El potencial del podcast en el ámbito universitario como recurso didáctico para mejorar las competencias comunicativas y emocionales del alumnado

Mejorar la capacitación de los profesionales de enfermería en estas habilidades, mediante la incorporación de nuevas metodologías y recursos didácticos que contribuyan a un aprendizaje significativo, tendrá beneficios directos en la humanización de los cuidados y en un mejor desempeño profesional de la enfermería, así como la mejora en la satisfacción y recuperación de las personas necesitadas de cuidados en los servicios de salud. Tratando de dar respuesta a la necesidad de incorporar nuevos enfoques pedagógicos, la innovación docente que se propone reside en un nuevo planteamiento metodológico sustentado por el enfoque constructivista y la incorporación de las TIC en los procesos de enseñanza-aprendizaje, para favorecer el desarrollo de procesos de enseñanza- aprendizaje activo, participativo e interdisciplinario. Se trata de una propuesta de innovación metodológica, fundamentada en el reclamo e importancia de recuperar la participación del alumnado en los procesos de enseñanza y aprendizaje, favoreciendo entornos que promuevan la construcción de conocimiento de manera colectiva, por parte de los estudiantes, con la incorporación del Podcast como recurso didáctico, y bajo un enfoque interdisciplinario. Por último, situamos como eje vehicular del aprendizaje la investigación en grupo, al ser un elemento motivador de nuevas prácticas educativas que consigue aprendizajes activos y significativos, siendo el propio alumnado el que trata de dar respuesta a los interrogantes de la investigación.pp.2627-263

PREVALENCIA DE LA POBLACIÓN CON HIPOACUSIA NEUROSENSORIAL BILATERAL DEL MUNICIPIO DE PAMPLONA, NORTE DE SANTANDER

INTRODUCCIÓN: Establecer las características del grupo de usuarios con Hipoacusia Neurosensorial Bilateral HNB permitió agrupar la población de acuerdo a sus características y necesidades comunes, con el objetivo de obtener la base de datos que será utilizada para el estudio de satisfacción sobre el uso de audífonos en esta población. MÉTODOS: Esta investigación se realizó en la ciudad de Pamplona Colombia y sus municipios aledaños, de carácter cuantitativo y descriptivo correlacional de corte transversal, contó con una muestra total de 6.316 usuarios, tomados de 3 bases de datos de Historias Clínicas de pacientes atendidos por el servicio de fonoaudiología durante los años 2006 a 2016. RESULTADOS: A partir de la cuantificación de los datos se obtiene una muestra total de 678 usuarios con HNB, siendo 348 hombres y 330 mujeres, además se evidencia que 456 personas se encuentran en el grupo de la tercera edad y solo 185 cuentan con adaptación de audífonos. ANÁLISIS Y DISCUSIÓN: la HNB se relaciona directamente con la edad, sin embargo, cuando nos referimos al sexo no existe un factor predominante frente al género, paralelo a ello se evidencia que, aunque el índice de HNB es alto son pocas las personas que adquieren las prótesis auditivas. CONCLUSIONES: No existe un predominio en cuanto al género con HNB sin embargo se evidencia que efectivamente un factor predominante para esta alteración es la edad, y de la misma forma el porcentaje de personas con esta deficiencia que tienen los audífonos es realmente bajo

Effectiveness of the Epley's maneuver performed in primary care to treat posterior canal benign paroxysmal positional vertigo: study protocol for a randomized controlled trial

Background: Vertigo is a common medical condition with a broad spectrum of diagnoses which requires an integrated approach to patients through a structured clinical interview and physical examination. The main cause of vertigo in primary care is benign paroxysmal positional vertigo (BPPV), which should be confirmed by a positive D-H positional test and treated with repositioning maneuvers. The objective of this study is to evaluate the effectiveness of Epley's maneuver performed by general practitioners (GPs) in the treatment of BPPV. Methods/Design: This study is a randomized clinical trial conducted in the primary care setting. The study's scope will include two urban primary care centers which provide care for approximately 49,400 patients. All patients attending these two primary care centers, who are newly diagnosed with benign paroxysmal positional vertigo, will be invited to participate in the study and will be randomly assigned either to the treatment group (Epley's maneuver) or to the control group (a sham maneuver). Both groups will receive betahistine. Outcome variables will be: response to the D-H test, patients' report on presence or absence of vertigo during the previous week (dichotomous variable: yes/no), intensity of vertigo symptoms on a Likert-type scale in the previous week, total score on the Dizziness Handicap Inventory (DHI) and quantity of betahistine taken. We will use descriptive statistics of all variables collected. Groups will be compared using the intent-to-treat approach and either parametric or nonparametric tests, depending on the nature and distribution of the variables. Chi-square test or Fisher's exact test will be conducted to compare categorical measures and Student's t-test or Mann-Whitney U-test will be used for intergroup comparison variables. Discussion: Positive results from our study will highlight that treatment of benign paroxysmal positional vertigo can be performed by trained general practitioners (GPs) and, therefore, its widespread practice may contribute to improve the quality of life of BPPV patients

Observar per comprendre. Recull d’anàlisis d’usos i artefactes

Facultat de Belles Arts, Universitat de Barcelona. Assignatura: Artefactes i usos: disseny inclusiu, Curs: 2016-2017, Coordinador: Miquel Mallol Esquef

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

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

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Centrality evolution of the charged-particle pseudorapidity density over a broad pseudorapidity range in Pb-Pb collisions at root s(NN)=2.76TeV

Peer reviewe

Prácticas organizativas y significados que construyen los Asociados de Asochapinero

El objetivo de la investigación fue identificar las prácticas organizacionales que se despliegan en el marco de una asociación. Además de hacer una aproximación a la cultura organizacional de la Asociación de recicladores de Chapinero - Asochapinero, el estudio se llevó a cabo desde un enfoque cualitativo y se utilizaron estrategias como entrevistas a profundidad y observación participante. El análisis de la información recolectada permitió identificar algunas características de la asociación con respecto a su dinámica organizacional, como prácticas de liderazgo en proceso de trasformación hacia estilos menos autoritarios y la emergencia de mujeres líderes, lo que contrarresta la lógica individualista del trabajo y permite la construcción de los cimientos de una cultura política necesaria para el proceso de empoderamiento del grupo de recicladores, de cara a las reformas que se vienen dando en el sistema de aseo de Bogotá