Aprendizajes de los maestros de Salamina Caldas sobre su quehacer en tiempos de pandemia

El trabajo investigativo que se presenta tuvo como objetivo comprender los aprendizajes de los maestros de Salamina sobre su quehacer en tiempos de pandemia. Es así como se recurrió a un enfoque de investigación cualitativo de tipo estudio de caso colectivo. Se aplicó un formulario electrónico de única pregunta abierta a 90 maestros de Salamina, Caldas de 4 instituciones educativas: 2 rurales y 2 urbanas. El análisis de la información se efectuó a partir  del método de análisis de material cualitativo. Los principales resultados encontrados evidencian la emergencia de 3 categorías: entrega-donación, reflexión práctica y actitudes de aprendizaje. Se concluye que el quehacer del maestro está marcado por las dinámicas sociales del momento. Es decir, en las circunstancias de emergencia sanitaria actuales los maestros de Salamina, a partir de la incertidumbre, tuvieron que adaptarse a las nuevas realidades problematizando elementos cotidianos como su oficio, sus prácticas, y sus habilidades

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Reputable ways of coexistence. Agroecological experiences for social transformation in Colombia

Este es el segundo libro de una trilogía dedicada a los procesos agroecológicos, al reconocimiento de la agricultura campesina familiar y comunitaria y a las formas dignas de coexistencia que desde allí se tejen en Colombia. Procura aportar desde un enfoque socio político una categoría social que enriquece de manera complementaria la invitación que la agroecología hace para entender los procesos ecosistémicos y la importancia de revalorizar los saberes y haceres de las comunidades locales para transformar su realidad. Gustavo Wilches-Chaux insiste en que este es un libro urgente en estos tiempos de grandes exigencias donde el cuidado mutuo se convierte en una prioridad y el llamado nos convoca a reexistir con dignidad y armonía. En esta ocasión la Cátedra Unesco en Desarrollo Sostenible presenta el trabajo articulado entre el Instituto de Estudios Ambientales IDEA de la Universidad Nacional y la Universidad del Rosario, el cual enaltece estas experiencias agroecológicas como estrategias ejemplarizantes de conectividad y transformación social en el país.This is the second book in a trilogy dedicated to agroecological processes and to the acknowledgment of family and communal peasant agriculture based on which reputable forms of coexistence are created in Colombia. It seeks to propose, from a socio-political perspective, a social category that is complementary to the invitation made by agroecology to understand ecosystem processes and the importance of revaluating the knowledges and doings of local communities to transform their reality. Gustavo Wilches-Chaux insists that this is an urgent book in these times of great demands where mutual care becomes a priority and there is a call for all of us to re-exist with dignity and harmony. On this occasion, the UNESCO Chair in Sustainable Development presents the joint work between the Institute of Environmental Studies (IDEA) of the Universidad Nacional and the Universidad del Rosario, which highlights these agroecological experiences as exemplary strategies of connectivity and social transformation in the country

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population