Presentación: Universidad y red, el flujo desde Iberoamérica

La mayor innovación que la universidad pueda esperar del mundo digital dependerá de una buena y ambiciosa idea educativa. Esta puede ser la idea más general que se puede obtener de los cinco trabajos que constituyen este monográfico dedicado a la “Universidad red desde Iberoamérica”, volumen 5, número 2, 2016 de la Revista EDMETIC que tengo el placer de presentar

Revisión de la producción científica sobre WebQuest en los últimos 20 años: análisis bibliométrico en Scopus y Web of Science

Tras la primera formulación en 1995 sobre qué es una Web Quest ¿cuál es el estado de su desarrollo en el campo de la educación? Esta pregunta exige muchas miradas y respuestas. Este trabajo busca ser parte de esta evaluación poniendo en evidencia el desarrollo de la producción científica sobre WebQuest en las dos principales bases de datos científicas: WOS (Web of Science) y Scopus desde su formulación hasta la actualidad (1995-2014). El método es el análisis bibliométrico en base a las siguientes variables: número de artículos publicados, número de citas recibidas, principales revistas citantes, promedio de citas por año, nombre y país de los autores más citados y palabras clave. Se ha procedido a la identificación del perfil y las características de las publicaciones científicas que lo tratan, sobre la conclusión de una evidente dispersión y atomización de resultados, destacando la existencia de una significativa comunidad científica sobre Webquest en España.

LA INTERACCIÓN COOPERATIVA ASÍNCRONA EN LA FORMACIÓN VIRTUAL

The main objective of this research is to deepen our understanding of the concept of cooperative interaction under conditions of asynchronous mediation in virtual learning. The study starts with the basic assumption that technology is not a neutral component in an interaction (Person–Machine–Person). It follows; therefore, that a change in the way of perceiving interaction may be created by the way manoeuvrability is facilitated via the internet and the framework of virtuality. The research methodology examines the cooperative asynchronous interaction as two different but complementary processes. The initial, theoretical exploration is designed to understand the psychological, pedagogical and technological factors under which cooperation in virtual learning is generated. The subsequent, empirical exploration is designed to observe –via a triangulation of the data– how the cooperative interaction in learning groups using discussion boards to communicate in an asynchronous way, may be built into a university-level virtual learning experience.El objetivo general de esta investigación consiste en profundizar en el conocimiento de la interacción cooperativa bajo condiciones de mediación asíncrona en la formación virtual. Para abordar este estudio se parte del supuesto que sugiere que la tecnología no es un componente neutro en la interacción (Persona-Máquina- Persona), ya que al orientar una forma concreta de maniobrabilidad sustentada en y a través de Internet, reencuadraría también la percepción de los que interactúan dentro de los márgenes de la virtualidad. La metodología de investigación examina el único objeto de estudio, la interacción cooperativa asíncrona, a partir de dos procesos específicos pero complementarios entre sí. Inicialmente, la exploración teórica busca comprender los condicionantes psicológicos, pedagógicos y tecnológicos bajo los cuales se generaría la cooperación en la formación virtual. La exploración empírica, posterior a la teórica, busca observar –desde la triangulación de datos- cómo se entreteje la interacción cooperativa en equipos de aprendizaje mediada bajo una forma asíncrona escrita a través de los foros de discusión en una experiencia de formación virtual universitaria

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

© 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

© 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