Disminución de los vicios del lenguaje (vulgarismos y pobreza léxica) para mejorar la expresión oral a través de los medios audiovisuales en los estudiantes grado décimo de la jornada nocturna del Colegio Nueva Constitución.

La siguiente investigación se desarrolla a partir de la observación hecha en diversas sesiones de clase de español en el colegio Nueva Constitución jornada nocturna en el grado 502, en la que se pude establecer que los estudiantes presentan algunos problemas de expresión oral, luego de varias clases y actividades propuestas por los docentes. Ante la problemática encontrada se plantea el presente proyecto investigativo cuyo objetivo primordial es disminuir estos problemas y mejorar la expresión oral del grado 502. A continuación se presenta una breve explicación de los aspectos relevantes de este proyecto y cómo se desarrolla. En primer lugar, en la parte inicial del presente trabajo escrito, se presenta una descripción de las actividades iniciales de observación que permiten determinar el problema a trabajar durante un periodo de 8 meses, donde se encuentra que la principal falencia de los estudiantes es la dificultad de expresarse de manera oral frente a sus compañeros. Al observar que dicha falencia es repetitiva a lo largo de las clases realizadas, se decide obtener un recurso que permita un análisis más específico y minucioso de los elementos que afectan su comunicación oral, por tal razón se recurre a la grabación de videos. En segundo lugar, a partir de la observación y la información obtenida de los videos grabados en clase, se puede establecer que los problemas reiterativos de expresión oral son la pobreza léxica y los vulgarismos. Al poder determinar los problemas específicos de expresión oral, se realiza una recopilación de investigaciones realizadas con anterioridad para ver los estudios, propuestas y resultados obtenidos acerca del mismo tema, lo cual permite conocer que la estrategia más utilizada para superar dichas dificultades es la lectura.En razón a lo anterior se opta por buscar nuevas alternativas diferentes a la lectura para mejorar la expresión oral, por lo tanto se propone el uso de medios audiovisuales como herramienta principal para el mejoramiento de la expresión oral centrada en la pobreza léxica y los vulgarismos. Se recurre a la investigación-acción como enfoque metodológico y herramienta pedagógica para desarrollar el trabajo investigativo, además se hace uso de los diarios de campo, para hacer la descripción de la población y el problema observado. La propuesta pedagógica se desarrolla en cinco sesiones cuyo eje central es el uso de diversos videos creados gracias a tres herramientas audiovisuales: Powtoon, Animaker y Prezi a través de las cuales los estudiantes puedan encontrar un medio que les ayude a mejorar la forma en que expresan sus ideas en diferentes situaciones comunicativas. En la parte final del proyecto se encuentra el análisis de los talleres desarrollados, la evaluación de la propuesta, su validez y por último las ideas concluyentes del trabajo realizado.Universidad Libre Facultad de Ciencias de la Educación Programa Licenciatura en Educación Básica con énfasis en Humanidades e Idioma

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Proposal for the systemic implementation of process control In the department of maintenance of Tranzit S.A.S

En los últimos años la implementación de estrategias de control de procesos en las organizaciones ha jugado un papel muy importante en las empresas debido a la facilidad de medir resultados, detectar desviaciones y establecer medidas correctivas, esto ha generado que se aumente la competitividad y productividad en los departamentos de mantenimiento de las organizaciones y así mismo la necesidad de que todas las empresas manejen un mismo lenguaje para el control de sus procesos. Lo anterior ha generado que las organizaciones implementen esquemas de control estadísticos de procesos., que permita lograr objetivos que se establecen en la planificación, descubrir las diferencias que se presentan entre la ejecución y la planificación, que reconozca, anuncie y corrija los errores.In recent years the implementation of process control strategies in organizations has played a very important role in companies due to the ease of measuring results, detecting deviations and establishing corrective measures, this has led to increased competitiveness and productivity in the maintenance departments of the organizations and also the need for all companies to handle the same language for the control of their processes. This has led organizations to implement statistical process control schemes that allow achieving objectives that are established in planning, discover the differences that arise between execution and planning, that recognize, announce and correct errors

The Basic VRS-Effect Study : Clinical Trial Outcomes and Cost-Effectiveness of Low Vision Rehabilitation in Portugal

