Estratégia Empresarial : Formato de la Estratégia

La estrategia empresarial es uno de los campos de estudio que mayor interés ha despertado en el mundo académico y de los negocios. Articula las potencialidades de la empresa, mediante la acción coordinada y complementaria de sus componentes. En el presente trabajo se analiza los aspectos relevantes que intervienen en la formación de la estrategia para fortalecer la posición de una empresa, mediante este análisis se pretende entender que aspectos son considerados al momento de plantear una estrategia que contribuya al logro de los objetivos organizacionales. La formación de la estrategia denominada como planeación estratégica, se enfoca desde un principio en el desarrollo de la misión visión, estas implican resolver una serie de “cómos”: cómo hacer crecer el negocio, satisfacer a los clientes, ser mejores que los rivales y responder ante las condiciones cambiantes del mercado. En la formación de la estrategia se encuentra la escuela de pensamiento la cual está compuesta por diferentes escuelas propuestas por Henry Mintzberg, esta brinda aportaciones teóricas que muestran el papel central del medio ambiente externo a las organizaciones en el diseño de la estrategia principal. La formación de la estrategia toma en cuenta las decisiones de estrategia funcional, la estrategia funcional ampara las necesidades y propósitos del área funcional en relación con el cumplimiento de sus metas y objetivos. La estrategia corporativa define los negocios a los cuales la compañía se dedica, las oportunidades y amenazas que surgirán en el entorno y los objetivos de crecimiento que será preciso alcanzar. También maneja líneas de productos en base a factores: factores de crecimiento de mercado y participación del mercado. La metodología utilizada en la presente investigación, es la investigación documental, esta metodología genera un conocimiento valido y confiable para otras investigaciones que podrían llevarse a cabo dentro del área de administración estratégica

Evaluación de la sostenibilidad de la subcuenca hidrográfica La Fragua ubicada en el departamento de Nariño, mediante cuatro indicadores: Hidrología, Medio Ambiente, Vida y Política.

Maestría en Desarrollo Sostenible y Medio Ambiente, Facultad de Ciencias Contables, Económicas y Administrativas.Evaluación de la sostenibilidad de la subcuenca hidrográfica La Fragua ubicada en el departamento de Nariño, mediante cuatro indicadores: Hidrología, Medio Ambiente, Vida y Política. Para realizar este estudio, se aplicó la metodología del programa internacional de la UNESCO para América Latina y el Caribe, que integra los cuatro indicadores, lo cual permite identificar el estado de la cuenca, en el presente estudio se calculó la sostenibilidad de la cuenca presentando un puntaje de 0.42, con lo que se pudo inferir que, esta subcuenca se encuentra en un nivel bajo, debido a las cusas y efectos de las dinámicas y patrones de disminución de cobertura vegetal, el grado de calidad del recurso hídrico, elementos de conflictividad socio-ambiental y políticas aplicadas, en torno al uso de los recursos naturales y acceso a la biodiversidad, y las diferentes presiones que ejerce las actividades antropogénicas en la Subcuenca

Estado nutricional y hábitos alimentarios de los estudiantes de la especialidad de educación física de la Universidad Enrique Guzmán y Valle

El objetivo de este trabajo de investigación es relacionar el estado nutricional con los hábitos alimentarios de los estudiantes de Educación Física de la Universidad Nacional Enrique Guzmán y Valle. Metodología: La investigación es de tipo no experimental descriptivo con diseño correlacional, la muestra fue probabilística de tipo aleatorio simple, cuyo tamaño fue 184 estudiantes de la especialidad mencionada. Se realizaron medidas antropométricas como la talla y peso para calcular el ÍMC y clasificarlo el estado nutricional. Se empleó un cuestionario de hábitos alimentarios que está compuesto por 23 ítems, este instrumento fue validado mediante un juicio de expertos. Los datos fueron procesados mediante la estadística descriptiva e inferencial. Se determinó la correlación mediante el Rho de Spearman. Resultados: Se identificó que el 67,9% de los estudiantes de educación física tenían un estado nutricional normal, el 28,8% sobrepeso, asimismo el 3,3% obesidad y 0,0% delgadez. Por lo que consideramos al estado nutricional como preocupante. El 63,5% de los estudiantes respondieron que no en costumbres alimentarias y 57,3% respondió que sí en conducta alimentaria; por lo tanto, la dimensión costumbres alimentarias de la variable hábitos alimentarios no presentan aceptación. Conclusión: Existe relación significativa entre los hábitos alimentarios y el estado nutricional de los estudiantes de educación física de la Universidad Nacional Enrique Guzmán y Valle.The objective of this research work is to relate the nutritional status with the eating habits of the Physical Education students of the Enrique Guzmán y Valle National University. Methodology: The research is of a non-experimental descriptive type with a correlational design, the sample was probabilistic of a simple random type, whose size was 184 students of the aforementioned specialty. Anthropometric measurements such as height and weight were taken to calculate the BMI and classify the nutritional status. A questionnaire on eating habits was used, which is made up of 23 items; this instrument was validated by expert judgment. Data were processed using descriptive and inferential statistics. Correlation was determined using Spearman's Rho. Results: It was identified that 67.9% of physical education students had a normal nutritional status, 28.8% overweight, likewise 3.3% obesity and 0.0% thinness. Therefore, we consider the nutritional status as worrisome. 63.5% of the students answered no in eating habits and 57.3% answered yes in eating behavior; therefore, the eating habits dimension of the eating habits variable is not accepted. Conclusion: There is a significant relationship between eating habits and the nutritional status of physical education students at the Enrique Guzmán y Valle National University.ChosicaEducación Alimentaria y Nutrición en la ComunidadEscuela Profesional de Nutrición Human

