constituci?n Pol?tica Nacional, Ley general de educaci?n y ley 1404 (Escuela de Padres); est?ndares b?sicos de competencias en lenguaje, lineamientos curriculares y como soporte te?rico a Van Dijk, Vigotsky y Sidney S?nchez . Es una investigaci?n formativa, con enfoque cualitativo. Los instrumentos de recolecci?n de datos fueron: observaci?n directa, diario de campo y encuestas cerradas a padres y estudiantes. Ante el problema encontrado se plantearon tres etapas: pol?ticas educativas, Iguales o diferentes y As? me expreso yo. En ellas se desarrollaron estrategias obteniendo como resultado promoci?n de procesos de heterogeneidad desde la producci?n escrita.ABSTRACT. Homogeneity and heterogeneity in rural schools focuses on the influence of the pedagogical speech on the education policies targeting students? homogenization. Fostering education for diversity and suggest the research question as: How to determine and articulate the influence of the pedagogical speech in the student population targeted by the program ?escuela nueva? or new school at the Instituci?n educativa T?cnica Gabriela Mistral sede Inali y el Quebrad?n sede ?la Conquista? to promote writing production, favoring heterogeneous processes? The targeted populations for the present study are outstanding students of the ?nueva escuela? model from the aforementioned institutions, located in the municipalities of Rioblanco and Melgar, in Tolima. These students present specific characteristics that shape their performance. Their ages are between 7 and 13 years who receive classes in the morning. Most of the students belong to the socio-economic strata 1. They live in rural area surrounding the schools. This is based on the Constitution, the General Education Law 1404 (Parents school); Basic standards for language competencies, curricular guidelines and technical support from Van Dijk, Vigotsky, and Sidney S?nchez. This is a formative research, with a qualitative focus. The data collection instruments were: in-situ observation, field diaries, closed surveys to parents and students. Based on the problem identified, three stages were proposed: educational policies, Equal o Different and This is how I express myself. On each stage, strategies were developed. The result was the promotion of heterogeneity process in the writing production.INTRODUCCI?N 16 1. PROBLEMA 19 1.1 DESCRIPCI?N DEL PROBLEMA 19 1.2 PLANTEAMIENTO DEL PROBLEMA 21 1.3 FORMULACI?N DEL PROBLEMA 22 2. JUSTIFICACI?N 24 3. OBJETIVOS 27 3.1 OBJETIVO GENERAL 27 3.2 OBJETIVOS ESPEC?FICOS 27 4. MARCO REFERENCIAL 28 4.1 ANTECEDENTES 28 4.2 MARCO LEGAL 30 4.3 MARCO EPISTEMOL?GICO 31 4.4 MARCO PSICOL?GICO 44 4.5 MARCO PEDAG?GICO 45 4.6 MARCO CONCEPTUAL 46 5. METODOLOG?A 48 5.1 TIPO DE INVESTIGACI?N 48 5.2 PAR?METROS DE LA INVESTIGACI?N 49 5.3 PROCEDIMIENTOS PARA LA EJECUCI?N DEL PROCESO DE INVESTIGACI?N 58 6. AN?LISIS DE LOS RESULTADOS 64 7. CONCLUSIONES 75 8. RECOMENDACIONES 76 REFERENCIAS 77 ANEXOS 8

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research