Mejora del proceso administrativo en la motivación de los alumnos de la I.E 80528 José Néstor Esquivel Nuñez – JEC – de Santiago de Chuco

El presente trabajo de suficiencia profesional tiene como objetivo mejora del proceso administrativo en la motivación de los alumnos de la I.E. 80528 “José Néstor Esquivel Núñez”- JEC de Santiago de Chuco, se aplicó la muestra conformada por 149 alumnos del nivel secundario para conocer el nivel de motivación del alumnado del nivel secundaria, los cuales participaron de una encuesta realizada donde se obtuvo diferencias significativas en el trabajo del proceso administrativo, además se utilizó una metodología cualitativa. Los pasos del proceso administrativo son: la planificación, organización, dirección y control cuyos resultados fueron una serie de medidas correctivas y resultados favorables en la motivación, concientización a los participantes en las asistencias constantes y conductas inadecuadas, concluyendo que conocer las jerarquías en la institución y sus funciones de acuerdo a sus perfiles de cada integrante de la comunidad educativa mejora el proceso motivacional en los estudiantes. Finalmente el trabajo de suficiencia profesional realizado fue para dar solución e importancia a la implementación de un adecuado proceso administrativo el cual tuvo un efecto positivo en la gestión educativa

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia, Ciudad Bogotá, Departamento Cundinamarca, Municipio Mosquera

Colombia ha sido un país muy golpeado por la violencia desde hace más de 50 años por varios grupos armados que durante el desarrollo de sus actividades han tenido practicas violentas y han dejado muchas víctimas. Desde el análisis y la narración de sus vivencias se busca ampliar conocimientos respecto a las habilidades y significados correspondientes, mediante el relato y reconocimiento de su historia personal, esto siendo importante para una persona que ha tenido experiencias traumáticas, así lo indica White (2016) “dando prioridad a un nuevo desarrollo y una revigorización del sentido de sí mismo”. De acuerdo con la narración de la comisión de la verdad video de Shimaia, y El Tiempo Casa Editorial (2020) Masacre en El Salado, se pretende desde el rol del psicólogo identificar impactos psicosociales traumáticos, además de hacer un análisis reflexivo identificando emergentes psicosociales, recursos de afrontamiento y elementos resilientes y simbólicos identificando su posicionamiento como víctima o sobreviviente. Posteriormente para el caso Shimaia, se plantean una serie de preguntas (circulares, reflexivas y estratégicas) para un acercamiento psicosocial y en la masacre de El Salado, se da un abordaje por medio de acciones y estrategias que están enfocadas al mejoramiento de la calidad de vida y el fortalecimiento de habilidades de las víctimas del conflicto armado desde un enfoque de empoderamiento donde se pretende que las victimas puedan controlar las circunstancias y alcancen sus objetivos Powell (1990). A este documento se anexa la experiencia realizada en el paso 3.Colombia has been a country hard hit by violence for more than 50 years by various armed groups that during the course of their activities have engaged in violent practices and have left many victims. From the analysis and narration of their experiences, the aim is to expand knowledge regarding the corresponding skills and meanings, through the story and recognition of their personal history, this being important for a person who has had traumatic experiences, as indicated by White (2016). “giving priority to a new development and a reinvigoration of the sense of self”. According to the narration of the video truth commission of Shimaia, and El Tiempo Casa Editorial (2020) Massacre in El Salado, it is intended from the role of the psychologist to identify traumatic psychosocial impacts, in addition to making a reflective analysis identifying emerging psychosocial, coping resources and resilient and symbolic elements identifying their position as a victim or survivor. Subsequently, for the Shimaia case, a series of questions (circular, reflective and strategic) are posed for a psychosocial approach and in the El Salado massacre, an approach is given through actions and strategies that are focused on improving the quality of life and the strengthening of the abilities of the victims of the armed conflict from an empowerment approach where it is intended that the victims can control the circumstances and achieve their objectives Powell, (1990). The experience carried out in step 3 is attached to this document

Evaluación del estado nutricional de niños en edad escolar de dos localidades indígenas de Oaxaca

