Taller DEDRA para mejorar la expresión oral en estudiantes de cuarto de secundaria, Institución Educativa Modelo - Trujillo 2020

El objetivo general: Comprobar si el Taller DEDRA mejora la expresión oral en las estudiantes del 4° grado de secundaria en la I. E. “Modelo”, Trujillo, 2020. Se fundamenta en las teorías de Hymes y cognitiva de Piaget. La investigación es aplicada, diseño cuasi experimental, población 190 estudiantes y la muestra es de 30 estudiantes por grupo experimental y control. El instrumento aplicado: Cuestionario, validado por juicio de 5 expertos con índice de confiabilidad del 0,941. En los resultados, la variable expresión oral, presenta en el nivel inicio 36.7% para el pre test experimental y 60% para el pre test control. En el nivel previsto el post test experimental ostenta el 46.7% y en el post test control el 23%. El nivel destacado el post test experimental registra el 26.7% y el post test control el 3.3%. En la prueba de comparación de resultados entre el post test del grupo control y post test del grupo experimental, el p-valor es de 0,000 (p< 0,05) demostrando diferencias estadísticas en un nivel de confianza al 95%. Se concluye que: El Taller DEDRA, mejora significativamente la expresión oral de las estudiantes del 4° grado de secundaria en la I. E. Modelo, Trujillo, 2020

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