Introduction The aim of this study was twofold: (1) to investigate the clinical impact of vision rehabilitation in patients with vision impairment and (2) to investigate the cost-effectiveness of a basic vision rehabilitation service in Portugal. Methods The trial recruited patients diagnosed with age-related macular degeneration or diabetic retinopathy (DR) and visual acuity in the range 0.4–1.0logMAR in the better-seeing eye. Participants were randomised to one of the study arms consisting of immediate intervention and delayed intervention. The intervention included: new refractive correction, optical reading aids, in-office training and advice about modifications at home. Visual ability, health-related quality of life and costs were measured. Economic analysis was performed to evaluate whether the intervention was cost-effective. The trial compared the outcomes 12 weeks after the start in both arms. Results Of the 46 participants, 34 (74%) were diagnosed with DR, 25 (54%) were female, and mean age was 70.08 years (SD = 8.74). In the immediate intervention arm visual ability increased a mean of 0.523 logits (SE = 0.11) (p < 0.001). Changes in the delayed intervention arm were not statistically significant (p = 0.95). Acuity in the better-seeing eye, near acuity and critical print size also improved during the study. The mean cost of the intervention was €118.79 (SD = 24.37). The incremental cost-effectiveness ratio using the EQ-5D-5L was 30,421€/QALY and 1186€/QALY when using near acuity. Conclusion The current study gives evidence of positive clinical impact of a basic vision rehabilitation intervention and shows that a basic vision rehabilitation service is cost-effective. These findings are important to clinical and rehabilitation practices and for planning vision rehabilitation services. Trial Registration Retrospectively registered, 21/01/2019. ISRCTN10894889, https://www.isrctn.com/ISRCTN10894889Introduktion Syftet med denna studie var tvåfaldigt: (1) att undersöka den kliniska effekten av synrehabilitering hos patienter med synnedsättning och (2) att undersöka kostnadseffektiviteten för en grundläggande synrehabiliteringstjänst i Portugal. Metoder Studien rekryterade patienter med diagnosen åldersrelaterad makuladegeneration eller diabetisk retinopati (DR) och synskärpa i intervallet 0,4–1,0 logMAR i det bättre seende ögat. Deltagarna randomiserades till en av studiearmarna bestående av omedelbar intervention och fördröjd intervention. Interventionen inkluderade: ny refraktiv korrigering, optiska läshjälpmedel, utbildning på kontoret och råd om modifieringar i hemmet. Synförmåga, hälsorelaterad livskvalitet och kostnader mättes. Ekonomisk analys gjordes för att utvärdera om interventionen var kostnadseffektiv. Studien jämförde resultaten 12 veckor efter starten i båda armarna. Resultat Av de 46 deltagarna fick 34 (74%) diagnosen DR, 25 (54%) var kvinnor och medelåldern var 70,08 år (SD = 8,74). I den omedelbara interventionsarmen ökade synförmågan med ett medelvärde på 0,523 logits (SE = 0,11) (p < 0,001). Förändringar i den fördröjda interventionsarmen var inte statistiskt signifikanta (p = 0,95). Skärpan i det bättre seende ögat, nära skärpa och kritisk utskriftsstorlek förbättrades också under studien. Medelkostnaden för interventionen var €118,79 (SD = 24,37). Det inkrementella kostnadseffektivitetsförhållandet med EQ-5D-5L var 30 421 €/QALY och 1 186 €/QALY vid användning av nära skärpa. Slutsats Den aktuella studien ger bevis på positiv klinisk effekt av en grundläggande synrehabiliteringsinsats och visar att en grundläggande synrehabiliteringstjänst är kostnadseffektiv. Dessa fynd är viktiga för kliniska och rehabiliterande metoder och för planering av synrehabiliteringstjänster. Provregistrering Retrospektivt registrerad, 21/01/2019. ISRCTN10894889, https://www.isrctn.com/ISRCTN10894889Introdução Este estudo teve um duplo objetivo: (1) investigar o impacto clínico da reabilitação visual em pacientes com deficiência visual e (2) investigar a relação custo-efetividade de um serviço básico de reabilitação visual em Portugal. Métodos O estudo recrutou pacientes diagnosticados com degeneração macular relacionada com a idade ou retinopatia diabética (RD) e acuidade visual na faixa de 0,4 a 1,0 logMAR no olho com melhor visão. Os participantes foram randomizados para um dos braços do estudo consistindo em: intervenção imediata e intervenção tardia. A intervenção incluiu: nova correção refrativa, auxiliares ópticos para leitura, treino em consultório e conselhos sobre modificações em casa. A capacidade visual, qualidade de vida relacionada com a saúde e custos foram medidos. A análise econômica foi realizada para avaliar se a intervenção foi custo-efetiva. O estudo comparou os resultados 12 semanas após o início em ambos os braços do ensaio clinico. Resultados Dos 46 participantes, 34 (74%) foram diagnosticados com RD, 25 (54%) eram do sexo feminino e a média de idade foi de 70,08 anos (DP = 8,74). No braço de intervenção imediata, a capacidade visual aumentou em média 0,523 logits (erro padrao = 0,11) (p < 0,001). As mundancas no braço de intervenção tardia não foram estatisticamente significativas (p = 0,95). A acuidade no olho olho com melhor visão, a acuidade visual ao perto e o tamanho crítico da letra para leitura também melhoraram durante o estudo. O custo médio da intervenção foi de 118,79€ (DP = 24,37). A relação custo-efetividade incremental usando o EQ-5D-5L foi de 30.421€/QALY e 1.186€/QALY ao usar a acuidade de perto. Conclusão O estudo atual fornece evidências do impacto clínico positivo de uma intervenção básica de reabilitação da visão e mostra que um serviço básico de reabilitação da visão é custo-efetivo. Estes resultados são importantes para as práticas clínicas e de reabilitação e para o planeamneto de serviços de reabilitação visual. Registro do ensaio Registrado retrospectivamente em 21/01/2019. ISRCTN10894889, https://www.isrctn.com/ISRCTN1089488

