De cómo la Administración podrá desarrollar una teoría que favorezca el bienestar

La administración como campo del conocimiento ha dedicado sus esfuerzos a producir teorías, métodos y técnicas que permiten desarrollar la racionalidad prevista por el sistema económico imperante, con lo cual ha contribuido al establecimiento de desigualdades inicuas y a la destrucción de la naturaleza.Resolver el problema de cómo administrar, ha llevado a encontrar soluciones y modelos que buscan la eficiencia en la relación costo-beneficio para satisfacción de los inversionistas privados, desconociendo sus impactos sociales y ecológicos.Las escuelas y los tratadistas que producen las teorías de la administración debería ocuparse de diseñar modelos organizacionales que incorporen al sistema económico nuevos conceptos y nuevas estructuras de costos que incluyan la cooperación y la ecología al lado del concepto de competencia.Administration, as a field of knowledge, has dedicated its efforts into producing theories. aproaches and techniques that open way to the development of rationality, foreseen by the ruling economical systems, with which it has contributed to the establishment of iniquitous inequalities and to the destruction of nature.Resolving the problem of how to administrate has led into finding solutions that seek effi-ciency in the cost-benefit relatinship for the satisfaction of private investors, failing to rec-ognize its social and ecological impacts.Schools and experts who produce theories of administration should occupy themselves in designing organizational models that would incorpórate new concepts and new structures of costs to the economical system, which in-clude cooperation and ecology along with the concept of competition

De cómo la Administración podrá desarrollar una teoría que favorezca el bienestar

Administration, as a field of knowledge, has dedicated its efforts into producing theories. aproaches and techniques that open way to the development of rationality, foreseen by the ruling economical systems, with which it has contributed to the establishment of iniquitous inequalities and to the destruction of nature.Resolving the problem of how to administrate has led into finding solutions that seek effi-ciency in the cost-benefit relatinship for the satisfaction of private investors, failing to rec-ognize its social and ecological impacts.Schools and experts who produce theories of administration should occupy themselves in designing organizational models that would incorpórate new concepts and new structures of costs to the economical system, which in-clude cooperation and ecology along with the concept of competition.La administración como campo del conocimiento ha dedicado sus esfuerzos a producir teorías, métodos y técnicas que permiten desarrollar la racionalidad prevista por el sistema económico imperante, con lo cual ha contribuido al establecimiento de desigualdades inicuas y a la destrucción de la naturaleza.Resolver el problema de cómo administrar, ha llevado a encontrar soluciones y modelos que buscan la eficiencia en la relación costo-beneficio para satisfacción de los inversionistas privados, desconociendo sus impactos sociales y ecológicos.Las escuelas y los tratadistas que producen las teorías de la administración debería ocuparse de diseñar modelos organizacionales que incorporen al sistema económico nuevos conceptos y nuevas estructuras de costos que incluyan la cooperación y la ecología al lado del concepto de competencia

Covid-19: consecuencias y desafíos en la economía colombiana. Una mirada desde las universidades

Este libro reúne diferentes hallazgos, perspectivas y efectos ante un fenómeno que, más de un año después, todavía representa un reto científico, médico y social para todos. Igualmente, esta obra representa el objetivo de la Red Investigadores de Economía: aunar esfuerzos para encontrar respuestas y para fortalecer la investigación en el país, aumentar la difusión de trabajos de calidad y propiciar el encuentro entre académicos, universidades y el Banco de la República. Las investigaciones expuestas en este libro pasaron por un proceso de selección por parte del comité científico, asegurando que hubiese una pluralidad de miradas y de instituciones educativas, además del Banco, donde se relacionaran los efectos de la pandemia y la actividad económica en el país, las consecuencias sociales y regionales. El texto está dividido en cuatro partes. En la primera se hace un análisis macroeconómico de los efectos de la pandemia; para ello se examinan los efectos de la emergencia sanitaria a nivel nacional y regional mediante modelos macroeconómicos que permiten obtener respuestas ante preguntas muy relevantes. La segunda sección trata sobre el impacto en el mercado laboral, el efecto del Covid-19 en la distribución del ingreso y el efecto de corto plazo en el mercado urbano. La tercera parte aborda los efectos de la pandemia en los agentes económicos y en otros mercados. Ello incluye la exposición del empleo al Covid-19, la vulnerabilidad económica de los hogares en el país y su respuesta en el consumo, patrones de actividad laboral y salud mental, efectos en la educación, inseguridad alimentaria de la población migrante, entre otros. Por último, el cuarto segmento hace un énfasis especial en los efectos diferenciales entre las regiones del país y la heterogeneidad de dicho impacto; para ello se analizan temas de informalidad, vulnerabilidad, fuerza de trabajo disponible, entre otros, en distintas regiones del país

Avances de la Investigación en Ingeniería

El texto está conformado por 31 capítulos, agrupados en 5 grandes áreas temáticas. En la primera parte se encuentran los trabajos relacionados con el tema de los Recursos Hidráulicos; en la segunda parte se tratan temas relacionados con la Planificación y Gestión del Territorio; la tercera parte está relacionada con el Manejo Integral de los Recursos Agua, Aire y Suelo; la cuarta parte incluye la Investigación Aplicada a la Ingeniería de Sistemas, y la última parte comprende la Investigación Aplicada a la Ingeniería Civil

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

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

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