3 research outputs found
Origami: una técnica lúdica y accesible para la enseñanza de poliedros
El objetivo de esta muestra es presentar algunos poliedros y un conjunto de mĂłdulos de papel que permiten, bajo la tĂ©cnica de origami, involucrar a los estudiantes en actividades dinámicas y participativas que posibilitan el análisis de propiedades geomĂ©tricas, la construcciĂłn de conjeturas e incluso la elaboraciĂłn de pruebas visuales. La tĂ©cnica de origami ofrece a los docentes una oportunidad de generar, con recursos de bajo costo, un ambiente lĂşdico para la enseñanza de la geometrĂa tridimensional. Al mismo tiempo, favorece la observaciĂłn, intuiciĂłn espacial y la creatividad. Los materiales didácticos de la muestra se dividen en: Cuerpos construidos: se exhiben cuerpos geomĂ©tricos cĂłncavos y convexos confeccionados algunos con la tĂ©cnica de origami modular y otros con cartapesta. La manipulaciĂłn de esta muestra permitirá identificar la propiedad de convexidad en algunos poliedros y otras caracterĂsticas de los mismos. Cuerpos por construir: conjunto de piezas básicas de papel llamadas mĂłdulos. Se propone a los estudiantes confeccionar poliedros regulares mediante ensamblaje de estos mĂłdulos de papel, con la tĂ©cnica de origami modular. Tal consigna tiene la finalidad de descubrir que sĂłlo es posible armar cinco poliedros regulares
El origami como recurso didáctico de la enseñanza de la geometrĂa con poliedros: una propuesta didática
En este trabajo, presentaremos una propuesta didáctica para la enseñanza de contenidos de geometrĂa tridimensional con actividades que involucran el uso del origami. En particular, la propuesta estará centrada en favorecer el aprendizaje de conceptos relacionados con los poliedros regulares. La versatilidad del tema para ser trabajado desde lo matemático, lo artĂstico y lo histĂłrico, motivĂł su selecciĂłn, y en esta propuesta intenta explotar tales caracterĂsticas El origami modular consiste en hacer figuras utilizando varios papeles que darán lugar a piezas individuales denominadas mĂłdulos. Cada mĂłdulo posee solapas y bolsillos que se usan para ensamblarlos entre sĂ. Los beneficios y cualidades del origami son varios, entre ellos, podemos citar el de motivar al estudiante a ser creativo, ya que le permite desarrollar sus propios modelos e investigar la conexiĂłn que tiene con la geometrĂa plana y espacial. La secuencia de actividades planteada busca favorecer la exploraciĂłn y manipulaciĂłn de poliedros como asĂ tambiĂ©n la elaboraciĂłn de conjeturas sobre por quĂ© son sĂłlo cinco los poliedros regulares y su justificaciĂłn mediante pruebas y argumentos visuales que emergen de dicha manipulaciĂłn. Se presentarán posibles intervenciones del docente y de los estudiantes de nivel secundario para los cuales fue elaborada la secuencia
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030