EDUCACIÓN SUPERIOR EN LA ADMINISTRACIÓN Y SU APRECIO LABORAL EN MÉXICO

This essay addresses the issue of management higher education appreciation on labor context in Mexico. Some aspects and factors involved in the current phenomenon which seems that do not match the objectives of High Education Institutions (HEI) to the needs of the business sector of the country are exposed. Education competency, implementation and certification of quality systems as important factors in order to develop students holistically in those skills than the workforce demand arise. The conclusion that there are inconsistencies in the premises stated, due the fact of having a career is not synonymous of getting a good job and proper wage. It is required coordination and cooperation among agencies, institutions and companies to improve this situation, creating fast and efficient strategies to achieve an effective implementation

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

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 middle-income 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 low-income 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 low-income, 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

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

Análisis Especialista Seis Sigma y Cultura Organizacional en la relación con la Estrategia Seis Sigma y la Competitividad

Los factores para el éxito así como los desafíos que enfrenta la implementación de la estrategia Seis Sigma, revela que tanto el trabajador y la organización tienen una participación activa que ayudan o dificultan la ejecución de la estrategia Seis Sigma. Por tanto, el objetivo de este trabajo de investigación fue desarrollar un modelo que analice al Especialista Seis Sigma y la Cultura Organizacional y la relación con la Estrategia Seis Sigma y ésta con la Competitividad. El enfoque de la investigación fue cuantitativo, con un diseño no experimental dentro de los diseños transeccional, con un alcance correlacional-causal. La población de estudios se desarrolló en el sector de fabricación de partes para vehículos automotores, localizadas geográficamente en Ciudad Juárez Chihuahua. La prueba estadística utilizada para contrastar las hipótesis fue la técnica de modelado de ecuaciones estructurales. Se aportó evidencia a favor que la Cultura Organizacional y el Especialista Seis Sigma tienen una relación significativa con la Estrategia Seis Sigma y ésta tiene una relación significativa con la Competitividad, confirmado uno de los varios modelos posibles y para el contexto del sector que fue estudiado. Por consiguiente, el especialista Seis Sigma y la cultura organizacional tienen una relación que juntos fortalecen las organizaciones para el cumplimiento de estrategias organizacionales competitivas como lo es la estrategia Seis Sigma. Finalmente, proporcionar un trampolín hacia una mayor investigación en esta corriente, otras interrelaciones y /o modelos con posibles cambios en el área de estudio. Encontrándose coincidencias en algunos estudios solo por pares de variables pero no en si en todo el modelo

Los métodos estadísticos como fuente de mejora de la calidad en las empresas de manufactura

El presente ensayo tiene como objetivo mostrar la relación de los métodos estadísticos como una de las técnicas cuantitativas de mayor utilidad en la mejora de la calidad en empresas de manufactura, describiendo los conceptos, teorías relevantes que enmarcan la importancia de los métodos estadísticos, sistemas de la calidad, líderes filosóficos, metodologías y sistemas de la organización, así como estudios de investigación aplicada, que muestran el uso de los métodos estadísticos como herramientas de calidad en las empresas; encontrándose en algunos de estos estudios un porcentaje bajo del uso de métodos estadísticos, en otros estudios cómo se han aplicado las herramientas estadísticas en los procesos y los beneficios en estos, y en algún otro estudio las herramientas estadísticas como factor de éxito en Seis Sigma. El presente trabajo parte de una comprensiva revisión de literatura mediante el análisis de artículos científicos. Por tanto, el estado del uso y el tipo de métodos estadísticos que se presentan en la realidad de los procesos requieren acciones de la compañía, que van desde un posible programa de capacitación hasta un cambio de cultura y aprendizaje organizacionales

Los métodos estadísticos como fuente de mejora de la calidad en las empresas de manufactura

El presente ensayo tiene como objetivo mostrar la relación de los métodos estadísticos como una de las técnicas cuantitativas de mayor utilidad en la mejora de la calidad en empresas de manufactura, describiendo los conceptos, teorías relevantes que enmarcan la importancia de los métodos estadísticos, sistemas de la calidad, líderes filosóficos, metodologías y sistemas de la organización, así como estudios de investigación aplicada, que muestran el uso de los métodos estadísticos como herramientas de calidad en las empresas; encontrándose en algunos de estos estudios un porcentaje bajo del uso de métodos estadísticos, en otros estudios cómo se han aplicado las herramientas estadísticas en los procesos y los beneficios en estos, y en algún otro estudio las herramientas estadísticas como factor de éxito en Seis Sigma. El presente trabajo parte de una comprensiva revisión de literatura mediante el análisis de artículos científicos. Por tanto, el estado del uso y el tipo de métodos estadísticos que se presentan en la realidad de los procesos requieren acciones de la compañía, que van desde un posible programa de capacitación hasta un cambio de cultura y aprendizaje organizacionales

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN