Methodology for the organization didactic environment in computer program

Se realiza un estudio de enfoque cualitativo fenomenológico con el objetivo de diseñar un sistema organizativo-metodológico para el análisis de la información recuperada en la red, que beneficie y estimule el desarrollo de las investigaciones estudiantiles, en la Filial de Ciencias Médicas de Guantánamo, en el período 2011 - 2012. Los datos primarios se recogen mediante métodos de la observación participante y entrevistas a profundidad, donde se obtienen resúmenes descriptivos a los cuales se les aplica la técnica de triangulación de métodos hasta lograr reflejar las problemáticas que amparan el presente trabajo. Se concluye que les corresponde al colectivo docente unido a los tutores y masa estudiantil, desarrollar y aplicar estrategias de análisis y filtrado de la información en la red, a nivel institucional, para enfrentar los desafíos actuales de las nuevas Tecnologías de Información Científica (TIC) y la transculturación que imponen los países capitalistas desarrollados a los del llamado tercer mundo. A phenomenological qualitative study is carried out with the objective of designing an organizational-methodological system for the analysis of the information retrieved in the network that will benefit and stimulate the development of student research in the Guantanamo Branch of Medical Sciences in The period 2011 - 2012. The primary data are collected through participant observation methods and in-depth interviews, where descriptive summaries are obtained to which the technique of triangulation of methods is applied to reflect the problems that cover the present work. It is concluded that it is the responsibility of the teaching group, together with tutors and student masses, to develop and apply strategies for analyzing and filtering the information in the network, at institutional level, to face the current challenges of the new Information Technologies (ICT) And the transculturation imposed by the developed capitalist countries to the so-called third worl

Nueva estrategia pedagógica para construir conocimientos tecnológicos de salud: “mesa servida”

La “Mesa Servida” es una estrategia pedagógica, basada en los nuevos enfoques de la educación superior, en la que se asumen posiciones constructivistas, que se mezclan con la enseñanza problémica para convertirla en desarrolladora y evacuarla en el contexto materialista y dialéctico de la educación cubana. Responde a la solución de los problemas didáctico-metodológicos que surgieron a partir del cambio brusco en el proceso de formación del técnico de salud cubano, de una enseñanza media superior politécnica a la enseñanza superior. Esta estrategia pedagógica, junto a otras que se desarrollan en el marco de un macroproyecto de investigación como tarea de educación y promoción de salud, ha sido expuesta a la crítica científica y validada por expertos en las ciencias pedagógicas. Por los excelentes resultados académicos logrados con su aplicación, se pone a la disposición de los docentes del país que enfrentan las mismas dificultades. El trabajo recibió premio de Relevante en el Fórum Municipal de Ciencia y Técnica y en el evento de base Pedagogía 2005

Técnica pedagógica para la construcción de conocimientos tecnológicos de salud denominada: “el proyecto perspectivo para el desarrollo conceptual tecnológico”

Esta investigación cualitativa, es parte de la 3ra. Tarea del Macroproyecto GEMDITPS para la Ortopedia Pediátrica, referente al desarrollo de estrategias para la educación y promoción de conocimientos tecnológicos de salud ante las deformidades ortopédicas más frecuentes de nuestro medio. En ellas se han logrado establecer y validar teóricamente más de cuatro técnicas o estrategias pedagógicas en las cuales se destaca esta propuesta, de la cual sólo hacemos una síntesis de su contenido y forma. Este trabajo obtuvo premio “Relevante” en el FORUM de Base de Ciencia y Técnica del 2005

Proyecto perspectivo para el desarrollo conceptual tecnológico

Se presenta una estrategia pedagógica de corte constructivista, la que se propone con la finalidad de generalizar la experiencia entre otros docentes del país a fin de introducir métodos activos que aseguren un aprendizaje significativo y productivo en el proceso de enseñanza de las asignaturas tecnológicas de los perfiles de Ortoprótesis y Rehabilitación, de la carrera de Tecnología de la Salud. La estrategia se fundamenta en las tendencias pedagógicas de David Paulo Ausubel, basada en los esquemas conceptuales de Piaget y Novak, el paradigma socio-cultural de Lev Vigotsky, que se entrelazan con la enseñanza problémica de Majmutov y la estructura de los proyectos de investigación para estimular la indagación y la formación de valores y habilidades profesionales que responden al nuevo modelo pedagógico. El trabajo obtuvo premio de “Relevante” en el Fórum de Base de Ciencia y Técnica de 2005

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

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

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: 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. Funding: National Institute for Health and Care Research