Modelo de gestión de calidad que permita disminuir el índice de deserción en estudios de modalidad no escolarizada para nivel superior

Las estadísticas de la ANUIES (2016), indicaron que la matrícula correspondiente al nivel licenciatura en modalidad no escolarizada para el ciclo escolar 2015-2016 era de 497,646 reflejando un incremento de 26%, lo que significa que está creciendo de manera considerable. Sin embargo, el índice de deserción sigue siendo un tema a tratar lo que nos llevó en este trabajo a encontrar estrategias para disminuirlo. Se presenta la propuesta de modelo de gestión de calidad con el objetivo de encontrar alternativas que coadyuven al logro de mayores oportunidades de permanencia. Derivado de lo anterior, se revisaron modelos que han surgido para gestionar la calidad en el e-learning: e-quality framewok (propuesto por el Institute of Higher Education Policy and The Sloan Consortium), OLC’s Five Pillars of Quality Online Education (creado por Online Learning Consortium) y The e-Learning Maturity Model (fundado por Marshall). Con los elementos complementarios entre los modelos se generó un instrumento de recolección de datos y se aplicó en una Institución de Educación Superior. Se propuso un procedimiento para obtener resultados, los cuales permiten identificar los factores que más influyen en la deserción escolar y derivan en el planteamiento de acciones sugeridas de mejora. El procedimiento se tendría que aplicar para cada plan de estudios que tenga problema de deserción mayor con el propósito de generar resultados y estrategias ah doc. Después de haber aplicado el procedimiento en un semestre y plan de estudios específico se recomienda generar estrategias realistas para ser implementadas. Además, se recomienda volver a aplicar el instrumento para el mismo plan de estudios y después de haber implementado algunas acciones de mejora; con la finalidad de observar los cambios en la percepción del estudiante, de tal manera que el estudio se vuelva longitudinal; quizá como encuesta de satisfacción del usuario y sea aplicada de manera oficial cada semestre. También, se recomienda que el estudio se vuelva correlacional una vez que se aplique en varias universidades de México. Por otro lado, y dado que el instrumento propuesto es aplicable a los estudiantes es pertinente que el estudio se complemente con otro instrumento aplicable a los demás actores de la educación no escolarizada (sistema a distancia) para que se tengan resultados desde diferentes perspectivas

Modelo de gestión de calidad que permita disminuir el índice de deserción en estudios de modalidad no escolarizada para nivel superior

Las estadísticas de la ANUIES (2016), indicaron que la matrícula correspondiente al nivel licenciatura en modalidad no escolarizada para el ciclo escolar 2015-2016 era de 497,646 reflejando un incremento de 26%, lo que significa que está creciendo de manera considerable. Sin embargo, el índice de deserción sigue siendo un tema a tratar lo que nos llevó en este trabajo a encontrar estrategias para disminuirlo. Se presenta la propuesta de modelo de gestión de calidad con el objetivo de encontrar alternativas que coadyuven al logro de mayores oportunidades de permanencia

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Ruralidad y campesinado

¿Existe aún el campo? ¿Desapareció el campesinado? ¿Triunfó la expansión del modo de vida urbano y de los urbanistas? ¿Subsiste aún un modo de vida rural? ¿Existe aún una cultura campesina? ¿Cuáles son las tensiones y principales amenazas que recorren el mundo rural latinoamericano? ¿Cuáles son las formas de resistencia desde la identidad campesina e indígena a la marea globalizante? ¿Qué experiencias promisorias y/ o exitosas se están desplegando en el mundo rural? ¿Cómo se ha transformado la ruralidad en las últimas décadas? ¿Cómo se enlaza la producción agraria con la emergencia de territorios intermedios? son algunas de las muchas preguntas que abordamos en este número de Polis

Global variations in heart failure etiology, management, and outcomes

Importance: Most epidemiological studies of heart failure (HF) have been conducted in high-income countries with limited comparable data from middle- or low-income countries. Objective: To examine differences in HF etiology, treatment, and outcomes between groups of countries at different levels of economic development. Design, Setting, and Participants: Multinational HF registry of 23 341 participants in 40 high-income, upper–middle-income, lower–middle-income, and low-income countries, followed up for a median period of 2.0 years. Main Outcomes and Measures: HF cause, HF medication use, hospitalization, and death. Results: Mean (SD) age of participants was 63.1 (14.9) years, and 9119 (39.1%) were female. The most common cause of HF was ischemic heart disease (38.1%) followed by hypertension (20.2%). The proportion of participants with HF with reduced ejection fraction taking the combination of a β-blocker, renin-angiotensin system inhibitor, and mineralocorticoid receptor antagonist was highest in upper–middle-income (61.9%) and high-income countries (51.1%), and it was lowest in low-income (45.7%) and lower–middle-income countries (39.5%) (P &lt; .001). The age- and sex- standardized mortality rate per 100 person-years was lowest in high-income countries (7.8 [95% CI, 7.5-8.2]), 9.3 (95% CI, 8.8-9.9) in upper–middle-income countries, 15.7 (95% CI, 15.0-16.4) in lower–middle-income countries, and it was highest in low-income countries (19.1 [95% CI, 17.6-20.7]). Hospitalization rates were more frequent than death rates in high-income countries (ratio = 3.8) and in upper–middle-income countries (ratio = 2.4), similar in lower–middle-income countries (ratio = 1.1), and less frequent in low-income countries (ratio = 0.6). The 30-day case-fatality rate after first hospital admission was lowest in high-income countries (6.7%), followed by upper–middle-income countries (9.7%), then lower–middle-income countries (21.1%), and highest in low-income countries (31.6%). The proportional risk of death within 30 days of a first hospital admission was 3- to 5-fold higher in lower–middle-income countries and low-income countries compared with high-income countries after adjusting for patient characteristics and use of long-term HF therapies. Conclusions and Relevance: This study of HF patients from 40 different countries and derived from 4 different economic levels demonstrated differences in HF etiologies, management, and outcomes. These data may be useful in planning approaches to improve HF prevention and treatment globally

Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries

Background: Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0–14 years) and adults (aged 15–99 years) diagnosed with a haematological malignancy during 2000–14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0–24 years). Methods: We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0–14 years), adolescents (15–19 years), and young adults (20–24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. Findings: 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010–14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010–14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000–14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. Interpretation: This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group

Alirocumab and cardiovascular outcomes after acute coronary syndrome

BACKGROUN