Impacto de la tecnología en tiempos de pandemia a nivel preescolar

The health contingency due to COVID-19 led to the transformation of life as we knew it, in education it provided the opportunity to discover the need to establish new strategies to address teaching-learning, in training at the preschool level, it was found that parents family, the children and the teaching staff lacked the skills in the management of communication and communication technologies called ICT, which allow working remotely using electronic means, it is important to emphasize the information that it is not possible to address to the students of the 21st century with 20th century pedagogical tools. In Zapotlán el Grande Jalisco, the WhatsApp social network was implemented, due to the versatility and accessibility it offers users by allowing them to send documents, images, videos, audio and video calls, in addition to providing the possibility of maintaining asynchronous or synchronous communication as required between children, parents and teachers in a very simple way, enhancing creative skills. Two surveys were applied, 641 to the parents of infants and 58 to teachers, where it was found that the most well-known and versatile means of communication was the WhatsApp social network with 82% by students and 89% by educators.La contingencia sanitaria por COVID-19 propicio la transformación de la vida como la conocíamos, en la educación brindo la oportunidad para descubrir la necesidad de establecer nuevas estrategias para abordar la enseñanza-aprendizaje, en la formación a nivel preescolar, se encontró que los padres de familia, los niños y el personal docente carecían de las competencias en el manejo de las tecnologías de la información  y comunicación denominadas TIC, las cuales permiten trabajar a distancia utilizando medios electrónicos, es importante enfatizar que no es posible abordar a los estudiantes del siglo XXI con herramientas pedagógicas del siglo XX. En Zapotlán el Grande Jalisco se implementó la red social WhatsApp, por la versatilidad Y accesibilidad que ofrece a los usuarios al permitir enviar documentos, imágenes, videos, audios y videollamadas, además de brindar la posibilidad de mantener comunicación asíncrona o síncrona según se requiera entre los niños, padres de familia y docentes de una forma muy sencilla, potencializando las habilidades creativas. Se aplicaron dos encuestas, 641 a los padres de los infantes y 58 a docentes, donde se encontró que el medio de comunicación más conocido y versátil fue la red social WhatsApp con 82% por los educandos y 89% por los educadores

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Incidencia de la disfuncionalidad familiar en el consumo de drogas en jóvenes del Reparto Rubén Darío, León Sureste

Tesis (Lic. en Trabajo Social)-Universidad Nacional Autónoma de Nicaragua, LeónUNAN-Leó

Cultural and language exchange: a learning opportunity and path to integrate

Depto. de Trabajo Social y Servicios SocialesFac. de Trabajo SocialFALSEsubmitte

Survival rates and worker compensation expenses in a national cohort of Mexican workers with permanent occupational disability caused by diabetes

Abstract Background Permanent occupational disability is one of the most severe consequences of diabetes that impedes the performance of usual working activities among economically active individuals. Survival rates and worker compensation expenses have not previously been examined among Mexican workers. We aimed to describe the worker compensation expenses derived from pension payments and also to examine the survival rates and characteristics associated with all-cause mortality, in a cohort of 34,014 Mexican workers with permanent occupational disability caused by diabetes during the years 2000–2013 at the Mexican Institute of Social Security. Methods A cross-sectional analysis study was conducted using national administrative records data from the entire country, regarding permanent occupational disability medical certification, pension payment and vital status. Survival rates were estimated using the Kaplan–Meier method. Multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HR) and 95 % confidence intervals (95 % CI) in order to assess the cohort characteristics and all-cause mortality risk. Total expenses derived from pension payments for the period were accounted for in U.S. dollars (USD, 2013). Results There were 12,917 deaths in 142,725.1 person-years. Median survival time was 7.26 years. After multivariate adjusted analysis, males (HR, 1.39; 95 % CI, 1.29–1.50), agricultural, forestry, and fishery workers (HR, 1.41; 95 % CI, 1.15–1.73) and renal complications (HR, 3.49; 95 % CI, 3.18–3.83) had the highest association with all-cause mortality. The all-period expenses derived from pension payments amounted to $777.78 million USD (2013), and showed a sustained increment: from$58.28 million USD in 2000 to $111.62 million USD in 2013 (percentage increase of 91.5$ 777 million USD and showed an important increase from 2000 to 2013

