Caja de herramientas para el fortalecimiento de los procesos de gestión de riesgo en las áreas de la gestión escolar de las instituciones educativas distritales.

63 p. Libro DigitalEste documento es el producto de una construcción participativa de un grupo de docentes de las IED y de expertos en el tema de la gestión del riesgo –GR–, quienes, en una relación dialógica desde sus saberes y experiencias, consolidan una propuesta para comprender la GER como una estrategia que aporta a la institucionalización de la GR y, con ello, a la garantía del derecho a la educación. Está organizado en cuatro capítulos, y además cuenta con una caja de herramientas que incluye una serie de actividades para que la institución educativa materialice la GER de acuerdo con sus propias necesidades contextuales. Por lo tanto, sus cuatro capítulos, como un hipertexto, se articulan de manera simultánea con la caja de herramientas, permitiendo una lectura dinámica entre capítulos y actividades.1 th ed

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

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis

Guía pedagógica : reconociendo la diversidad en la escuela

El siguiente material pedagógico busca posicionar el reconocimiento de la diversidad de los niños, niñas y jóvenes como agentes políticos para la construcción de escuelas como territorios de paz. Propone ejercicios para la incorporación de los enfoques de género y diferenciales en la escuela, que den lugar al reconocimiento de la diversidad, así como reflexionar colectivamente sobre la importancia de generar acciones diferenciales para el respeto y la garantía de derechos en la escuela

Caja de herramientas del programa integral de educación socioemocional, ciudadana y escuelas como territorios de paz : módulo Estrategia Respuesta Integral De Orientación Pedagógica RIO-P

La estrategia RIO-P – Respuesta Integral de Orientación Pedagógica - es una de las cuatro estrategias del Programa Integral de Educación Socioemocional, Ciudadana y Escuelas como Territorios de Paz, el cual tiene como objetivos promover una educación integral en la que se privilegie la formación del SER y el SABER desde una perspectiva de Buen vivir y, en esta misma línea, desarrollar y fortalecer capacidades socioemocionales y ciudadanas en las personas que habitamos la escuela y los territorios, considerando que estas tienen un lugar preponderante en los procesos de enseñanza y aprendizaje, así como en los espacios convivenciales en donde tejemos nuestras experiencias, relaciones, vínculos y afectos. El presente módulo tiene como propósito contribuir a la transformación colectiva y participativa de la convivencia escolar, por medio del acompañamiento a los colegios en sus acciones pedagógicas para la promoción de derechos y la prevención de vulneraciones y, asimismo, para el fortalecimiento de capacidades socioemocionales y ciudadanas de la comunidad educativa