Introducción: La malnutrición es un problema grave en la edad escolar y se polariza en excesos o carencias que pueden perjudicar física, psicológica y fisiológicamente la salud de los niños a corto y largo plazo. Objetivo: Conocer el estado nutricional de escolares de dos localidades indígenas de Oaxaca. Método: Se realizó un estudio transversal observacional en 120 niños escolares de 6 a 12 años de las localidades de Progreso Guevea y Xadani Guevea de Humboldt, Oaxaca. Se obtuvo el peso y la talla. El estado nutricio se determinó a través del puntaje z del IMC para la edad y talla para la edad en STATA V. 14. El análisis de los datos se realizó por medio de frecuencias, porcentajes, diferencias de medias y pruebas de Chi-cuadrada,T de Student y U deMann-Whitney en SPSS V. 24. Resultados: De los 120 niños analizados se obtuvo una prevalencia de sobrepeso y obesidad de 15% y de desnutrición de 16.7%. Se encontraron diferencias significativas de desnutrición entre localidades (p=0.02) y entre alumnos de menor y mayor grado (p=0.00). Se observó mayor proporción de niñas con obesidad. Conclusiones: La doble carga de desnutrición, sobrepeso y obesidad sigue permeando diferentes zonas indígenas del país mostrándose en similitud de proporciones, considerándose aún un problema de salud pública mundial

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

TI - Introducción al Diseño Arquitectónico - AR305 - 202102

Descripción: El TI - Introducción al diseño arquitectónico es un curso de especialidad en la carrera. Busca que el estudiante se familiarice con la composición arquitectónica mediante la intuición y la plástica. Este es el primero de los diez cursos de talleres de diseño arquitectónico, que constituyen la columna vertebral de la carrera de Arquitectura. En este taller, el estudiante adquiere los fundamentos para el ejercicio de proyectar a través de ejercicios de composición tridimensionales con elementos tales como; punto, línea, plano y volumen como insumo para descubrimiento de. las posibilidades que ofrecen las propiedades de adición, sustracción, repetición, transformación, así como conceptos para el logro de volúmenes armados y excavados. En base a esta experiencia, que ocupa por lo menos la mitad del periodo, se hacen los primeros diseños de espacios (con criterios funcionales muy básicos) en los que se trabaja con escaleras, relaciones espaciales y las nociones de ingresar y circular entre otras estrategias de conexión con la realidad. En el curso TI - Introducción al diseño arquitectónico los contextos pueden ser teóricos, virtuales o conceptuales, la escala es un factor relativo a la composición la creación de espacios para personas y la función forma parte de las reglas de juego de cada ejercicio. Propósito: El curso TI - Introducción al diseño arquitectónico ha sido diseñado con el propósito de permitir al futuro arquitecto desarrollar las competencias iniciales de composición, a través del uso del lenguaje arquitectónico, sistemas ordenadores y resolución de encargos básicos de arquitectura. El curso contribuye a desarrollar la competencia general Pensamiento Innovador y la competencia específica Diseño fundamentado (que corresponde a los criterios NAAB: PC2, PC5 y SC5) ambas en Nivel 1. Sus prerrequisitos son MA95 Nivelación de Física o haber aprobado la prueba de definición de niveles de Física, MA392 Nivelación de Matemática o haber aprobado la prueba de definición de niveles de Matemáticas y AR206 Taller de Aptitud Vocacional para Arquitectura

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this

Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis

Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P&lt;0.001), which persisted after risk adjustment in a mixed-effects model (adjusted odds ratio: 0.73, 95% confidence interval 0.63-0.84, P&lt;0.001). This association was consistent across sensitivity and subgroup analyses, including a propensity-score matched model. In nine eligible non-randomised studies identified, a pooled mean of 64% of patients underwent telemedicine follow-up. Upon meta-analysis, the SSI rate reported was lower with telemedicine (odds ratio: 0.67, 0.47-0.94) than in-person (reference) follow-up (I2=0.45, P=0.12), although there a high risk of bias in included studies. Conclusions: Use of telemedicine to assess the surgical wound post-discharge is feasible, but risks underreporting of SSI. Standardised tools for remote assessment of SSI must be evaluated and adopted as telemedicine is upscaled globally