Absent Foveal Pit, Also Known as Fovea Plana, in a Child without Associated Ocular or Systemic Findings

The purpose of this report is to describe a case of bilateral foveal hypoplasia in the absence of other ophthalmological or systemic manifestations. We characterize the case of a 9-year-old Caucasian male who underwent full ophthalmologic examination, including functional measures of vision and structural measurements of the eye. Best corrected visual acuity was 0.50 logMAR in the right eye and 0.40 logMAR in the left eye. Ophthalmoscopy revealed a lack of foveal reflex that was further investigated. Optical coherence tomography (OCT) confirmed the absence of foveal depression (pit). OCT images demonstrated the abnormal structure of retina in a region in which we expected a fovea; these findings were decisive to determine the cause of reduced acuity in the child

Diseño del programa de vigilancia epidemiológica para riesgo ergonómico de la empresa Ovneofrio S.A.S.

El objetivo de este trabajo es plantear la formulación de un programa de vigilancia Epidemiológica para la organización Ovneofrio S.A.S predominando la importancia en la prevención del riesgo ergonómico, evitando efectos que se traducen en enfermedades laborales a largo plazo.TÍTULO 7 1. PROBLEMA DE INVESTIGACIÓN 7 1.1. Descripción del problema 7 1.2. Formulación del Problema 8 1.3. Sistematización 8 2. OBJETIVOS 9 2.1. Objetivo general 9 2.2. Objetivos específicos 9 3. JUSTIFICACIÓN Y DELIMITACIÓN 10 3.1. Justificación 10 3.2. Delimitación 11 3.3. Limitación 11 3.3.1. Económico 11 4. MARCO DE REFERENCIA 11 4.1. Estado del Arte 11 4.2. Marco Teórico 16 4.3. Marco Legal 30 5. MARCO METODOLÓGICO 37 5.1. Población 37 5.2. Muestra 37 5.3. Inclusión 38 5.4. Exclusión 38 5.5. Materiales 38 5.6. Fuentes de información 38 5.7. Fases de estudio 38 5.8. Cronograma 43 5.9. Instrumentos de Recolección de Datos 44 5.10. Consentimiento Informado para los Participantes de Investigación 46 6. RESULTADOS 48 7. ANÁLISIS FINANCIERO 61 8. CONCLUSIONES Y RECOMENDACIONES 64 8.1. Conclusiones 64 8.2. Recomendaciones 66 9. REFERENCIAS 67EspecializaciónEspecialista en Gerencia de la Seguridad y Salud en el TrabajoEspecialización en Gerencia de la Seguridad y Salud en el Trabaj

La produccion escrita en la Institucion Educativa Distrital

El presente proyecto tiene como objetivo reflexionar sobre la implementación de las distintas metodologías sobre la enseñanza de la producción escrita, en un contexto mundial atravesado por una pandemia, el cual a promovido diversas alternativas como la puesta en marcha de nuevas tecnologías de la información y comunicación aplicadas a la educación que generan un proceso de aprendizaje integral donde la didáctica y la lúdica son elementos importantes en la reflexión y labor del docente, que se lleva a cabo día a día por el bienestar estudiantil. Como maestras en formación hemos llevado a cabo nuevas tecnologías en la práctica pedagógica para la formación integral de los estudiantes, asimismo se ha posibilitado la observación de diferentes situaciones que se presentan en el aula debido al cambio de metodología vivenciando nuevas alternativas que se presentan para lograr significativamente un proceso de enseñanza construyendo espacios llamativos y nutridos que fomenten la participación y concentración de cada niño y niña. La práctica pedagógica en la cual se situará la presente ponencia se desarrolla en la Institución Educativa Distrital Villa Amalia específicamente en el grado primero, donde se implementa la caracterización de la producción escrita a través de diferentes espacios que se ven desarrollados durante las diversas áreas del aprendizaje involucrando juegos, guías y actividades que cautivan la atención de los estudiantesUniversidad Libre de Colombia, Ciencias de la Educación, Licenciatura en Pedagogía InfantilThe purpose of this project is to reflect on the implementation of the different methodologies on the teaching of written production, in a global context crossed by a pandemic, which has promoted various alternatives such as the implementation of new information and communication technologies. applied to education that generate a comprehensive learning process where didactics and play are important elements in the reflection and work of the teacher, which is carried out day by day for student welfare. As teachers in training we have carried out new technologies in the pedagogical practice for the integral formation of the students, it has also been possible to observe different situations that arise in the classroom due to the change in methodology, experiencing new alternatives that are presented to achieve significantly a teaching process building attractive and nurtured spaces that encourage the participation and concentration of each boy and girl. The pedagogical practice in which this paper will be placed is developed in the Villa Amalia District Educational Institution specifically in the first grade, where the characterization of written production is implemented through different spaces that are developed during the various areas of learning. involving games, guides and activities that captivate the attention of students