Estrategias didácticas fundamentadas en pictograma para el desarrollo del proceso lecto-escritor en niños de preescolar

The teaching of reading and writing is one of the most important challenges for teachers, in the initial stage of the academic education of the child, so it is interesting to have innovative and creative strategies for the teaching of reading and writing, in the present investigation intends to configure a pedagogical proposal based on pictography to strengthen the reading-writing process in students of the IED Brisas del Rio transition degree. This research is framed in the empirical approach, also known as concrete induction, since that we started with the observation of the learning process of the transition students of the Brisas del RIO IED and the way the teacher developed the academic process, the paradigm under which this research is guided is inductive, known as a probabilistic or measurementist, as well called positivist or quantitative, this is based on observation mechanisms about how a certain reality is, and what is the pattern of regularity that it can present. The method used is the induction - deduction, it is a quasi - experimental quantitative research of an applicative nature, that was carried out with two natural or intact groups, the groups were already conformed with criteria alien to the present investigation, for the methodological route they designed three phases where the investigative process was traveled, a first phase of a theoretical-explanatory nature, which consisted in generating a systematic configuration that allowed the design to be based, from an ideal theoretical perspective, to later integrate it or complement it with the real perspective or practice ; a second phase of empirical or field nature, which includes the characterization of the population census, the sample and the problematic indicators; and finally, a third phase of a Proposed nature and implementation, refers to the design of the proposal based on pictograms to strengthen the reader-writer process, this research is applied in a first phase, where the design is proposed and the way must be applied, but the proposal as such is not carried out. In this work, the result of a research carried out in the I.E.D. Brisas del Río, in Barranquilla, in which a controlled strategy was applied, based on the Pictogram, which resulted in scientific results that ensure that the use of the pictogram facilitates the apprehension and association of ideas in children and allows for achievements important in the reading-writing process in transition students, should certainly be taken into account when looking for new teaching strategies; the final results show the difference in the results of one group and anotherLa enseñanza de la lectura y escritura constituye uno de los retos más importantes para los docentes, en la etapa inicial de la formación académica del niño, es así, que es interesante investigar en conocer novedosas y creativas estrategias para la enseñanaza de la lectura y escritura, en la presente investigación se propone configurar una propuesta pedagógica fundamentada en la pictografía para fortalecer el proceso lecto-escritor en los estudiantes del grado transición de la I.E.D Brisas del Rio. Esta investigación, se encuadra en el enfoque empírico, conocido también como inductivo concreto ,ya que iniciamos con la observación del proceso de aprendizaje de los estudiantes de transición de la I.E.D Brisas del RIO y la forma como el docente desarrollaba el proceso académico, el paradigma bajo el cual se guía esta investigación es inductivo, conocido como medicionista o probabilista, también llamado positivista o cuantitativo, este se fundamenta en mecanismos de observación de una determinada realidad, y cuál es el patrón de regularidad que puede presentar la misma. El método empleado es la inducción – deducción, es una investigación de corte cuantitativo cuasi-experimental de carácter aplicativo, que fue realizada con dos grupos naturales o intactos, los grupos ya estaban conformados con criterios ajenos a la presente investigación, para la ruta metodologica se diseñaron tres fases en donde se transitó el proceso investigativo, determinados así , una primera fase de naturaleza teórica-explicativa, que consistió en generar una configuración sistemática que permitió fundamentar el diseño, desde una perspectiva teórica ideal, para luego integrarla o complementarla con la perspectiva real o práctica; una segunda fase de naturaleza empírica o de campo, que comprende la caracterización del censo poblacional, la muestra y los indicadores problemáticos; y finalmente, una tercera fase de naturaleza Propositiva e implementación, que hace referencia al diseño de la propuesta basada en pictogramas para fortalecer el proceso lecto-escritor, esta investigacion es aplicativa en una primera fase, donde se propone el diseño y se plantea el modo como debe aplicarse, mas no se lleva a cabo la propuesta como tal. En este trabajo se muestra el resultado de una investigación adelantada en la I.E.D. Brisas del Río, en Barranquilla, en la que se aplicó una estrategia controlada, basada en el Pictograma, producto de lo cual se obtuvieron resultados cientificos que permiten asegurar que el uso del pictograma facilitan la aprehensión y asociación de ideas en los menores y permiten logros importantes en el proceso lecto-escritor en los estudiantes de transición, sin duda se deben tener en cuenta a la hora de buscar nuevas estrategias de enseñanaza; los resultados finales evidencian la diferencia en los resultados de un grupo y otro

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London