Modern handheld devices and wireless communications foster new kinds of communication and interaction that can define new approaches to teaching and learning. Mobile learning (m-learning) seeks to ...use them extensively, exactly in the same way in which e-learning uses personal computers and wired communication technologies. In this new mobile environment, new applications and educational models need to be created and tested to confirm (or reject) their validity and usefulness. In this article, we present a mobile tool aimed at self-assessment, which allows students to test their knowledge at any place and at any time. The degree to which the students' achievement improved is also evaluated, and a survey on the students' opinion of the new tool was also conducted. An experimental group of 20- to 21-year-old nursing students was chosen to test the tool. Results show that this kind of tool improves students' achievement and does not make necessary to introduce substantial changes in current teaching activities and methodology.
ObjectiveTo describe mortality of in-hospital patients with COVID-19 and compare risk factors between survivors and non-survivors.DesignProspective cohort of adult inpatients.SettingTertiary ...healthcare teaching hospital in Guadalajara, Mexico.ParticipantsAll patients with confirmed COVID-19 hospitalised from 25 March to 7 September 2020 were included. End of study: 7 November 2020.Primary outcome measuresPatient survival analysed by the Kaplan-Meier method and comparison of factors by the log-rank test. Mortality risk factors analysed by multivariate Cox’s proportional-hazard model.ResultsOne thousand ten patients included: 386 (38%) died, 618 (61%) alive at discharge and six (0.6%) remained hospitalised. There was predominance of men (63%) and high frequency of overweight–obesity (71%); hypertension (54%); diabetes (40%); and lung (9%), cardiovascular (8%) and kidney diseases (11%); all of them significantly more frequent in non-survivors. Overweight–obesity was not different between groups, but severity of disease (Manchester Triage System and quick Sequential Organ Failure Assessment) was significantly worse in non-survivors, who were also significantly older (65 vs 45 years, respectively) and had haematological, biochemical, coagulation and inflammatory biomarkers more altered than survivors. Mortality predictors were invasive mechanical ventilation (IMV; OR 3.31, p<0.0001), admission to intensive care unit (ICU; OR 2.18, p<0.0001), age (OR 1.02, p<0.0001), Manchester Triage System (urgent OR 1.44, p=0.02; immediate/very urgent OR 2.02, p=0.004), baseline C reactive protein (CRP; OR 1.002, p=0.009) and antecedent of kidney disease (OR 1.58, p=0.04)ConclusionsMortality in hospitalised patients with COVID-19 in this emerging country centre seemed to be higher than in developed countries. Patients displayed a high frequency of risk factors for poor outcome, but the need for IMV, ICU admission, older age, more severe disease at admission, antecedent of kidney disease and higher CRP levels significantly predicted mortality.
La eficacia antifúngica de los extractos acuosos de mesocarpio de coco (Cocos nucifera L.) (EAC) y el quitosano comercial (QC) aplicados de manera individual y en combinación se evaluó contra ...Rhizopus stolonifer en términos de crecimiento micelial, esporulación y germinación de las esporas, así como la obtención de los modelos de crecimiento primario en dos temperaturas de almacenamiento (15-25 ºC). La aplicación de los EAC al 10% redujo significativamente el crecimiento micelial de R. stolonifer (58.81 ± 6.48%); por otro lado, el QC (1.5%) mostró un efecto de control de hasta un 87%, sin embargo, la combinación de los EAC (10%) con el QC (1.5%) fue más efectiva al reducir el crecimiento micelial (> 93 %). Todos los tratamientos fueron efectivos para disminuir la producción de esporas (> 94 %) en comparación con el control (agar). El QC al combinarse con los EAC fue más efectivo inhibiendola elongación del tubo germinal (> 98 %) comparado con los tratamientos individuales (< 48 %). El modelo modificado de Gompertz mostró un ajuste adecuado para ambos rangos de temperatura (> 98-99 %) observándose diferencias significativas (p ≤ 0.05) entre las variables de velocidad máxima (Vmáx) y periodo de latencia (ƛ), no obstante, todos los tratamientos mostraron un efecto fungistático sobre el desarrollo micelial de R. stolonifer. La combinación de los EAC y el QC puede ser una alternativa eco-amigable contra la pudrición suave de los frutos de guanábana.
We sought to describe neonatal morbidities and therapeutic interventions in very low-birth-weight (VLBW) and extremely low-birth-weight (ELBW) infants cared for in Spanish hospitals. We preformed a ...prospective collection of data covering the perinatal period until discharge by the SEN1500 network. This network, set up by the Spanish Society of Neonatology, targets VLBW and ELBW infants (400 to 1500 g) admitted to neonatal units in Spanish hospitals. Data were recorded in electronic form and controlled for possible errors or inconsistencies before analysis. We report data for 8836 neonates admitted to 48 neonatal units from January 2002 to December 2005. Prenatal steroids were given to significantly more newborns in 2003 to 2005 (79.4%) than in 2002 (73.4%), although the remaining perinatal data examined failed to significantly vary. Delivery was by cesarean section in 69.8% of cases but significantly lower (35.9%) for infants under a postmenstrual age of 26 weeks. Hyaline membrane disease was diagnosed in 53.9% of the newborns and bronchopulmonary dysplasia (BPD) in 10.46%. Mechanical ventilation was employed in 69.1%, surfactant in 50.3%, and steroids for BPD in 5.3%. Intraventricular hemorrhage grades 3 to 4 (8.1%) and cystic leukomalacia (2.6%) were the most relevant brain ultrasonography findings. Rates of early- and late-onset septicemia were 5% and 29.4%, respectively. Further diagnoses were necrotizing enterocolitis (NEC; 6.9%) and persistent ductus arteriosus (PDA; 24.2%); 40.6% of the cases of NEC and 15.3% of those of PDA required surgery. In addition, 26.6% of the newborns required supplementary oxygen at 28 days of life. The number of newborns who had not recovered their birth weight at this age fell from 3.1% in 2002 to 1.5% in 2005. Rates of prenatal steroid use, cesarean delivery, and main morbidities were comparable to figures cited for other patient series, although our BPD rate was among the lowest reported and nosocomial sepsis rate among the highest.
