La investigación como estrategia formativa

Certanly, research is an essential activity for global education growth, and its impact on the significant progress as a society and country, not only in terms of academic quality, but in all aspects of daily life.Research is an essential function of the Institutions of Higher Education, IES, and is a key element in the educational process, because through it is generated knowledge and learning for the generation of new knowledge is encouraged; also research links the university with society. Being an essential, substantive role, research becomes the duty be universities. For this reason the Higher Education Institutions should develop capacities for research students and incorporate their practice as learning-teaching strategy in the curriculum.Sin duda alguna, la investigación es una actividad imprescindible para el crecimiento educativo mundial, además de su impacto en el progreso significativo como sociedad y país, no solo en términos de calidad académica, sino en todos los aspectos de la vida cotidiana.La investigación es una función esencial de las Instituciones de Educación Superior, IES, y constituye un elemento fundamental en el proceso educativo, porque a través de ella se genera conocimiento y se propicia el aprendizaje para la generación de nuevos saberes; además, la investigación vincula a la universidad con la sociedad. Al ser una función esencial, sustantiva, la investigación se convierte en el deber ser de las universidades. Por esta razónlas IES deben desarrollar capacidades para la investigación en los estudiantese incorporar su práctica como estrategia de aprendizaje-enseñanza en elcurrículo

Prescripción inadecuada de medicamentos: aportaciones de los paradigmas científicos a su conocimiento

Se realizó una revisión narrativa con análisis temático sobre las aportaciones de los paradigmas científicos al conocimiento de la prescripción inadecuada de medicamentos. Se buscaron artículos de acceso abierto indexados en PubMed© entre 2010-2014, y se sistematizó información sobre el paradigma, tipo de publicación, perspectiva teórica, objetivo, método y resultados. De los 992 artículos encontrados, se seleccionaron 118, y se tomó una muestra propositiva de 15, según su diseño, representando los cuatro paradigmas. Los artículos positivistas reportaron prevalencia, factores asociados, efectividad de intervenciones y criterios de evaluación; los interpretativos explicaron las causas del problema según los involucrados; los críticos denunciaron la influencia de la industria farmacéutica; y el participativo abordó el problema secundariamente y lo solucionó en un escenario para una enfermedad y grupo farmacológico específicos. Se concluyó que la prescripción inadecuada de medicamentos como problema de investigación en salud pública recibe aportes de los cuatro paradigmas, con dominio del positivismo, lo que se atribuye al carácter paradigmático de la ciencia desde la que se le aborda habitualmente, y que una perspectiva multi-paradigmática es el mejor abordaje.This study conducted a narrative review with thematic analysis about contributions of scientific paradigms to knowledge of inadequate drugs prescription. We searched open access articles indexed in PubMed© between 2010 and 2014, and we systematized information about scientific paradigm, publication type, theoretical perspective, objective, method and results. From the 992 articles found, 118 were selected. From those, we chose a purposive sample of 15, according to the design of the studies, representing the four paradigms. The positivists articles reported prevalence, associated factors, effectiveness of interventions and evaluation criteria; the interpretive explained the causes of the problem according to those involved; the critics denounced the influence of pharmaceutical industry; and the participative addressed the problem secondarily and solved it in a scenario for a specific disease and pharmacological. We concluded that the inadequate drugs prescription as research problem in public health had contributions from the four paradigms, with dominance of positivism, which is attributed to the paradigmatic perspective of the science, from which it is usually studied, and that a multiparadigmatic perspective is the best approach to the public health issue

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

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

Factores asociados a estancia académica prolongada en el Programa de Nivelación a la Licenciatura en Trabajo Social, Universidad de Guadalajara, México

The career of Leveling Degree Program of Social Work originated by necessity of leveling degree from Technician to Licenciate; in this way, this population had an opportunity to continue with academic training. This career has a premise of award a degree in a shorter time, upon completed the requeriments for graduation because these students had previous knowledge and work experience, only they lack a formation higher education but this does not happen as such. The objective was analyze factors that prolonging the course of studies in students of NILITS in University of Guadalajara. This study was a cross sectional for obtaining students' characteristics and the graduation's date in the same group. We estimated measures of association as X2, t of student, Fisher exact test. In our results, the associated factor related with prolongation of academic stay was age (t=7.15, p=0.007) was negative influence in the process to obtain academic degree of this program; namely, the older lower graduation rate. By the group of age, 20 to 29 years old (X2=8.80, p=0.003) and 30 to 39 years old (X2=5.56, p=0.01) obtained the degree before than the group of 50 to 59 years old. We concluded the age of the students is the socioambiental factor that prolonging the students' academic stay in the program. A solution to this problem would be setting standards for hiring, promotion and retention in the program.La carrera de Nivelación a la Licenciatura en Trabajo Social surgió tras la necesidad de nivelar al grado de Licenciatura a los Técnicos en Trabajo Social, y así esta población tuviera la oportunidad de continuar con su formación académica. Esta carrera tiene la premisa de otorgar en un período breve de tiempo el grado de licenciatura a los alumnos, una vez cumplidos los requisitos para egresar, debido a que éstos ya cuentan con conocimientos previos y experiencia laboral que sólo han de completarse; más sin embargo, esto no sucede como tal. El objetivo fue Analizar los factores que prolongan la estancia académica de los alumnos de la Nivelación a la Licenciatura en Trabajo Social, Universidad de Guadalajara. Este es un estudio transversal analítico donde se obtuvieron datos demográficos y de titulación de los alumnos. Se calcularon pruebas X2, t de Student y Prueba Exacta de Fisher. En nuestros resultados, el factor asociado relacionado con la prolongación de la estancia académica fue la edad (t=7.15, p=0.007) influye negativamente en el proceso de titulación de los alumnos de este programa, es decir, a mayor edad menor índice de titulación. Los grupos de edad, de 20 a 29 (X2=8.80, p=0.003) y 30 a 39 (X2=5.56, p=0.01) se titulan en un período más corto con respecto a los de 50 a 59 años. La edad de los estudiantes es el factor socio-ambiental que prolonga la estancia de los estudiantes en el programa. Una solución al problema sería establecer normas que regulen el ingreso, promoción y permanencia en el programa

Elementos presentes en la construcción de aprendizaje significativo en alumnos y docentes del Posgrado en Ciencias de la Salud Pública, Universidad de Guadalajara

This article analyses the educational and training elements from Graduate in Public Health Program in the University of Guadalajara, those conducive, incorporate and difficult the meaningful learning in students with previous studies in Public Health. It is a qualitative study of case study making to 15 students and 8 professors from PCSP. The technique used was focus groups and the information obtained five teams as: previous knowledge, educational experience in the classroom, teaching profile, contrasting with the new models of teaching and learning and tools to obtain meaningful learning in PCSP. The professors and students concluded that requires a climate of trust, motivation and necessary instruments to students display their potentials.El presente artículo analiza los elementos didácticos y formativos del Programa de Posgrado en Ciencias de la Salud Pública (PCSP) de la Universidad de Guadalajara, que propician, incorporan y dificultan el aprendizaje significativo en alumnos con formación académica previa en alguna de las áreas de la Salud Pública. Es un estudio cualitativo de estudio de caso realizado a 15 estudiantes y 8 profesores del PCSP en el período de enero a diciembre de 2008 mediante grupos focales. Se identifican cinco temáticas a desarrollar: conocimientos previos en donde se determina la formación académica previa y el punto de partida de la enseñanza; experiencia formativa en la interacción áulica en donde tanto docentes y alumnos buscan un mismo fin; perfil docente, el PCSP tiene profesores preparados en las área del conocimiento que imparte; contrastación con los nuevos modelos de enseñanza-aprendizaje, el alumno debe tomar una parte activa en su proceso de enseñanza-aprendizaje y para apoyarlo se le asigna un tutor; y herramientas para obtener aprendizaje significativo en el PCSP. Los docentes y alumnos concluyeron en que se requiere un clima de confianza, motivador y con los medios necesarios para que los alumnos desplieguen sus potencialidades. Los alumnos perciben a sus profesores como mediadores afectivo-cognitivo en el proceso de enseñanza-aprendizaje. Las deficiencias en este proceso consisten en la carencia de evaluación entre lo aprendido y lo que se debió aprender

El paradigma pedagógico constructivista en el Posgrado en Ciencias de Salud Pública

The constructivist educational paradigm is the way of interpreting reality and the way in which the subject appropriates knowledge. The Graduate Public Health, this paradigm is designed to train researchers from different areas based on their own experiences and is an essential tool to explain and functional program model focused on learning. Students in this graduate are subjects that have an average age of 32, which is part of learning where assimilation and accommodation play an important role during their academic stay in it.El paradigma pedagógico constructivista es la manera de interpretar la realidad y la forma en como el sujeto se apropia de su conocimiento. En el Posgrado de Salud Pública, este paradigma tiene la finalidad de formar investigadores de las diferentes áreas partiendo de sus experiencias propias y resulta en una herramienta fundamental para explicar y hacer funcional el modelo curricular centrado en el aprendizaje. Los alumnos de este posgrado son sujetos que tienen una edad promedio de 32 años, de los cuales se parte su aprendizaje donde la asimilación y acomodación juegan un papel importante durante su estancia académica en el mismo