Teachers’ Use of ICTs in Public Language Education: Evidence from Second Language Secondary-school Classrooms

Worldwide, curricular changes and financial investments are currently underway to promote the integration of technology in public education and English language learning at a young age. This study examines the ICTs that have become part of the daily instructional practices and educational settings of teachers of English who work with young learners in public schools. To this end, this mixed-methods study draws on a quantitative descriptive-exploratory design and a qualitative multiple-case study. The quantitative data were collected through a Likert questionnaire administered to 28 secondary school teachers of English across 17 municipalities in five regions of Southeast Mexico and 2,944 learners. The qualitative data were gathered from a subsample of six teachers through longitudinal classroom observations, teacher and administrator interviews, and school visits. The non-parametric analyses of the quantitative data and the categorical aggregation analyses of the qualitative data reveal that the use of some multimedia and mobile-assisted communication resources is emerging in the L2 public classrooms. In line with findings from other international contexts, variables that seem particular to public education for young learners and their school setting, however, led teachers to prefer using their own technological devices that included laptops, multimedia material, and cellphones, rather than those in the schools

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

El Sistema Educativo Mexicano: orientaciones y perspectivas ante la diversidad lingüística y cultural

Este artículo presenta un recorrido histórico del Sistema Educativo Mexicano y sus distintos modelos para atender la diversidad lingüística y cultural del país. Se parte de las disparidades sociales, lingüísticas y económicas entre las tres grandes regiones de México para enfatizar que un modelo educativo homogéneo, ajeno a estas características, continúa reproduciendo la pobreza, el rezago social y educativo, y la marginación

La enseñanza de lenguas extranjeras y el empleo de las TIC en las escuelas secundarias públicas

Worldwide, curricular changes and financial investments are currently underway to promote the integration of technology in public education and English language learning at a young age. This study examines the ICTs that have become part of the daily instructional practices and educational settings of teachers of English who work with young learners in public schools. To this end, this mixed-methods study draws on a quantitative descriptive-exploratory design and a qualitative multiple-case study. The quantitative data were collected through a Likert questionnaire administered to 28 secondary school teachers of English across 17 municipalities in five regions of Southeast Mexico and 2,944 learners. The qualitative data were gathered from a subsample of six teachers through longitudinal classroom observations, teacher and administrator interviews, and school visits. The non-parametric analyses of the quantitative data and the categorical aggregation analyses of the qualitative data reveal that the use of some multimedia and mobile-assisted communication resources is emerging in the L2 public classrooms. In line with findings from other international contexts, variables that seem particular to public education for young learners and their school setting, however, led teachers to prefer using their own technological devices that included laptops, multimedia material, and cellphones, rather than those in the schools.La educación pública en diversos países está experimentando una serie de reformas que favorecen la integración de la tecnología en la educación pública y el aprendizaje del inglés a una temprana edad. El presente estudio mixto, examinó el empleo de la tecnología en las prácticas pedagógicas cotidianas de los profesores de inglés en la educación secundaria pública y los recursos tecnológicos de los que disponen normalmente en sus escuelas. Para la fase cuantitativa se empleó un diseño descriptivo-exploratorio, a través de un cuestionario tipo Likert aplicado a 28 profesores y 2.944 alumnos en 17 municipios del sureste mexicano. Para la cualitativa, se empleó un estudio de múltiples casos con un sub-grupo de seis profesores del cual se recolectó información a través de observaciones de clases, entrevistas con docentes y directivos, y visitas a las instalaciones de las escuelas. El empleo de análisis no-paramétrico con los datos cuantitativos y de agregación categórica con los datos cualitativos permitió identificar algunos recursos multimedia y de comunicación móvil que los profesores tienden a emplear de manera cotidiana en el aula. No obstante, diversos factores relacionados con aspectos propios de la educación pública y el contexto escolar influyeron para que los profesores prefirieran sus propios medios tecnológicos tales como ordenadores portátiles, teléfonos inteligentes y materiales multimedia a los disponibles en su institución

Teachers’ Use of ICTs in Public Language Education: Evidence from Second Language Secondary-school Classrooms

Worldwide, curricular changes and financial investments are currently underway to promote the integration of technology in public education and English language learning at a young age. This study examines the ICTs that have become part of the daily instructional practices and educational settings of teachers of English who work with young learners in public schools. To this end, this mixed-methods study draws on a quantitative descriptive-exploratory design and a qualitative multiple-case study. The quantitative data were collected through a Likert questionnaire administered to 28 secondary school teachers of English across 17 municipalities in five regions of Southeast Mexico and 2,944 learners. The qualitative data were gathered from a subsample of six teachers through longitudinal classroom observations, teacher and administrator interviews, and school visits. The non-parametric analyses of the quantitative data and the categorical aggregation analyses of the qualitative data reveal that the use of some multimedia and mobile-assisted communication resources is emerging in the L2 public classrooms. In line with findings from other international contexts, variables that seem particular to public education for young learners and their school setting, however, led teachers to prefer using their own technological devices that included laptops, multimedia material, and cellphones, rather than those in the schools

Clinical characterization of data-driven diabetes subgroups in Mexicans using a reproducible machine learning approach

