Estilos de enseñanza utilizada por el profesorado de educación física de los colegios de la red Sip con respecto al desarrollo de la inclusión de alumnos con Necesidades Educativas Especiales permanentes

Tesis (Profesor de Educación Física para la Enseñanza Básica, Licenciado en Educación)La Educación Física es una asignatura de gran importancia para todos los alumnos del país donde la inclusión ha tomado bastante relevancia para el desarrollo de dicha asignatura lo cual implica cambios y modificaciones de contenidos, enfoques, estructuras y estrategias basados en la responsabilidad del sistema educativo y en este caso los establecimientos de la Red SIP, para así contribuir con la mejora de la educación en todos sus aspectos. El presente estudio, posee como objetivo general determinar e identificar los estilos de enseñanza utilizados por los profesores de Educación Física de 4 colegios SIP para el desarrollo de la inclusión de alumnos con Necesidades Educativas Especiales Permanentes (NEEP). La importancia de este estudio radica en identificar el nivel de conocimiento, estilos de enseñanza, estrategias metodológicas y formación del profesorado en cuanto a las necesidades de los alumnos. Lo cual contribuye a un proceso de enseñanza-aprendizaje más inclusivo e íntegro, para todos los alumnos donde, además, el profesor se potencia de manera significativa aportando a su desarrollo profesional. Para recoger la información necesaria, es importante tener en cuenta que la investigación que se desarrolla es de tipo descriptiva, ya que a partir de las conclusiones que se presentan, se darán a conocer los diferentes escenarios en los cuales se desarrolla el profesor de Educación Física en cuanto a los niños con Necesidades Educativas Especiales Permanentes, destacando por lo demás, que el estudio es una investigación de tipo cuantitativa, donde se le asigna a cada profesor, según los resultados obtenidos en la encuesta, un tipo de estilo de enseñanza el cual resulta predominante en el momento de trabajar con los alumnos con NEEP. Dentro del análisis de los datos obtenidos durante la investigación se identifica el nivel de conocimiento de los profesores respecto a la presencia de NEEP en su comunidad educativa, sobre los estilos de enseñanza, el tipo de evaluación y metodologías de enseñanza aplicadas principalmente por el profesorado de la red SIP. Por consiguiente, dichas conclusiones responden cada uno de los objetivos propuestos en el desarrollo del estudio

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