Dentro de un aula hospitalaria

“Dentro de un aula hospitalaria” es el tema principal que se aborda en este Trabajo de Fin de Grado. El presente trabajo se centra en el proceso de enseñanza-aprendizaje que se realiza con los niños en un contexto hospitalario y consta de dos partes bien diferenciadas. En la primera se desarrolla una fundamentación teórica donde se define el concepto de aula hospitalaria y se hace un recorrido histórico desde su origen hasta la actualidad. En la segunda parte está formada por un conjunto de actividades educativas para llevar a cabo en el aula hospitalaria.Grado en Educación Primari

The multiple sclerosis: concept, history and implications in the school

[ES] Este trabajo se centra en el impacto que provoca la Esclerosis Múltiple en la vida de un niño dividiendo el trabajo en dos partes bien diferenciadas. En la primera se desarrolla una fundamentación teórica donde se define y da conocer la Esclerosis Múltiple. La segunda parte está formada por una investigación de varios casos de pacientes que sufren la enfermedad, contrastando sus puntos de vista en relación a la enfermedad y la escuela.[EN] This article is focused on the impact that multiple sclerosis causes on children life, being divided in two different parts. In the first one, a theoretical foundation it´s expound on, where multiple sclerosis. The second one is made by investigation of some patients with this sickness, matching their point of view according to the illness and the school.Gómez Gómez, MC.; Navarro Palomares, S. (2020). La esclerosis múltiple: concepto, historia e implicaciones en la escuela. Revista sobre la infancia y la adolescencia. 0(18):1-16. https://doi.org/10.4995/reinad.2020.11870OJS116018Arroyo, R. (2016). Rendirse no es una opción. Barcelona, España: AmatBalicovic Boras, I. y Robles Gentile, A. (2006-2007) Esclerosis Múltiple Universitat de Barcelona. Recuperado el 4 de febrero de 2017. http://diposit.ub.edu/dspace/bitstream/2445/7122/1/ESCLEROSIS%20MULTIPLE.pdfChildhood MS: A guide for parents, 2º edición. Multiple Sclerosis Society (2008). Recuperado el 12 de febrero de 2017. https://www.mssociety.org.uk/sites/default/files/Documents/Core%20pubs/Childhood%20MS%20a%20guide%20for%20parents.pdfCovo Torres, P. (22-01-2015) Introducción a la historia de la esclerosis múltiple. Acta Neurológica Colombiana. 31(1):119-124. Recuperado el 15 de febrero de 2017. http://www.scielo.org.co/pdf/anco/v31n1/v31n1a17.pdf https://doi.org/10.22379/2422402217Forján Albarracín, J. D y Espidia Segura O.M. (Diciembre 2011- Marzo 2012) Esclerosis Múltiple en pacientes pediátricos: fisiopatología, diagnóstico y manejo. Med Unab vol.14(3) 167-179. Recuperado el 21 de Enero de 2017. http://venus.unab.edu.co/index.php/medunab/article/view/900/819Garcea, O; Correale, J. (2004). Vivir con esclerosis Múltiple. Madrid, España: PanamericanaLyncent-Mejorado, D. y Berragán Pérez E. (2006) Esclerosis múltiple en pediatría. Mediagrafic Artemisa. vol.63. 40-46. Recuperado el 21 de enero de 2017. http://www.medigraphic.com/pdfs/bmhim/hi-2006/hi061f.pdfPeña, J. A; Montiel-Nava, C; Rovelo, M. E; González, S y Mora la Cruz, E. (2006) Esclerosis Múltiple en niños: clarificando su ubicación dentro de espectro desmielinizante. Investigación clínica. 47 (4): 413-425. Recuperado el 12 de febrero de 2017.http://www.scielo.org.ve/scielo.php?script=sci_arttext&pid=S0535-51332006000400010Sánchez- Calderón, T; de Santos, S; Martin, T; Angulo, J y Careaga, J. Esclerosis múltiple en la infancia: nuestra experiencia y revisión de la literatura. Revista neurológica. 27 (156): 237-241. Recuperado el 12 de febrero de 2017. http://www.neurologia.com/articulo/98054 https://doi.org/10.33588/rn.27156.98054Velasco Mora, M. (Noviembre de 2008) Esclerosis Múltiple. Innovación y experiencias educativas. Nº 12. Recuperado el 24 de enero de 2017. http://www.csi-csif.es/andalucia/modules/mod_ense/revista/pdf/Numero_12/MARTA_VELASCO_1.pd

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

Search for the standard model Higgs boson at LEP

The four LEP Collaborations, ALEPH, DELPHI, L3 and OPAL, have collected a total of 2461 pb(-1) of e(+)e(-) collision data at centre-of-mass energies between 189 and 209 GeV. The data are used to search for the Standard Model Higgs boson. The search results of the four Collaborations are combined and examined in a likelihood test for their consistency with two hypotheses: the background hypothesis and the signal plus background hypothesis. The corresponding confidences have been computed as functions of the hypothetical Higgs boson mass. A lower bound of 114.4 GeV/c(2) is established, at the 95% confidence level, on the mass of the Standard Model Higgs boson. The LEP data are also used to set upper bounds on the HZZ coupling for various assumptions concerning the decay of the Higgs boson. (C) 2003 Elsevier B.V. All rights reserved

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit:prospective analysis of data from 27 countries

Purpose: As global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperative mortality. Methods: Planned analysis of data collected during an international 7-day cohort study of adults undergoing elective in-patient surgery. We used risk-adjusted mixed-effects logistic regression models to evaluate the association between admission to critical care immediately after surgery and in-hospital mortality. We evaluated hospital-level associations between mortality and critical care admission immediately after surgery, critical care admission to treat life-threatening complications, and hospital provision of critical care beds. We evaluated the effect of national income using interaction tests. Results: 44,814 patients from 474 hospitals in 27 countries were available for analysis. Death was more frequent amongst patients admitted directly to critical care after surgery (critical care: 103/4317 patients [2%], standard ward: 99/39,566 patients [0.3%]; adjusted OR 3.01 [2.10–5.21]; p &lt; 0.001). This association may differ with national income (high income countries OR 2.50 vs. low and middle income countries OR 4.68; p = 0.07). At hospital level, there was no association between mortality and critical care admission directly after surgery (p = 0.26), critical care admission to treat complications (p = 0.33), or provision of critical care beds (p = 0.70). Findings of the hospital-level analyses were not affected by national income status. A sensitivity analysis including only high-risk patients yielded similar findings. Conclusions: We did not identify any survival benefit from critical care admission following surgery