The purpose of this study was to analyze the mortality and its prognostic factors in a Spanish cohort of very low birthweight (VLBW) infants during the period 2002 to 2005. Using the Spanish Society ...of Neonatology database (SEN 1500), 8942 infants with a birthweight < 1500 g were recruited. The overall mortality was 17.3%. However, this incidence underwent a significant decrease over the study period, from 19.4% in 2002 to 15.2% in 2005 ( P = 0.003). Mortality ranged from 12.4% in 25% of the participating neonatal units to 19.4% in a further 25%. Mortality was higher in outborn infants (25.8%) than in inborn infants (16.6%) ( P < 0.001). The mortality rates of these neonates are also presented by 100-g intervals (401 to 1500) and for the different hospitalization times: in the delivery room, within 24 hours and 28 days of birth, at 36 weeks of postmenstrual age, and on discharge. Of note was that mortality was greatest within 24 hours and 28 days of birth in each of the weight groups ( P < 0.001). In conclusion, in the cohort of infants < 1500 g examined, mortality in the period from 2002 to 2005 was still high, especially among newborns weighing < 1000 g. We did, however, observe a decreasing trend in mortality rates for the participating neonatal units over the 4 study years. Our findings highlight the need to promote intrauterine transport and improve neonatal transport as well as the management of these infants in the delivery room and within the first 28 days of life.
Se realizó un análisis crítico del Programa de la asignatura Pediatría, teniendo en cuenta las nuevas transformaciones que han tenido lugar en la Educación Superior en general y en la Educación ...Médica en particular, con el fin de sugerir cambios que ayuden a perfeccionar la enseñanza de la Pediatría en nuestro medio. Las respuestas de la Educación Superior en el mundo que se transforma deben guiarse por los criterios que determinan su jerarquía, a saber: pertinencia, calidad e internacionalización. La Universidad alcanzará su excelencia cuando la ciencia, la tecnología y el arte que en ella se desarrollan, formen parte de la cultura de la sociedad como consecuencia de su competencia e interacción. El encargo social de la Universidad es el de formar profesionales competentes, capaces de asimilar los cambios tecnológicos e introducirlos en la práctica social de forma creativa e innovadora; esto exige transformaciones en el proceso de formación del profesional que respondan a la dinámica de cambio cultural del mundo para este nuevo siglo. El Diseño Curricular ha pasado por ciertas etapas y su reevaluación ha determinado que el proceso de perfeccionamiento de la educación superior constituya uno de los retos que se imponen. En general, los procesos educativos actuales, nos han motivado a hacer un análisis crítico del programa para evaluar su transformación en los momentos actuales.A critical analysis of the Syllabus of the subject of Pediatrics was carried out, considering the new transformations that have taken place in the Higher Education generally and the Medical Education particularly, aimed at suggesting changes which help to perfect the teaching of Pediatrics in our environment. The responses of the Higher Education in the world that is being transformed should follow the criteria that determine their hierarchy, namely, pertinence, quality and internationalization. The university will reach its excellence when the science, technology, and art developed in it take part in the culture of the society as a consequence of its competence and interaction with it. The University's social assignment is to form competent professionals, capable of assimilating the technological changes and introduce them into the social practice in a creative and innovative way; this demands transformations in the process of forming the professional, which respond to the cultural change dynamics of the world for this new century. The Curricular Design has undergone different stages, and its re-evaluation has caused the process of perfecting the higher education to be one of the challenges to be faced, generally, in the current educational processes, which motivates us to critically analyze the syllabus to evaluate its transformation today.
Se realizó un análisis crítico del Programa de la asignatura Pediatría, teniendo en cuenta las nuevas transformaciones que han tenido lugar en la Educación Superior en general y en la Educación ...Médica en particular, con el fin de sugerir cambios que ayuden a perfeccionar la enseñanza de la Pediatría en nuestro medio. Las respuestas de la Educación Superior en el mundo que se transforma deben guiarse por los criterios que determinan su jerarquía, a saber: pertinencia, calidad e internacionalización. La Universidad alcanzará su excelencia cuando la ciencia, la tecnología y el arte que en ella se desarrollan, formen parte de la cultura de la sociedad como consecuencia de su competencia e interacción. El encargo social de la Universidad es el de formar profesionales competentes, capaces de asimilar los cambios tecnológicos e introducirlos en la práctica social de forma creativa e innovadora; esto exige transformaciones en el proceso de formación del profesional que respondan a la dinámica de cambio cultural del mundo para este nuevo siglo. El Diseño Curricular ha pasado por ciertas etapas y su reevaluación ha determinado que el proceso de perfeccionamiento de la educación superior constituya uno de los retos que se imponen. En general, los procesos educativos actuales, nos han motivado a hacer un análisis crítico del programa para evaluar su transformación en los momentos actuales.
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