Introduction Previous reports in European populations demonstrated the existence of five data-driven adult-onset diabetes subgroups. Here, we use self-normalizing neural networks (SNNN) to improve reproducibility of these data-driven diabetes subgroups in Mexican cohorts to extend its application to more diverse settings.Research design and methods We trained SNNN and compared it with k-means clustering to classify diabetes subgroups in a multiethnic and representative population-based National Health and Nutrition Examination Survey (NHANES) datasets with all available measures (training sample: NHANES-III, n=1132; validation sample: NHANES 1999–2006, n=626). SNNN models were then applied to four Mexican cohorts (SIGMA-UIEM, n=1521; Metabolic Syndrome cohort, n=6144; ENSANUT 2016, n=614 and CAIPaDi, n=1608) to characterize diabetes subgroups in Mexicans according to treatment response, risk for chronic complications and risk factors for the incidence of each subgroup.Results SNNN yielded four reproducible clinical profiles (obesity related, insulin deficient, insulin resistant, age related) in NHANES and Mexican cohorts even without C-peptide measurements. We observed in a population-based survey a high prevalence of the insulin-deficient form (41.25%, 95% CI 41.02% to 41.48%), followed by obesity-related (33.60%, 95% CI 33.40% to 33.79%), age-related (14.72%, 95% CI 14.63% to 14.82%) and severe insulin-resistant groups. A significant association was found between the SLC16A11 diabetes risk variant and the obesity-related subgroup (OR 1.42, 95% CI 1.10 to 1.83, p=0.008). Among incident cases, we observed a greater incidence of mild obesity-related diabetes (n=149, 45.0%). In a diabetes outpatient clinic cohort, we observed increased 1-year risk (HR 1.59, 95% CI 1.01 to 2.51) and 2-year risk (HR 1.94, 95% CI 1.13 to 3.31) for incident retinopathy in the insulin-deficient group and decreased 2-year diabetic retinopathy risk for the obesity-related subgroup (HR 0.49, 95% CI 0.27 to 0.89).Conclusions Diabetes subgroup phenotypes are reproducible using SNNN; our algorithm is available as web-based tool. Application of these models allowed for better characterization of diabetes subgroups and risk factors in Mexicans that could have clinical applications

A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study

© 2023Background: The benefit of pharmacogenetic testing before starting drug therapy has been well documented for several single gene–drug combinations. However, the clinical utility of a pre-emptive genotyping strategy using a pharmacogenetic panel has not been rigorously assessed. Methods: We conducted an open-label, multicentre, controlled, cluster-randomised, crossover implementation study of a 12-gene pharmacogenetic panel in 18 hospitals, nine community health centres, and 28 community pharmacies in seven European countries (Austria, Greece, Italy, the Netherlands, Slovenia, Spain, and the UK). Patients aged 18 years or older receiving a first prescription for a drug clinically recommended in the guidelines of the Dutch Pharmacogenetics Working Group (ie, the index drug) as part of routine care were eligible for inclusion. Exclusion criteria included previous genetic testing for a gene relevant to the index drug, a planned duration of treatment of less than 7 consecutive days, and severe renal or liver insufficiency. All patients gave written informed consent before taking part in the study. Participants were genotyped for 50 germline variants in 12 genes, and those with an actionable variant (ie, a drug–gene interaction test result for which the Dutch Pharmacogenetics Working Group [DPWG] recommended a change to standard-of-care drug treatment) were treated according to DPWG recommendations. Patients in the control group received standard treatment. To prepare clinicians for pre-emptive pharmacogenetic testing, local teams were educated during a site-initiation visit and online educational material was made available. The primary outcome was the occurrence of clinically relevant adverse drug reactions within the 12-week follow-up period. Analyses were irrespective of patient adherence to the DPWG guidelines. The primary analysis was done using a gatekeeping analysis, in which outcomes in people with an actionable drug–gene interaction in the study group versus the control group were compared, and only if the difference was statistically significant was an analysis done that included all of the patients in the study. Outcomes were compared between the study and control groups, both for patients with an actionable drug–gene interaction test result (ie, a result for which the DPWG recommended a change to standard-of-care drug treatment) and for all patients who received at least one dose of index drug. The safety analysis included all participants who received at least one dose of a study drug. This study is registered with ClinicalTrials.gov, NCT03093818 and is closed to new participants. Findings: Between March 7, 2017, and June 30, 2020, 41 696 patients were assessed for eligibility and 6944 (51·4 % female, 48·6% male; 97·7% self-reported European, Mediterranean, or Middle Eastern ethnicity) were enrolled and assigned to receive genotype-guided drug treatment (n=3342) or standard care (n=3602). 99 patients (52 [1·6%] of the study group and 47 [1·3%] of the control group) withdrew consent after group assignment. 652 participants (367 [11·0%] in the study group and 285 [7·9%] in the control group) were lost to follow-up. In patients with an actionable test result for the index drug (n=1558), a clinically relevant adverse drug reaction occurred in 152 (21·0%) of 725 patients in the study group and 231 (27·7%) of 833 patients in the control group (odds ratio [OR] 0·70 [95% CI 0·54–0·91]; p=0·0075), whereas for all patients, the incidence was 628 (21·5%) of 2923 patients in the study group and 934 (28·6%) of 3270 patients in the control group (OR 0·70 [95% CI 0·61–0·79]; p <0·0001). Interpretation: Genotype-guided treatment using a 12-gene pharmacogenetic panel significantly reduced the incidence of clinically relevant adverse drug reactions and was feasible across diverse European health-care system organisations and settings. Large-scale implementation could help to make drug therapy increasingly safe. Funding: European Union Horizon 2020