Estrategia y planificación de las alianzas estratégicas entre empresas

La globalización de la economía y la dificultad por parte de las empresas de llegar a ser plenamente competitivas en todas las etapas de sus sistemas de negocio y en mercados distintos del propio, ha provocado que la cooperación entre empresas se haya vuelto una necesidad. Partiendo de que las decisiones acerca del gobierno de una alianza estratégica no terminan con su formación. El objetivo del presente artículo, es mostrar en qué consiste el proceso de planificación y gestión de una alianza, haciendo especial hincapié en tres aspectos: la estructura contractual, los principales criterios que debemos tener presentes a la hora de seleccionar los socios y los sistemas de control y gestión existentes en el desarrollo del acuerdo.The economy globalization and the companies’ difficulties in becoming fully competitive in all segments of their businesses and in markets other than theirs, has resulted in venture cooperation becoming a need. It being understood that decisions on the management of strategic alliances go beyond their formation. The aim of this article is to outline the planning and management process of an alliance, especially emphasizing three aspects: the contractual structure, the main criteria to be taken into account to select partners, and the control and management systems for the implementation of the corresponding agreement

Aptitud clínica en la interpretación de electrocardiograma en una muestra de médicos becarios

ResumenIntroducciónLas enfermedades cardiovasculares son la principal causa de muerte en México. La educación en interpretación electrocardiográfica (ECG) aún es deficiente en pregrado y posgrado.ObjetivoEvaluar la interpretación ECG en becarios.Material y métodoEncuesta comparativa en 98 becarios, 70 internos de pregrado y 28 residentes de tres especialidades y un grupo de otras, en cuatro hospitales generales de zona. Variable dependiente: calificación obtenida en instrumento, conformado con 72 reactivos, con los siguientes indicadores: ritmo (15), medición (20), morfología (20) y diagnóstico (17), en cinco casos clínicos (fibrilación auricular, infarto agudo, hipertrofia ventricular izquierda, bloqueo rama izquierda y normalidad). Validación teórica, de contenido y constructo por tres cardiólogos, tres internistas y un médico familiar (técnica Delphi). Prueba piloto en 20 alumnos. Consistencia de 0.86 (Kuder-Richardson). Estadísticos: U de Mann-Whitney y Kruskal-Wallis (comparaciones intergrupales), Spearman y ANOVA.ResultadosLas calificaciones más altas (44) las obtuvieron los residentes, con la mitad de lo esperado (72), los internos obtuvieron una calificación menor (39). Hubo diferencias entre grupos de internos (p<0.05), pero no entre los que ingresaron seis meses antes. Los residentes de Medicina Interna obtuvieron medianas superiores (48) vs. los de pediatría (p<0.03) (mediana 31).DiscusiónLos resultados muestran pobre conocimiento en la interpretación del ECG. La no diferencia entre internos que ya han cursado un semestre, traduce una desvinculación clínica confirmada también por los valores bajos de los residentes con ocho meses cursados de su primer año.ConclusionesEs importante desarrollar el aprendizaje del ECG vinculado a la clínica durante el pregrado y posgrado.AbstractIntroductionCardiovascular diseases are the leading cause of death in Mexico. The education in the electrocardiogram (ECG) interpretation is deficient in students and residents.ObjectiveTo assess the student’s skills on ECG interpretation.Methods and materialsComparative survey of 98 students, 70 in medical internship and 28 residents of three specialties and a group of others, in four general hospitals. Dependent variable: Calculated medians in instrument conformed to 72 items, with the next indicators: rhythm (15), measurements (20), morphology (20) and diagnostic (17), in five clinical cases (auricular fibrillation, acute infarct, left ventricular hypertrophy, left bundle branch block and normality). Theorical, content and construct validity by three cardiologist, three internist’s, and one family physician (Delphi technique) was performed. Pre-test pilot in 20 students was obtained. Reliability 0.86 (Kuder-Richardson). Statistics: U Mann-Whitney and Kruskal-Wallis (intergroup comparisons), Spearman and ANOVA tests were used.ResultsThe highest rates were obtained (44) by residents, with half of the expected (72), the interns obtained a less rate (39). There was difference between the interns groups (p<0.05), but not between the ones that started six months earlier. Internal medicine residents showed better rates median (48) vs. pediatricians (p<0.03, median 31).Discussionthe results show the low knowledge in the interpretation of ECG’S. There is no difference between groups of interns who had one semester; this translates to a clinical disengagement confirmed by the low rates of the residents who had completed 8 months of their first year. Conclusions: It’s important to link the learning of ECG with the clinic activity while internship and residence

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Congreso Internacional de Responsabilidad Social Apuestas para el desarrollo regional.

Congreso Internacional de Responsabilidad Social: apuestas para el desarrollo regional [Edición 1 / Nov. 6 - 7: 2019 Bogotá D.C.]El Congreso Internacional de Responsabilidad Social “Apuestas para el Desarrollo Regional”, se llevó a cabo los días 6 y 7 de noviembre de 2019 en la ciudad de Bogotá D.C. como un evento académico e investigativo liderado por la Corporación Universitaria Minuto de Dios -UNIMINUTO – Rectoría Cundinamarca cuya pretensión fue el fomento de nuevos paradigmas, la divulgación de conocimiento renovado en torno a la Responsabilidad Social; finalidad adoptada institucionalmente como postura ética y política que impacta la docencia, la investigación y la proyección social, y cuyo propósito central es la promoción de una “sensibilización consciente y crítica ante las situaciones problemáticas, tanto de las comunidades como del país, al igual que la adquisición de unas competencias orientadas a la promoción y al compromiso con el desarrollo humano y social integral”. (UNIMINUTO, 2014). Dicha postura, de conciencia crítica y sensibilización social, sumada a la experiencia adquirida mediante el trabajo articulado con otras instituciones de índole académico y de forma directa con las comunidades, permitió establecer como objetivo central del evento la reflexión de los diferentes grupos de interés, la gestión de sus impactos como elementos puntuales que contribuyeron en la audiencia a la toma de conciencia frente al papel que se debe asumir a favor de la responsabilidad social como aporte seguro al desarrollo regional y a su vez al fortalecimiento de los Objetivos de Desarrollo Sostenible

Congreso Internacional de Responsabilidad Social Apuestas para el desarrollo regional.

Congreso Internacional de Responsabilidad Social: apuestas para el desarrollo regional [Edición 1 / Nov. 6 - 7: 2019 Bogotá D.C.]El Congreso Internacional de Responsabilidad Social “Apuestas para el Desarrollo Regional”, se llevó a cabo los días 6 y 7 de noviembre de 2019 en la ciudad de Bogotá D.C. como un evento académico e investigativo liderado por la Corporación Universitaria Minuto de Dios -UNIMINUTO – Rectoría Cundinamarca cuya pretensión fue el fomento de nuevos paradigmas, la divulgación de conocimiento renovado en torno a la Responsabilidad Social; finalidad adoptada institucionalmente como postura ética y política que impacta la docencia, la investigación y la proyección social, y cuyo propósito central es la promoción de una “sensibilización consciente y crítica ante las situaciones problemáticas, tanto de las comunidades como del país, al igual que la adquisición de unas competencias orientadas a la promoción y al compromiso con el desarrollo humano y social integral”. (UNIMINUTO, 2014). Dicha postura, de conciencia crítica y sensibilización social, sumada a la experiencia adquirida mediante el trabajo articulado con otras instituciones de índole académico y de forma directa con las comunidades, permitió establecer como objetivo central del evento la reflexión de los diferentes grupos de interés, la gestión de sus impactos como elementos puntuales que contribuyeron en la audiencia a la toma de conciencia frente al papel que se debe asumir a favor de la responsabilidad social como aporte seguro al desarrollo regional y a su vez al fortalecimiento de los Objetivos de Desarrollo Sostenible

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake