VISIONES DE LA EDUCACION FINANCIERA: Analisis y perspectivas.

Este libro es el resultado de un trabajo de investigación por parte de todos los autores quienes integraron los capítulos, por lo que agradecemos su confianza e interés para ser parte de este gran proyecto académico. Gracias a los enlaces de cada una de las Instituciones que aceptaron respaldar este libro: Marlen Rocío Reyes Hernández, Profesora-Investigadora de la Universidad Autónoma del Estado de México; Rogelio Valenzuela Díaz, Decano de la Facultad de Economía de la Universidad de Panamá; Samuel Alberto Moreno Peralta, Presidente del Colegio de Economistas de Panamá, a los miembros de la Asociación Mexicana de Especialistas en Educación Financiera, Asociación Valor México y la Federación de Economistas de la República Mexicana. Asimismo, hacemos una deferencia a los jóvenes talentosos que acompañaron en la coordinación del documento final, entrañables alumnos, becarios y amigos: Julio César Silva Vázquez y Alfredo Larry Vargas Hernández, que estamos convencidas que alcanzarán todas sus metas que se propongan en la vida. También es necesario reconocer a nuestras amadas familias que compartieron el tiempo de convivencia, para que lográramos la realización de este libroVisiones de la educación financiera: análisis y perspectivas es una obra que enmarca la importancia de la educación financiera en la sociedad en el contexto actual. Las decisiones que en este tema realiza un individuo pueden impactar positiva o negativamente su estabilidad económica por un periodo indeterminado, es aquí cuando la educación financiera actúa como una herramienta trascendental en su bienestar personal. Además de tener la función de armadura ante las batallas que se libran en los mercados —como la crisis financiera de 2008— funge como dinamizador de las economías al potenciar los proyectos de inversión con el aumento del emprendedurismo, impactando así en las variables macroeconómicas. Esta área del conocimiento ha adquirido importancia y popularidad a nivel internacional a raíz de las crisis económicas de los últimos años, sin embargo, aún existen, entre otras, brechas sociodemográficas, culturales, económicas, que no permiten el acceso a estas enseñanzas, excluyendo parte de la población del proceso del bienestar económico. Para ejemplificar esta desigualdad, en los capítulos se plasma un panorama internacional de la educación financiera, considerando las implicaciones y retos que han tenido las estrategias nacionales de educación financiera a nivel mundial

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Visiones de la educación financiera: Análisis y perspectivas

"Visiones de la educación financiera: análisis y perspectivas es una obra que enmarca la importancia de la educación financiera en la sociedad en el contexto actual. Las decisiones que en este tema realiza un individuo pueden impactar positiva o negativamente su estabilidad económica por un periodo indeterminado, es aquí cuando la educación financiera actúa como una herramienta trascendental en su bienestar personal. Además de tener la función de armadura ante las batallas que se libran en los mercados —como la crisis financiera de 2008— funge como dinamizador de las economías al potenciar los proyectos de inversión con el aumento del emprendedurismo, impactando así en las variables macroeconómicas. Esta área del conocimiento ha adquirido importancia y popularidad a nivel internacional a raíz de las crisis económicas de los últimos años, sin embargo, aún existen, entre otras, brechas sociodemográficas, culturales, económicas, que no permiten el acceso a estas enseñanzas, excluyendo parte de la población del proceso del bienestar económico. Para ejemplificar esta desigualdad, en los capítulos se plasma un panorama internacional de la educación financiera, considerando las implicaciones y retos que han tenido las estrategias nacionales de educación financiera a nivel mundial"

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

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