La autonomía en el proceso de enseñanza-aprendizaje no presencial de lenguas extranjeras en la universidad de Matanzas

This article deals with the analysis of autonomy in the foreign language teaching-learning process in the context of the social distance imposed by the Covid-19 pandemics. Such reality led the Cuban university to implement emergency changes in its system, assuming features of distance education, particularized in a distance learning format. Such is the case of Matanzas University Language School, which faculty searched for ways of improving the students’ autonomy from a developmental perspective. Meanwhile, technology, with its virtual environment, reached untold levels of preponderance. The results of teaching, the methodological activity, the interaction with the students and the continuous diagnosis update, favored the identification of theoretical positioning reflected in this work, as well as the best practices in favor of the assimilation of strategies, the cooperation and help levels offer. As a result, we share criteria about the co-direction of the process, as well as the best practices, focused on a student who becomes more and more autonomous and committed with the social assignment of his future profession.El artículo aborda el análisis de la autonomía en el proceso de enseñanza-aprendizaje de lenguas extranjeras en el contexto del distanciamiento social que ha impuesto la pandemia de la Covid-19. Esta realidad condujo a la universidad cubana a adoptar cambios emergentes en su sistema, que asumió rasgos de la educación a distancia, concretados en una modalidad no presencial. Tal fue el caso de la Facultad de Idiomas de la Universidad de Matanzas, con un colectivo pedagógico que se implicó en la búsqueda de las vías y formas de favorecer la autonomía de sus estudiantes desde una perspectiva desarrolladora. Mientras tanto, la tecnología con sus entornos virtuales alcanzó niveles inéditos de preponderancia. Los resultados de la actividad docente-metodológica, el intercambio con los estudiantes y el seguimiento al diagnóstico en general permitieron identificar las posiciones teóricas que se reflejan en este trabajo, así como las mejores prácticas en favor de la asunción de estrategias, la cooperación y el ofrecimiento de niveles de ayudas. Como resultado, se comparten criterios sobre la codirección del proceso, así como las mejores prácticas, en función de un estudiante que se muestre cada vez más autónomo y comprometido con el encargo social de su futura profesión

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN

Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data

Background: General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observational studies compared with patients treated without GA. We assessed functional outcome in ischaemic stroke patients with large vessel anterior circulation occlusion undergoing endovascular thrombectomy under GA, versus thrombectomy not under GA (with or without sedation) versus standard care (ie, no thrombectomy), stratified by the use of GA versus standard care. Methods: For this meta-analysis, patient-level data were pooled from all patients included in randomised trials in PuMed published between Jan 1, 2010, and May 31, 2017, that compared endovascular thrombectomy predominantly done with stent retrievers with standard care in anterior circulation ischaemic stroke patients (HERMES Collaboration). The primary outcome was functional outcome assessed by ordinal analysis of the modified Rankin scale (mRS) at 90 days in the GA and non-GA subgroups of patients treated with endovascular therapy versus those patients treated with standard care, adjusted for baseline prognostic variables. To account for between-trial variance we used mixed-effects modelling with a random effect for trials incorporated in all models. Bias was assessed using the Cochrane method. The meta-analysis was prospectively designed, but not registered. Findings: Seven trials were identified by our search; of 1764 patients included in these trials, 871 were allocated to endovascular thrombectomy and 893 were assigned standard care. After exclusion of 74 patients (72 did not undergo the procedure and two had missing data on anaesthetic strategy), 236 (30%) of 797 patients who had endovascular procedures were treated under GA. At baseline, patients receiving GA were younger and had a shorter delay between stroke onset and randomisation but they had similar pre-treatment clinical severity compared with patients who did not have GA. Endovascular thrombectomy improved functional outcome at 3 months both in patients who had GA (adjusted common odds ratio (cOR) 1·52, 95% CI 1·09–2·11, p=0·014) and in those who did not have GA (adjusted cOR 2·33, 95% CI 1·75–3·10, p<0·0001) versus standard care. However, outcomes were significantly better for patients who did not receive GA versus those who received GA (covariate-adjusted cOR 1·53, 95% CI 1·14–2·04, p=0·0044). The risk of bias and variability between studies was assessed to be low. Interpretation: Worse outcomes after endovascular thrombectomy were associated with GA, after adjustment for baseline prognostic variables. These data support avoidance of GA whenever possible. The procedure did, however, remain effective versus standard care in patients treated under GA, indicating that treatment should not be withheld in those who require anaesthesia for medical reasons