Las redes sociales y comunidades virtuales en el contexto educativo

Social networks and online communities are connection and interaction spaces between people that the use of the internet has generated. These virtual spaces can be used in the educational context and transform teachinglearning processes as spaces for communication and socialization, especially considering that the role of the teacher and student has also been transformed by this context.Las redes sociales y comunidades virtuales son espacios de conexión e interacción entre las personas que ha generado el uso de Internet. Estos espacios virtuales pueden aprovecharse en el contexto educativo y transformar los procesos de enseñanza-aprendizaje como espacios de comunicación y socialización, considerando especialmente que el rol del docente y alumno también se ha transformado con esta realidad

Estado del Arte. Tecnologías de la información y la comunicación (TIC) para la inclusión de personas con discapacidad en ámbitos educativos

El presente Estado de Arte es el resultado de una investigación cualitativa descriptiva de corte documental, el cual presenta el levantamiento de información relacionada con las Tecnologías de la Información y la Comunicación (TIC) para la inclusión de personas con discapacidad (PCD) en ámbitos educativos desarrollado en los países de Colombia, Argentina, Chile y México durante los años 2000 a 2014. La investigación presenta tres fases. La primera, una etapa de documentación donde se rastrearon los trabajos investigativos, tesis y artículos de revistas especializadas en formato digital, en la etapa de interpretación se efectúo el análisis de la información a partir de dos categorías principales. Finalmente presenta las conclusiones del avance en el tema, algunas reflexiones finales y propuestas para investigaciones futuras.The present State of the Art is the result of a research work developed under a qualitative- descriptive methodology of documentary-style that presents the gathering of information related with Information and Communications Technology (ICT) for the inclusion of People with Disabilities in educational settings developed in the countries of Colombia, Argentina, Chile and Mexico between the years of 2000 to 2014. The research was conducted in three stages. The first, a stage of documentation where the research papers, theses and journal articles that deal with the subject were tracked or located in digital format, in the interpretation stage the information analysis was performed by two main categories. Finally succeeded in establishing the conclusions about the progress on the topic, some final reflections and suggestions for future research.Licenciado (a) en Educación Básica con Énfasis en Humanidades y Lengua CastellanaPregrad

Caracterización genética y molecular de Pseudomonas Aeruginosa causante de infecciones en UCI de tres ciudades de Colombia.

Pseudomonas aeruginosa, ubiquitous bacteria that can generate complicated infections in hospital patients, increasing morbidity and mortality rates due to increased antimicrobial resistance in clinical use, especially the last therapeutic option as carbapenems for the acquisition of resistance determinants through mainly mobile genetic elements.OBJECTIVE: To characterize the resistance profile and molecular characteristics of P. aeruginosa isolated from adult patients with a diagnosis of infection in three intensive care units in Colombia. METHODS: Patients with P. aeruginosa infections in adults were analyzed UCI. A bacterial isolates were determined profile of susceptibility to 12 antibiotics and resistance genes were amplified β-lactams, quinolones, sulfonamides and genetic platforms like integron class 1 and 2. The genetic relationship by PFGE and MLST. RESULTS: In the study 40 patients of which 23 (57.5%) analyzed belong to an ICU in the city of Pereira. The main sources of isolating microorganisms are 13 blood cultures (32.5%) and urine-11 (27.5%). Resistance profiles SAM-SAM-FOX and FOX-SXT occurred in 6 (15.0%) and 4 (10.0%) isolates respectively. The β-lactamases frequently were blaTEM type in 8 (20.0%), blaSHV seven (17.5%) and blaCTX-M 3 (7.5%), carbapenemases blaVIM blaKPC-2 and type 4 (9.7%) and 3 (7.5%). Isolates presented a polyclonal behavior pulsotypes 28. The KPC-producing isolates 2 and VIM are associated with the ST235 and ST111 respectively. CONCLUSION: those generated in ICUs participating entities infections are highly variable and moderate resistance to carbapenems associated with the presence of KPC-2 and VIM associated with the pandemic clone ST235 and ST111.Pseudomonas aeruginosa, bacteria ubicua que puede generar infecciones complicadas en pacientes hospitalarios, incrementando los índices de morbimortalidad debido al incremento de resistencia a los antimicrobianos de uso clínico, en especial los de última opción terapéutica como los carbapenémicos por la adquisición de determinantes de resistencia a través de elementos genéticos móviles principalmente. OBJETIVO: Caracterizar el perfil de resistencia y características moleculares de P. aeruginosa, aislada de pacientes adultos con diagnóstico de infección en tres unidades de cuidados intensivos en Colombia.MÉTODOS: Se analizaron pacientes con infecciones por P.aeruginosa en UCI adultos. A los aislamientos bacterianos se les determinó el perfil de susceptibilidad a 12 antibióticos y se amplificaron genes de resistencia a β-lactámicos, quinolonas, sulfonamidas y plataformas genéticas como integrón clase 1 y 2. La relación genética por medio de PFGE y MLST. RESULTADOS: En el estudio se analizaron 40 pacientes de los cuales 23(57,5%) pertenecen a una UCI en la ciudad de Pereira. Las principales fuentes de aislamiento de los microorganismos son hemocultivos 13(32,5%) y urocultivos 11(27,5%). Los perfiles de resistencia SAM-FOX y SAM-FOX-SXT se presentaron en 6(15,0%) y 4(10,0%) aislamientos respectivamente. Las β-lactamasas más frecuentes fueron de tipo blaTEM, en 8(20,0%), blaSHV 7(17.5%) y blaCTX-M 3(7.5%), carbapenemasas de tipo blaKPC-2 y blaVIM en 4(9.7%) y 3(7.5%). Los aislamientos presentan un comportamiento policlonal con 28 pulsotipos. Los aislamientos productores de KPC-2 y VIM se encuentran asociados al ST235 y ST111 respectivamente. CONCLUSIONES: las infecciones generadas en las UCI de las entidades participantes presentan gran variabilidad y con una moderada resistencia a carbapenémicos asociados a la presencia de KPC-2 y VIM asociados al clon pandémico ST235 y ST111

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