Skill Levels on Visualization and Spatial Reasoning in Pre-service Primary Teachers

We apply theoretical tools from the onto-semiotic approach to present skill levels on tasks requiring visualization and spatial reasoning. These scales are derived from the analysis of visualization and spatial reasoning skills involved in solving a questionnaire supplied to 400 pre-service primary teachers. In order to set skill levels, we describe different types of cognitive configurations considering the network of mathematical objects involved in solving the items. The results show that there may be several configurations at each level and the levels depend on both certain conditions of the task and the visualization skills required. In most cases, the ratio of students expressing high level is significantly below than those of exhibiting low level. The analysis manifests that students put into play variety and quantity of visual objects and processes; however, most did not reach the solution successfully. This leads to the need for specific training actions.This work was funded by the Spanish FEDER/ Ministry of Science, Innovation and Universities – Research Agency / project EDU2017_84979-R, and the European Erasmus + program (2019-1-CZ01-KA201-061377)

Mathematical learning for children through project work

El quehacer diario de las maestras y maestros de Educación Infantil determina en buena medida las acciones matemáticas que su alumnado desarrolla en el aula, y que después traslada a contextos y situaciones cotidianos de su contorno. La forma de enseñar y programar experiencias y situaciones ricas en procesos matemáticos por parte de los docentes cobra por tanto importancia desde las primeras etapas educativas. Se trata de que las matemáticas supongan para el alumnado una herramienta útil y funcional, que permita la inclusión social, y no únicamente la segregación de los estudiantes por sus resultados. El trabajo por proyectos permite a priori crear situaciones significativas, en las que a través de la acción se abstraen y comprenden los nuevos aprendizajes. En este trabajo se presenta un estudio del análisis e implantación de los proyectos de trabajo en un aula de educación infantil, desde su programación hasta su evaluación, así como su correlación con las capacidades matemáticas del alumnado.The work of Early Childhood Education teachers determines to a large extent the mathematical actions which their students develop in the classroom, and which later they transfer to daily contexts. Therefore, it is important that teachers program and develop rich mathematical experiences from the first levels. It is about made mathematics a useful and functional tool for students allowing social inclusion, but not the segregation of students by results. Project-based learning allows a priori significant situations in which the new learning are abstracted and understood through the action. This paper presents a study of the analysis and implementation of work projects in a classroom for early childhood education, from its programming to its evaluation, as well as its correlation with the mathematical abilities of the students

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

Background 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

Aprendizaje matemático infantil a través del trabajo por proyectos

El quehacer diario de las maestras y maestros de Educación Infantil determina en buena medida las acciones matemáticas que su alumnado desarrolla en el aula, y que después traslada a contextos y situaciones cotidianos de su contorno. La forma de enseñar y programar experiencias y situaciones ricas en procesos matemáticos por parte de los docentes cobra por tanto importancia desde las primeras etapas educativas. Se trata de que las matemáticas supongan para el alumnado una herramienta útil y funcional, que permita la inclusión social, y no únicamente la segregación de los estudiantes por sus resultados. El trabajo por proyectos permite a priori crear situaciones significativas, en las que a través de la acción se abstraen y comprenden los nuevos aprendizajes. En este trabajo se presenta un estudio del análisis e implantación de los proyectos de trabajo en un aula de educación infantil, desde su programación hasta su evaluación, así como su correlación con las capacidades matemáticas del alumnado

Prospective Primary Teachers’ Didactic-Mathematical Knowledge in a Service-Learning Project for Inclusion

An analysis of the didactic-mathematical knowledge put into play by a sample of 30 prospective primary teachers during their participation in a Service-Learning program focused on mathematical stimulation as a measure of attention to adolescents at risk of social exclusion is presented. The program aimed to respond to current training demands by promoting the development of mathematics-specific professional competencies, as well as social skills to interact with students, and to positively influence the prospective teachers’ affection towards mathematics and its teaching. It was developed during three academic years in two phases: the learning module was oriented to the presentation of the mathematical stimulus program and the didactical analysis of the STEAM activities knocking it into shape; in the service module, the participants implemented the activities in an educational center with students at risk of social exclusion. The analysis was carried out from the video recordings of the sessions, the future teachers’ written reports with the analysis of the activities, questionnaires on the didactic-mathematical knowledge and a satisfaction test. The results show difficulties on the part of the future teachers to analyze some of the activities of the program, which seems to have its origin in their poor command of the common knowledge of the mathematical content, which also limits them when it comes to managing the activities in the way expected for the stimulus program. All in all, participation in the program was positively assessed by them in relation to its usefulness for their training. The potential benefit of Service-Learning programs such as the one addressed here in the face of a positive impact on the affections towards mathematics is concluded, as a necessary step for a more effective acquisition of didactic-mathematical knowledge and skills in the initial training

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

Background: 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

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