Pedagogical proposal under an innovative holistic approach mediated by a digital game for the strengthening of critical reading in fifth grade students of the Liceo Sur Andino Pitalito Huila Educational Institution

El desarrollo del presente estudio se enfocó en el fortalecimiento de la lectura crítica en estudiantes del grado quinto de la Institución Educativa Liceo Sur Andino de Pitalito Huila, a través de una propuesta pedagógica bajo enfoque holístico innovador mediada por el juego digital Cuadernia, convirtiendo este recurso, en un apoyo de transformación, interés y motivación para la población objeto de estudio, la cual presentó dificultades en la comprensión de textos en un nivel crítico. En esta medida, se estableció la siguiente pregunta problema ¿De qué manera la implementación de una propuesta pedagógica con un enfoque holístico innovador mediada por un juego digital contribuye significativamente en desarrollo de las competencias en lectura crítica en los estudiantes del grado quinto de la Institución Educativa Liceo Sur Andino del municipio de Pitalito Huila?. A partir de esto, se determinó que bajo un enfoque cualitativo con diseño investigación acción, se apliquen un cuestionario inicial, rejilla de observación, grupo de discusión y cuestionario final, como instrumentos de recolección de datos, que conllevan al alcance de los objetivos específicos. De acuerdo a los resultados obtenidos, se infiere que, los estudiantes tienen dificultades para la formación de las habilidades del nivel crítico, puesto que, los promedios de aciertos son mínimos. No obstante, con la implementación de la propuesta pedagógica bajo el enfoque holístico mediada en el juego digital Cuadernia, estos aciertos aumentaron significativamente, demostrando la efectividad de estas nuevas prácticas de enseñanza.Introducción ......................................................................................................... 10 1. Planteamiento del problema.......................................................................... 14 1.2 Descripción deL problema que origina la idea de trabajo de grado .......... 14 1.2 Pregunta o preguntas de investigación .................................................... 17 1.3 Objetivo General ...................................................................................... 17 1.4 Objetivos Específicos: .............................................................................. 17 1.5 Supuestos Teóricos ................................................................................. 18 1.6 Justificación: ............................................................................................ 18 2. Marco Referencial ............................................................................................ 22 2.1 Antecedentes ........................................................................................... 22 2.2 Marco Teórico .......................................................................................... 27 2.2.1 Comprensión lectora ........................................................................ 28 2.2.2 El juego digital.................................................................................. 33 2.2.3 Juego Digital Cuadernia ................................................................... 35 2.2.4 Constructivismo desde el Aprendizaje Significativo .......................... 38 2.3 Marco Conceptual .................................................................................... 42 2.3.1 Proceso de lectura. .......................................................................... 43 2.3.2 El juego digital para alcanzar retos de aprendizaje .......................... 49 2.3.3 Cuadernia como un juego digital ...................................................... 50 2.3.4 Aprendizaje significativo desde fundamentos del constructivismo. ... 52 2.3.5 Propuesta pedagógica ..................................................................... 55 2.4 Marco Legal ............................................................................................. 56 3. Metodología ..................................................................................................... 59 3.1 Paradigma ............................................................................................... 59 3.2 Enfoque ................................................................................................... 60 3.3 Diseño ..................................................................................................... 61 3.4 Supuestos cualitativos ............................................................................. 62 3.5 Categorías de análisis ............................................................................. 63 3.6 Contexto de la Investigación .................................................................... 64 3.7 Población ................................................................................................. 65 MAESTRÍA EN E-LEARNING 3.8 Muestra .................................................................................................... 66 3.9 Técnicas e Instrumentos de recolección de información. ......................... 66 3.9.1 Cuestionario ..................................................................................... 66 3.9.2 Observación participante ................................................................. 67 3.9.3 Grupo de Discusión ......................................................................... 67 3.10 Validez de Instrumentos......................................................................... 68 3.11 Técnicas y Análisis de datos .................................................................. 68 3.12 Aspectos Éticos ..................................................................................... 69 4. Análisis de Resultados .................................................................................. 71 4.1 Análisis Diagnóstico ................................................................................. 71 4.1.1 Cuestionario inicial ........................................................................... 71 4.1.2 Observación participante. ................................................................ 82 4.1.3 Diseño Propuesta pedagógica a través del Juego digital Cuadernia 85 4.2 Evaluación de Propuesta pedagógica. ................................................... 112 4.2.1 Cuestionario final ........................................................................... 112 4.2.2 Análisis Comparativo Cuestionario inicial y Cuestionario final. ....... 123 4.2.3 Grupo de Discusión ....................................................................... 124 5. Conclusiones ............................................................................................... 128 6. Recomendaciones ....................................................................................... 130 Referencias Bibliográficas .................................................................................. 131 Anexos ............................................................................................................... 137 Anexo A. Cuestionario inicial y final. ............................................................ 137 Anexo B. Rejilla de observación .................................................................. 142 Anexo C. Grupo de discusión ...................................................................... 143 Anexo D. Carta de Aval Institucional ............................................................ 145MaestríaThe development of this study focused on strengthening critical reading skills in fifth grade students of the Educational Institution Liceo Sur Andino of Pitalito Huila, through a pedagogical proposal under an innovative holistic approach mediated by the digital game Cuadernia, turning this resource into a support of transformation, interest and motivation for the population under study, which presented difficulties in the comprehension of texts at a critical level. To this extent, the following question was established How does the implementation of a pedagogical proposal with an innovative holistic approach mediated by a digital game contribute significantly to the development of critical reading skills in fifth grade students of the Educational Institution Liceo Sur Andino of the municipality of Pitalito Huila? From this, it was determined that under a qualitative approach with action research design, an initial questionnaire, observation grid, discussion group and final questionnaire were applied as data collection instruments, which lead to the achievement of the specific objectives. According to the results obtained, it is inferred that students have difficulties in the formation of critical level skills, since the averages of successes are minimal. However, with the implementation of the pedagogical proposal under the holistic approach mediated in the digital game Cuadernia, these successes increased significantly, demonstrating the effectiveness of these new teaching practices

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Al lado con la persona afectada por la enfermedad de Alzheimer en Huelva : instrumentos de mejora de la atención

Documento relacionado: Al lado, itinerario de atención compartida : Demencias, Alzheimer (http://hdl.handle.net/10668/487). Publicado en la página web de la Consejería de Salud y Bienestar Social: Consejería de Salud y Bienestar Social / Profesionales / Salud Pública / 'Al Lado' con... / 'Al Lado' con las personas afectadas por Alzheimer.YesEl contexto y la implementación de la Estrategia Al Lado se efectúa en tres niveles de desarrollo del proyecto (1, 2 y 3). En cada uno de ellos se definen las actividades realizadas y los actores implicados. Se especifican los productos obtenidos en cada nivel y, finalmente, se concreta el ámbito y el tiempo de aplicación en la provincia de Huelva

The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies

International audienceSignificance There is growing evidence that preexisting autoantibodies neutralizing type I interferons (IFNs) are strong determinants of life-threatening COVID-19 pneumonia. It is important to estimate their quantitative impact on COVID-19 mortality upon SARS-CoV-2 infection, by age and sex, as both the prevalence of these autoantibodies and the risk of COVID-19 death increase with age and are higher in men. Using an unvaccinated sample of 1,261 deceased patients and 34,159 individuals from the general population, we found that autoantibodies against type I IFNs strongly increased the SARS-CoV-2 infection fatality rate at all ages, in both men and women. Autoantibodies against type I IFNs are strong and common predictors of life-threatening COVID-19. Testing for these autoantibodies should be considered in the general population

The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies

International audienceSignificance There is growing evidence that preexisting autoantibodies neutralizing type I interferons (IFNs) are strong determinants of life-threatening COVID-19 pneumonia. It is important to estimate their quantitative impact on COVID-19 mortality upon SARS-CoV-2 infection, by age and sex, as both the prevalence of these autoantibodies and the risk of COVID-19 death increase with age and are higher in men. Using an unvaccinated sample of 1,261 deceased patients and 34,159 individuals from the general population, we found that autoantibodies against type I IFNs strongly increased the SARS-CoV-2 infection fatality rate at all ages, in both men and women. Autoantibodies against type I IFNs are strong and common predictors of life-threatening COVID-19. Testing for these autoantibodies should be considered in the general population

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified