Comparación de clima organizacional escolar y convivencia escolar en liceos prioritarios urbanos y rurales de las provincias de Curicó y Ñuble

98 p.El objetivo del presente estudio es describir organizaciones educacionales a partir de evaluaciones realizadas con el cuestionario de clima organizacional para instituciones educacionales chilenas y el cuestionario de convivencia escolar del MINEDUC (2002), evaluando si los resultados reflejan particularidades eventualmente asociadas a contextos rurales o urbanos. Para lo anterior, se utilizó una muestra total constituida por 175 profesores y 249 alumnos pertenecientes a 5 liceos prioritarios urbanos y rurales de la provincia de Curicó y Ñuble. El análisis de datos se realizó de manera distinta para clima y convivencia, para clima se realizó una prueba t para 2 muestras independientes, además de un análisis ANOVA y un procedimiento post-hoc de Tukey, para detectar las diferencias entre liceos, mientras que para convivencia se realizó un análisis de frecuencia de respuesta. Los resultados obtenidos respecto a clima indican que no existen diferencias significativas en el clima total entre liceos urbanos y liceos rurales, excepto en la variables motivación laboral. Sin embargo existen diferencias entre liceos por sí solos para las variables coordinación y apoyo de la dirección, motivación laboral y estilo de supervisión. Los resultados obtenidos en convivencia indican que los estudiantes de liceos rurales manifiestan tendencias más marcadas que los de liceos urbanos reportando por un lado el valor del respeto como algo central en las buenas relaciones interpersonales, y por otro, la violencia física o psicológica como manera de resolver conflictos entre compañeros. A partir de estos análisis se puede concluir que no existen diferencias significativas entre los contextos rurales y urbanos, y si las hubiera, a través de la medición de clima y convivencia no se podría detectar. Lo que se puede deber a que la influencia del contexto es mínima o muy difícil de determinar, o bien, que según la nueva definición de ruralidad planteada en el PNUD (2008), las diferencias entre el contexto rural y urbano están cada más acotadas. Finalmente, se concluye que al obtener información de clima y convivencia antes de iniciar una intervención en una institución escolar, dará la posibilidad de orientar esta intervención a aprovechar fortalezas o debilidades de los elementos interpersonales que afectan el funcionamiento de un establecimiento educacional. Palabras claves: Clima organizacional escolar, convivencia escolar, contextos educacionales./ ABSTRACT: The objective of this research is to describe organizations from diagnostic built with school organizational climate and school coexistence instruments, which reflect peculiarities associated with rural or urban contexts. The instruments used are the Litwin, Stringer and Newman´s organizational climate questionnaire arranged for Chilean educational institutions and the MINEDUC’s school coexistence questionnaire (2002). We used a total sample consists of 175 teachers and 249 students that belong to 5 priority urban and rural secondary schools in the provinces of Curicó and Ñuble. A t Test for 2 independent samples was made to analyze climate, also an ANOVA analysis and a post-hoc procedure of Tukey were applied. About coexistence was performed on an analysis of frequency response. The results about climate indicate no significant differences in total climate between both, urban and rural secundary high school, except in the work motivation variable. However, there are also differences between high schools alone in the coordination and management support, work motivation, and supervisory style variables. The results with respect to climate indicate no significant differences in the overall climate between urban high schools and rural secondary schools, except in the work motivation variable. but there are differences among secondary schools alone for variables structure, equipment and distribution of material, coordination and management support, work motivation, reward, and supervisory style. The results indicate that students living in rural secondary schools show trends more pronounced than those in urban high schools reporting on the one hand the value of respect as central to good relationships, and secondly, physical or psychological violence as a way of resolve conflicts among peers

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