Modified Guided Reading: Gateway to English as a Second Language and Literacy Learning

Guided reading is an important component of a comprehensive literacy program. Using this approach to reading instruction is beneficial to all students, including English‐language learners (ELLs). While guided reading is generally used in the early elementary grades, this approach is recommended for ELLs of all ages when appropriate methods and materials are used. Teachers can modify guided reading to better meet the literacy and second language (L2) learning needs of ELLs. Building on previous work in the area of guided reading and L2 reading instruction, this article describes guided‐reading modifications for ELLs, integrating reading, writing, listening, and speaking to build the four language skills. A lesson‐planning guide and examples are provided for teachers who are facing the challenge of providing language and literacy instruction to students learning to read in their L2

Placental Volume at 11-13 Weeks' Gestation in the Prediction of Birth Weight Percentile

&lt;i&gt;Objective:&lt;/i&gt; To determine the value of placental volume measured by 3D ultrasound at 11–13 weeks’ gestation in combination with maternal characteristics and serum pregnancy-associated plasma protein-A (PAPP-A) in the prediction of small and large for gestational age (SGA and LGA) neonates. &lt;i&gt;Methods:&lt;/i&gt; Maternal serum PAPP-A and placental volume were measured at 11–13 weeks in 3,104 singleton pregnancies. Regression analysis was used to examine the contribution of maternal characteristics, placental volume and PAPP-A in the prediction of SGA and LGA neonates. &lt;i&gt;Results:&lt;/i&gt; There was a significant association between placental volume and PAPP-A (r = 0.268, p &lt; 0.0001). Median placental volume and PAPP-A, expressed as multiples of the median (MoM) in appropriate for gestational age (AGA) neonates, were reduced in the SGA group (placental volume 0.88 MoM, vs. 1.00 MoM in AGA, p &lt; 0.0001; PAPP-A 0.92 MoM vs. 1.00 MoM in AGA, p = 0.019) and increased in the LGA group (placental volume 1.09 MoM vs. 1.00 MoM in AGA, p &lt; 0.0001; PAPP-A 1.15 MoM vs. 1.00 MoM in AGA, p = 0.015). Maternal characteristics with either placental volume or PAPP-A detected about 30% of the SGA or LGA neonates, at a false positive rate of 10%. &lt;i&gt;Conclusion:&lt;/i&gt; Measurement of placental volume and serum PAPP-A can improve the prediction of SGA or LGA neonates provided by maternal characteristics alone.</jats:p

Complicaciones del embarazo múltiple pretérmino en pacientes atendidas en el hospital IESS Latacunga

Background: Multiple pregnancy corresponds to pregnancies with two or more fetuses, this condition has increased in recent times due to assisted reproduction or due to the mother’s age. Objective: to describe the clinical characteristics and complications of multiple preterm pregnancy in patients treated at the IESS Latacunga Hospital, Ecuador. Methodology: A study with a retrospective and descriptive design was carried out in 15 pregnant women who were treated at the aforementioned hospital, during the period August 2019 - March 2020. The data were obtained from the medical records of the statistics department of the healthcare center. Results: 53% corresponded to mothers between 30 and 34 years old, 67% attended 4-6 prenatal controls, 80% were multiparous, 60% corresponded to a moderate preterm birth (32-34 weeks), the factors that influence in the complications, 53% were due to hypertension, 67% to poor prenatal control, the main maternal complication was high blood pressure (53%), as well as low weight and prematurity in neonates (60%). Conclusion: Poor prenatal control, age and a history of preterm delivery are frequent factors in pregnant women with multiple pregnancies, with a high frequency of maternal and neonatal complications.Antecedentes: Los embarazos múltiples son considerados los que corresponden a gestaciones con dos o más fetos los cuales se han incrementado en los últimos tiempos debido a una reproducción asistida o por la edad de la madre. &nbsp;Objetivo: describir las características clínicas y complicaciones del embarazo múltiple pretérmino en pacientes atendidas en el Hospital IESS Latacunga, Ecuador. Metodología: Se realizó un estudio con diseño retrospectivo y descriptivo en 15 en embarazadas que fueron atendidas en el mencionado hospital, durante el periodo agosto 2019 – marzo 2020. Los datos fueron obtenidos a partir de las historias clínicas del departamento de estadísticas del centro asistencial Resultados: El 53% correspondían a madres de 30 a 34 años, el 67% acudió a 4-6 controles prenatales, &nbsp;el 80% era multípara, el 60% correspondía a un parto pretérmino moderado (32-34 semanas), los factores que influyen en las complicaciones el 53% se debió a hipertensión, el 67% a mal control prenatal, las principal complicación materna fue la presión arterial elevada (53%), así como el bajopeso y prematuridad en los neonatos (60%). Conclusiones: El pobre control prenatal, la edad y el antecedente de parto pretérmino son factores frecuentes en las gestantes con embarazos múltiples, existiendo una alta frecuencia de complicaciones maternas y neonatales