Caracterización hidroquímica e isotópica de las aguas subterráneas del entorno de los Esteros de Iberá (Corrientes, Argentina)

Se han caracterizado química e isotópicamente las aguas subterráneas del entorno de los Esteros de l Iberá. Las aguas tienen mineralizaciones muy bajas a medias; las más salinas son de los sondeos más profundos (>1000 m). Hacia el centro, N y NE de la zona las aguas son principalmente bicarbonatadas sódicas, mientras que al S son bicarbonatadas cálcicas. Los dos pozos más profundos, Oberá (SO Misiones; 1050 m) y Monte Caseros (SE Corrientes; 1250 m), tienen aguas sulfatadas sódicas. El primero capta formaciones del SAG; el segundo formaciones salinas infrayacentes al SAG. En el entorno cercano a la laguna Iberá hay cuatro pozos de unos 100 m de profundidad que tienen agua clorurada sódica levemente salina, la cual parece ser mezcla del SAG y de otras formaciones. Varias aguas de distintas profundidades tienen actividades de 14C bajas. La combinación de δ18O, Cl y 14C sugiere que hay dos componentes antiguas que darían lugar a dos grupos de aguas mezcla.A chemical and isotopic characterization of the groundwaters around the Esteros del Iberá has been carried out. All groundwater samples have low to medium mineralization, except the two deepest samples (>1000 m). To the center, N and NE parts of the study area sodium-carbonate waters dominate; to the S and SE they are mostly calcium-carbonate. The two deepest samples, one in Oberá (SW Misiones; depth: 1050 m) and the other one in Monte Caseros (SE Corrientes; depth: 1250 m) belong to sodium-sulphate type. In the first case groundwater comes from GAS formations; in the second one deep saline groundwater comes from pre-GAS formations. In a small area close to the Iberá lagoon there are four wells around 100 m deep having sodium-chloride water, which is attributed to the GAS formations. Some groundwaters from different depths have low 14C activities. The combined study of δ18O, Cl and 14C suggests the presence of two different old components which would result on two groups of mixed waters.Universidad Nacional de La Plat

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Estudios de Caso sobre Ciencias Agropecuarias y Rurales en el siglo XXI.

Libro científico sobre estudios de casos en el medio agropecuario y ruralCon el advenimiento del siglo XXI y el avance de los procesos de globalización, el medio rural presenta diversos cambios económicos, sociales, políticos y culturales. Lo anterior significa que el campo es un objeto de estudio altamente dinámico, complejo e inasible. las ciencias agropecuarias y rurales, en la actualidad, requieren de un abordaje sistémico e interdisciplinario que den cuenta de la heterogeneidad de situaciones y contextos que enfrenta el campo mexicano. La presente obra agrupa 18 estudios de caso, que capturan algunas fotografías de las diversas problemáticas de la ruralidad mexicana, con lo cual se pretende dar cuenta tanto de los objetivos de estudio como de la perspectiva teórico metodológico desde que estos son abordados. lo anterior tiene que ver con el hecho de que las ciencias agropecuarias y rurales manifiestan un alto grado de observación empírica, motivo por el que los estudios de caso se convierten en la perspectiva metodológica idónea que permite ir y venir de la realidad a la teoría y viceversa para la construcción de objetos de estudio. En este volumen se aborda una gran diversidad de casos, que sintetizan la heterogeneidad de enfoques y perspectivas mediante las cuales los fenómenos agropecuarios y rurales han sido abordados en el Instituto de Ciencias Agropecuarias y Rurales de la Universidad Autónoma del Estado de México, en los últimos 30 años

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