Aportes de las estrategias metacognitivas al nivel de comprensión lectora inferencial

The purpose of this research was to establish the contributions of the use of Metacognitive Strategies at the level of Inferential Reading Comprehension in 5th grade students of the IED El Carmen, from the city of Santa Marta. The population universe was made up of 1014 students, from socioeconomic strata 0, 1 and 2, with a population of 380 elementary school students between the ages of 9 and 11, and a non-probabilistic sample of 33 students. A non-experimental field research with a mixed nature approach was projected, following the post-positivist paradigm. The standardized Evaluate to Advance test designed by ICFES (2020) was applied, and the Inventory of Metacognitive Skills MAI, designed by Schraw & Sperling (1994) and validated by Huertas, Vesga, and Galindo (2014); implemented in the current classroom space (Remote Education Model). Quantitative and qualitative results were obtained by means of which it was possible to establish that the contributions of Metacognitive Strategies at the level of Inferential Reading Comprehension in 5th grade students had a greater representation in the Organization, Monitoring and Planning strategies with a predominance of Declarative inferences and Macrostructural, with a positive correlation between the two variables: Metacognitive Strategies and Inferential Reading Comprehension.La presente investigación tuvo como propósito establecer los aportes del uso de estrategias metacognitivas al nivel de comprensión lectora inferencial en estudiantes de grado 5° de la IED El Carmen, de la ciudad de Santa Marta. El universo poblacional fue de 1014 estudiantes, de estratos socioeconómicos 0, 1 y 2, con una población de 380 estudiantes de la básica primaria en edades comprendidas entre 9 y 11 años, y una muestra no probabilística de 34 estudiantes. Se proyectó una investigación de campo no experimental con enfoque de naturaleza mixto, siguiendo un paradigma pospositivista. Se aplicó la prueba estandarizada Evaluar para Avanzar diseñada por el Instituto Colombiano para la Evaluación de la Calidad de la Educación ICFES y el Inventario de Habilidades Metacognitivas MAI, diseñado por Schraw & Sperling y validado por Huertas, Vesga, y Galindo; implementados en el espacio actual de clases (Modelo de educación remota). Se obtuvieron resultados cuantitativos y cualitativos por medio de los cuales se pudo establecer que los aportes de las Estrategias Metacognitivas al nivel de Comprensión Lectora Inferencial en estudiantes de grado 5° tuvo mayor representación en las estrategias de Organización, Monitoreo y Planificación con predominio de las inferencias Enunciativas y Macroestructurales, existiendo una correlación positiva entre las dos variables: Estrategias Metacognitivas y Comprensión Lectora Inferencial

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2