Comportamiento de los pacientes ancianos operados de cirugía cardíaca con circulación extracorpórea

Introduction: There is a steady increase in the number of elderly patients with severe cardiovascular diseases who require a surgical procedure to recover some quality of life that allows them a socially meaningful existence, despite the risks.Objectives: To analyze the behavior of elderly patients who underwent cardiac surgery with cardiopulmonary bypass.Method: A descriptive, retrospective, cross-sectional study was conducted with patients over 65 years of age who underwent surgery at the Cardiocentro Ernesto Che Guevara, in Santa Clara, from January 2013 to March 2014.Results: In the study, 73.1% of patients were men; and there was a predominance of subjects between 65 and 70 years of age, accounting for 67.3%. Coronary artery bypass graft was the most prevalent type of surgery and had the longest cardiopulmonary bypass times. Hypertension was present in 98.1% of patients. The most frequent postoperative complications were renal dysfunction and severe low cardiac output, with 44.2% and 34.6% respectively.Conclusions: There was a predominance of men, the age group of 65 to 70 years, hypertension, and patients who underwent coronary artery bypass graft with prolonged cardiopulmonary bypass. Renal dysfunction was the most frequent complication.Introducción: Cada día se incrementa el número de pacientes añosos con enfermedades cardiovasculares graves, que requieren de un acto quirúrgico para devolverle cierta calidad de vida que los haga socialmente útiles, a pesar de los riesgos.Objetivos: Analizar el comportamiento de los pacientes añosos sometidos a cirugía cardíaca con circulación extracorpórea.Método: Se realizó un estudio descriptivo, retrospectivo, transversal, con los pacientes de más de 65 años de edad intervenidos quirúrgicamente en el Cardiocentro Ernesto Che Guevara, de Santa Clara, desde enero del 2013 a marzo del 2014.Resultados: El 73,1 % fueron hombres y predominaron los pacientes comprendidos entre los 65 y 70 años con un 67,3 %. La revascularización miocárdica fue la cirugía de más incidencia y tiempos prolongados de circulación extracorpórea. El 98,1 % padecían de hipertensión arterial. Las complicaciones posoperatorias más frecuentes fueron la disfunción renal y el bajo gasto grave con 44,2 y 34,6 % respectivamente.Conclusiones: Predominaron los hombres, de 65 a 70 años, hipertensos, sometidos a revascularización miocárdica con circulación extracorpórea prolongada, siendo la disfunción renal la complicación más frecuente

Evolution of elderly patients who underwent cardiac surgery with cardiopulmonary bypass

Introduction: There is a steady increase in the number of elderly patients with severe cardiovascular diseases who require a surgical procedure to recover some quality of life that allows them a socially meaningful existence, despite the risks.Objectives: To analyze the behavior of elderly patients who underwent cardiac surgery with cardiopulmonary bypass.Method: A descriptive, retrospective, cross-sectional study was conducted with patients over 65 years of age who underwent surgery at the Cardiocentro Ernesto Che Guevara, in Santa Clara, from January 2013 to March 2014.Results: In the study, 73.1% of patients were men; and there was a predominance of subjects between 65 and 70 years of age, accounting for 67.3%. Coronary artery bypass graft was the most prevalent type of surgery and had the longest cardiopulmonary bypass times. Hypertension was present in 98.1% of patients. The most frequent postoperative complications were renal dysfunction and severe low cardiac output, with 44.2% and 34.6% respectively.Conclusions: There was a predominance of men, the age group of 65 to 70 years, hypertension, and patients who underwent coronary artery bypass graft with prolonged cardiopulmonary bypass. Renal dysfunction was the most frequent complication

Comportamiento de los pacientesancianosoperados de cirugíacardíaca con circulaciónextracorpórea/ Evolution of elderly patients who underwent cardiac surgery with cardiopulmonary bypass

Introduction: There is a steady increase in the number of elderly patients with severe cardiovascular diseases who require a surgical procedure to recover some quality of life that allows them a socially meaningful existence, despite the risks. Objectives: To analyze the behavior of elderly patients who underwent cardiac surgery with cardiopulmonary bypass. Method: A descriptive, retrospective, cross-sectional study was conducted with patients over 65 years of age who underwent surgery at the Cardiocentro Ernesto Che Guevara, in Santa Clara, from January 2013 to March 2014. Results: In the study, 73.1% of patients were men; and there was a predominance of subjects between 65 and 70 years of age, accounting for 67.3%. Coronary artery bypass graft was the most prevalent type of surgery and had the longest cardiopulmonary bypass times. Hypertension was present in 98.1% of patients. The most frequent postoperative complications were renal dysfunction and severe low cardiac output, with 44.2% and 34.6% respectively. Conclusions: There was a predominance of men, the age group of 65 to 70 years, hypertension, and patients who underwent coronary artery bypass graft with prolonged cardiopulmonary bypass. Renal dysfunction was the most frequent complication