La retórica y el debate como herramientas de aprendizaje

Convocatoria proyectos de innovación de Extremadura 2019/2020Se describe un proyecto llevado a cabo en el IES San Fernando (Badajoz) surgido del Departamento de Filosofía que tiene como objetivo principal mejorar las habilidades comunicativas del alumnado. Se pretendía que supieran hablar, transmitir ideas y opiniones, saber escuchar, compartir posturas, rebatir y estar preparados para cambiar de opinión. Otros objetivos del trabajo fueron: transmitir una visión de sociedad que se basa en el diálogo constructivo a través de una interacción respetuosa, rigurosamente fundamentada, reflexiva e inclusiva; lograr en los alumnos el desarrollo del pensamiento crítico y conseguir que comprendan la información que reciben, las inferencias y que sean capaces de evaluarla y generar nuevas propuestasExtremaduraES

Quorum sensing network in clinical strains of A. baumannii : AidA is a new quorum quenching enzyme

Acinetobacter baumannii is an important pathogen that causes nosocomial infections generally associated with high mortality and morbidity in Intensive Care Units (ICUs). Currently, little is known about the Quorum Sensing (QS)/Quorum Quenching (QQ) systems of this pathogen. We analyzed these mechanisms in seven clinical isolates of A. baumannii. Microarray analysis of one of these clinical isolates, Ab1 (A. baumannii ST-2-clon-2010), previously cultured in the presence of 3-oxo-C12-HSL (a QS signalling molecule) revealed a putative QQ enzyme (α/β hydrolase gene, AidA). This QQ enzyme was present in all nonmotile clinical isolates (67% of which were isolated from the respiratory tract) cultured in nutrient depleted LB medium. Interestingly, this gene was not located in the genome of the only motile clinical strain growing in this medium (A. baumannii strain Ab421-GEIH-2010 [Ab7], isolated from a blood sample). The AidA protein expressed in E. coli showed QQ activity. Finally, we observed downregulation of the AidA protein (QQ system attenuation) in the presence of HO (ROS stress). In conclusion, most of the A. baumannii clinical strains were not surface motile (84%) and were of respiratory origin (67%). Only the pilT gene was involved in surface motility and related to the QS system. Finally, a new QQ enzyme (α/β hydrolase gene, AidA protein) was detected in these strains

Sociedad y economía : estudios sobre Puerto Vallarta y su región

De manera general, podemos decir que los temas que se incluyen en este libro abordan aspectos muy significativos sobre la problemática económica y social de la región de Bahía de Banderas que seguramente nos permitirán entender la realidad que se vive en esta parte de la costa de Jalisco, y por qué no, tratar de incidir en ella para transformarla

Study protocol for a randomized clinical trial to assess 7 versus 14-days of treatment for Pseudomonas aeruginosa bloodstream infections (SHORTEN-2 trial)

Background Research priorities in Antimicrobial Stewardship (AMS) have rapidly evolved in the last decade. The need for a more efficient use of antimicrobials have fueled plenty of studies to define the optimal duration for antibiotic treatments, and yet, there still are large areas of uncertainty in common clinical scenarios. Pseudomonas aeruginosa has been pointed as a priority for clinical research, but it has been unattended by most randomized trials tackling the effectiveness of short treatments. The study protocol of the SHORTEN-2 trial is presented as a practical example of new ways to approach common obstacles for clinical research in AMS. Objective To determine whether a 7-day course of antibiotics is superior to 14-day schemes for treating bloodstream infections by P. aeruginosa (BSI-PA). Methods A superiority, open-label, randomized controlled trial will be performed across 30 Spanish hospitals. Adult patients with uncomplicated BSI-PA will be randomized to receive a 7 versus 14-day course of any active antibiotic. The primary endpoint will be the probability for the 7-day group of achieving better outcomes than the control group, assessing altogether clinical effectiveness, severe adverse events, and antibiotic exposure through a DOOR/RADAR analysis. Main secondary endpoints include treatment failure, BSI-PA relapses, and mortality. A superiority design was set for the primary endpoint and non-inferiority for treatment failure, resulting in a sample size of 304 patients. Conclusions SHORTEN-2 trial aligns with some of the priorities for clinical research in AMS. The implementation of several methodological innovations allowed overcoming common obstacles, like feasible sample sizes or measuring the clinical impact and unintended effects