Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

El sistema de onboarding y el desempeño laboral en los docentes a tiempo completo de una universidad privada de Villa El Salvador, Lima 2021 – II

El presente estudio tuvo como objetivo identificar la relación entre onboarding y desempeño docente de una universidad privada de Villa El Salvador. La presente investigación es de tipo básica, con un diseño no experimental, correlacional y de corte transversal. Se aplicó una encuesta como técnica para onboarding y para desempeño docente a toda la población, conformada por 67 docentes a tiempo completo. Adicionalmente se utilizó una ficha de autopercepción, actualización de syllabus y portafolio, encuesta de satisfacción del estudiante y ficha de evaluación del director y cumplimiento de tareas administrativas. En los resultados de la presente investigación se encontró que el coeficiente de correlación de Spearman entre onboarding y desempeño del docente a tiempo completo es de -0.058 con una significancia (p-valor=0.639) superior al 0.05. Asimismo, el coeficiente de correlación de Spearman de la dimensión Preonboarding y el desempeño del docente a tiempo completo es de 0.064 con una significancia (p-valor=0.610) superior al 0.05. Adicionalmente, el coeficiente de correlación de Spearman de la dimensión de del Proceso de onboarding para un buen recibimiento del primer día del docente a tiempo completo y el de desempeño del docente a tiempo completo es de -0.035 con una significancia (p-valor=0.778) superior al 0.05. Además, el coeficiente de correlación de Spearman de la dimensión del proceso de onboarding de mentoring o acompañamiento del docente y el desempeño del docente a tiempo completo es de -0.137 con una significancia (p-valor=0.267) superior al 0.05. Por último, el coeficiente de correlación de Spearman de la dimensión de onboarding continuo o seguimiento y el desempeño del docente a tiempo completo es de -0.243 con una significancia (p-valor=0.047) inferior al 0.05. Se concluye que no existe relación significativa entre el proceso de onboarding y el desempeño del docente a tiempo completo de una universidad privada de Villa el Salvador. Adicionalmente, solo la dimensión de onboarding continuo o seguimiento y el desempeño del docente a tiempo completo tienen una relación significativa.The purpose of this study was to identify the relationship between onboarding and teaching performance at a private university in Villa El Salvador. It was a basic research, non-experimental, correlational, cross-sectional design. A survey for onboarding and teaching performance was applied to the entire population, which consisted of 67 full-time teachers. Additionally, a self-perception form, syllabus and portfolio update, student satisfaction survey and evaluation form of the director and fulfillment of administrative tasks were used. In the results of the present research it was found that the Spearman correlation coefficient between onboarding and full-time faculty performance is -0.058 with a significance (p-value=0.639) higher than 0.05. Likewise, the Spearman correlation coefficient of the Preonboarding dimension and full-time teacher performance is 0.064 with a significance (p-value=0.610) higher than 0.05. Additionally, the Spearman's correlation coefficient of the Onboarding Process dimension for a good reception of the first day of the full-time teacher and that of full-time teacher performance is -0.035 with a significance (p-value=0.778) higher than 0.05. In addition, the Spearman correlation coefficient of the onboarding process dimension of mentoring and full-time teacher performance is -0.137 with a significance (p-value=0.267) greater than 0.05. Finally, the Spearman correlation coefficient of the continuous onboarding or follow-up dimension and full-time teacher performance is -0.243 with a significance (p-value=0.047) lower than 0.05. It is concluded that there is no significant relationship between the onboarding process and the performance of full-time teachers at a private university in Villa el Salvador. In addition, only the dimension of continuous onboarding or follow-up and the performance of full-time teachers have a significant relationship.Trabajo de investigació

Comprensión y Producción de Lenguaje I - HU543 - 202101

Descripción: Comprensión y Producción de Lenguaje 1 es un curso de primer ciclo, que busca desarrollar las habilidades vinculadas con la comprensión lectora y la redacción de textos escritos formales y adecuados a una situación comunicativa determinada. Por ello, durante el curso, las actividades posibilitarán que el estudiante reflexione sobre cómo el lenguaje es una herramienta que nos permite entender la realidad (comprensión) y comunicar adecuadamente nuestras ideas sobre ella (producción). Esta reflexión se realizará con énfasis en el uso del lenguaje en las redes sociales, espacio que se ha constituido como un nuevo lugar para la divulgación de asuntos diversos: desde temas de ocio o entretenimiento hasta temas académicos, científicos y políticos. En ese sentido, este curso propone que el alumno asuma el rol de un ciudadano crítico, es decir, aquella persona que no solo consume información, sino que produce contenido a partir de una investigación en fuentes confiables. Considerando lo explicado, nuestros alumnos no solo serán capaces de redactar un texto escrito formal de acuerdo con las necesidades comunicativas del ámbito universitario y de la sociedad actual, sino que podrán transformarlo en un texto multimodal (el cual involucra diferentes medios de comunicación: visual, auditivo, imagen, texto, entre otros) que tenga sentido en las redes sociales, lugar de interacción real con sus lectores. Estos productos comunicativos deberán presentar una organización conveniente, un desarrollo sólido y suficiente (lo que implica una lectura crítica de las fuentes de información), y una escritura acorde con la normativa vigente. 3 Propósito: El curso desarrolla la competencia de comunicación escrita, en el nivel 1; es decir, el estudiante es capaz de construir mensajes coherentes y sólidos que se adecúan a la situación y propósito comunicativo. Este desarrollo le permite la generación y construcción de nuevas ideas, lo cual es relevante para su vida académica y profesional. La actual sociedad de la información y el conocimiento, caracterizada por la disrupción, la innovación y la complejidad en las formas de comunicación mediadas por la tecnología, enfrenta al estudiante y al profesional a nuevos retos en las maneras de comunicar aquello que conoce y que construye. En este escenario, la competencia comunicativa escrita adquiere protagonismo como herramienta para transmitir el conocimiento creado. El curso se alinea con esta exigencia, pues contribuye a que el estudiante responda exitosamente a las demandas comunicativas del contexto académico, y a que el egresado pueda desenvolverse idóneamente en el campo profesional y laboral

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially