9 research outputs found

    Estrategias pedagógicas para contribuir al desarrollo de cultura ambiental en los estudiantes de grado sexto de la institución educativa santa cruz de lorica

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    La investigación se realizó con el propósito de contribuir al desarrollo de cultura ambiental en los niños de la Institución Educativa Santa Cruz de Lorica, debido al comportamiento de éstos en el ámbito escolar, social y ambiental, una de las formas para determinar la situación presentada fueron observaciones directas al entorno del plantel, del mismo modo se realizaron encuestas y posteriormente se elaboró un diagnóstico, esto se efectuó tomando una muestra de la población total como método de análisis. La investigación fue cualitativa y en tipo de diseño de investigación utilizado fue investigación-acción, lo que permitió encontrar vías apropiadas para seleccionar y aplicar las estrategias pedagógicas necesarias que lograron hacerle frente a la problemática encontrada, las cuales luego de su aplicación arrojaron resultados positivos como un mejor aprendizaje por parte de los estudiantes haciendo mejor relación de cómo llevar lo teórico a la práctica y así un mayor compromiso con respecto al cuidado del ambiente, demostrando que son un medio de enseñanza para despertar en los estudiantes el interés por cuidar el entorno escolar y el medio ambiente, de esta forma se aclararon conceptos, los cuales fueron incluidos por los estudiantes en sus esquemas de aprendizaje; logrando concluir de esta forma que las estrategias pedagógicas utilizadas de forma conjunta y con un mismo propósito causaron un impacto favorable en los estudiantes, estimulando en ellos la necesidad de cambiar sus actitudes en cuanto al cuidado del medio ambiente de su escuela o del lugar donde ellos se encuentren.Pregrad

    International Law Observatory: International Activity 2014

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    Este documento contiene en texto completo el articulo Observatorio de Derecho Internacional: actividad internacional 2014 publicado en ACDI - Anuario Colombiano de Derecho Internacional; Vol. 9 (2016): ACDI; 431-543;Annuaire Colombien de Droit International - ACDI; Vol. 9 (2016): ACDI; 431-543;Colombian Yearbook of International Law - CYIL; Vol. 9 (2016): ACDI; 431-543;2145-4493;2027-1131;10.12804/acdi9.1.201

    International Law Observatory: International Activity 2014

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    Este documento contiene en texto completo el articulo Observatorio de Derecho Internacional: actividad internacional 2014 publicado en ACDI - Anuario Colombiano de Derecho Internacional; Vol. 9 (2016): ACDI; 431-543;Annuaire Colombien de Droit International - ACDI; Vol. 9 (2016): ACDI; 431-543;Colombian Yearbook of International Law - CYIL; Vol. 9 (2016): ACDI; 431-543;2145-4493;2027-1131;10.12804/acdi9.1.201

    Mucopolysaccharidosis type iv: report of 5 cases of morquio syndrome

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    Mucopolysaccharidosis type IV or Morquio Syndrome, is a lysosomal deposit disease, of autosomal recessive inheritance with a similar incidence in men and women. The clinical picture is of variable expressiveness, its phenotype is characterized by skeletal dysplasia that includes neck and short trunk, short stature, keel thorax, kyphosis, scoliosis, genus valgus, flat foot, coxa valga, gait disorders, instability of the cervical spine and wedge or ovoid vertebrae. The treatment is symptomatic, with enzyme replacement. We present a series of 5 cases, the product of 2 couples, with a confirmed diagnosis of Mucopolysaccharidosis type IV, and different clinical presentation.Mucopolysaccharidosis type IV or Morquio Syndrome, is a lysosomal deposit disease, of autosomal recessive inheritance with a similar incidence in men and women. The clinical picture is of variable expressiveness, its phenotype is characterized by skeletal dysplasia that includes neck and short trunk, short stature, keel thorax, kyphosis, scoliosis, genus valgus, flat foot, coxa valga, gait disorders, instability of the cervical spine and wedge or ovoid vertebrae. The treatment is symptomatic, with enzyme replacement. We present a series of 5 cases, the product of 2 couples, with a confirmed diagnosis of Mucopolysaccharidosis type IV, and different clinical presentation

    Divulgación Científica No.4

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    En las instituciones encargadas de adelantar proyectos de investigación, como es el caso de la universidad, debemos reflexionar sobre lo que hacemos y sus implicaciones, de tal forma que encontremos claves para propiciar, desde nuestros saberes, agentes dinamizadores que animen la discusión, el debate y la comparación. Lo anterior con el enfoque de proponer caminos y soluciones para problemas actuales que nos aquejan como individuos. Las distintas búsquedas que hacemos apuntan a contribuir a la construcción de mejores sociedades, y la investigación es una valiosa herramienta con a que contamos para lograrlo. Es necesario entender la investigación como un agente que permite y propicia cambios.In the institutions in charge of carrying out research projects, such as the university, we must reflect on what we do and its implications, in such a way that we find keys to promote, from our knowledge, dynamic agents that encourage discussion, debate and the comparison. The above with the focus of proposing paths and solutions for current problems that afflict us as individuals. The different searches that we do aim to contribute to the construction of better societies, and research is a valuable tool that we have to achieve it. It is necessary to understand research as an agent that allows and promotes changes

    Divulgación Científica No.4

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    En las instituciones encargadas de adelantar proyectos de investigación, como es el caso de la universidad, debemos reflexionar sobre lo que hacemos y sus implicaciones, de tal forma que encontremos claves para propiciar, desde nuestros saberes, agentes dinamizadores que animen la discusión, el debate y la comparación. Lo anterior con el enfoque de proponer caminos y soluciones para problemas actuales que nos aquejan como individuos. Las distintas búsquedas que hacemos apuntan a contribuir a la construcción de mejores sociedades, y la investigación es una valiosa herramienta con a que contamos para lograrlo. Es necesario entender la investigación como un agente que permite y propicia cambios.In the institutions in charge of carrying out research projects, such as the university, we must reflect on what we do and its implications, in such a way that we find keys to promote, from our knowledge, dynamic agents that encourage discussion, debate and the comparison. The above with the focus of proposing paths and solutions for current problems that afflict us as individuals. The different searches that we do aim to contribute to the construction of better societies, and research is a valuable tool that we have to achieve it. It is necessary to understand research as an agent that allows and promotes changes

    Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

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    © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

    Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

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    © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research
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