Propuesta de mejora del nivel motivacional para el personal de las áreas banca personas y banca empresas del Banco Interamericano de Finanzas oficina 620 Chiclayo - 2015

Esta investigación tuvo como objetivo determinar del nivel motivacional del personal de las áreas comerciales del Banco Interamericano de Finanzas oficina 620 Chiclayo - 2015 basado en el análisis de los factores higiénicos y los factores motivacionales de la Teoría expuesta por Frederick Herzberg y en función a estos resultados, formular una propuesta de mejora de su nivel motivacional. El tipo de estudio de la investigación fue mixto (cualitativo y cuantitativo), porque se utilizó entrevistas exploratorias y luego se ejecutó una encuesta. Dentro de esta misma línea de acción, la encuesta aplicada se elaboró en base a la teoría de Frederick Herzberg, desarrollada en el trabajo “La motivación laboral: una propuesta de mejora” realizado por Cristina Fresno Lázaro. En este instrumento de medición se utilizó una escala de Likert, teniendo como población a la totalidad de los 21 colaboradores. En la investigación se puede concluir que el personal de las áreas de banca personas y banca empresas del Banco Interamericano de Finanzas, en cuanto a motivación, la mayoría de trabajadores se siente motivados intrínsecamente y en un porcentaje menor prevalece la motivación extrínseca. La variable de motivación según Herzberg se encuentra en un nivel alto para el 61%; por lo que se podría decir que, si motivan a sus colaboradores, pero no a todos de la misma manera; así mismo se caracteriza por tener los factores motivacionales como la dimensión que exponen los más altos niveles; al respecto la dimensión factores de higiene muestran un nivel medio

Trends in gender of authors of original research in oncology among major medical journals: a retrospective bibliometric study

MALF was supported by the Spanish National Health Institute Carlos III (Instituto de Salud Carlos III -ISCIII), Miguel Servet--I Investigator Grant/Award Number CP17/00206--EU--FEDER.Objective We evaluated the temporal trend in gender ratios of first and last authors in the field of oncological research published in major general medical and oncology journals and examined the gender pattern in coauthorship. Design We conducted a retrospective study in PubMed using the R package RISmed. We retrieved original research articles published in four general medical journals and six oncology specialty journals. These journals were selected based on their impact factors and popularity among oncologists. We identified the names of first and last authors from 1 January 2002 to 31 December 2019. The gender of the authors was identified and validated using the Gender API database (https:// gender-​api. com/). Primary and secondary outcome measures The percentages of first and last authors by gender and the gender ratios (male to female) and temporal trends in gender ratios of first and last authors were determined. Results We identified 34 624 research articles, in which 32 452 had the gender of both first and last authors identified. Among these 11 650 (33.6%) had women as the first author and 7908 (22.8%) as the last author, respectively. The proportion of female first and last authors increased from 26.6% and 16.2% in 2002, to 32.9% and 27.5% in 2019, respectively. However, the gender ratio (male to female) of first and last authors decreased by 1.5% and 2.6% per year, respectively, which were statistically significant (first author: incidence rate ratio (IRR) 0.98, 95% CI 0.97 to 1.00; last author: IRR 0.97, 95% CI 0.96 to 0.99). Male first and last authorship was the most common combination. Male–female and female– female pairs increased by 2.0% and 5.0%, respectively (IRR 1.02, 95% CI 1.01 to 1.03 and IRR 1.05, 95% CI 1.04 to 1.06, respectively). Conclusions The continued under-representation of women means that more efforts to address parity for advancement of women in academic oncology are needed.Spanish National Health Institute Carlos III (Instituto de Salud Carlos III -ISCIII) CP17/00206--EU--FEDE

Composition of lower urinary tract stones in canines in Mexico City

11th International symposium on urolithiasis, Nice, France, 2–5 September 2008 Urological Research (2008) 36:157–232. doi:10.1007/s00240-008-0145-5. http://www.springerlink.com/ content/x263655772684210/fulltext.pdf.Effective long-term management of urolithiasis depends on identification and manipulation of factors contributing to initial stone formation; identification of these factors depends on accurate identification of the mineral composition of the urolith involved. The purpose of this study was to determine the chemical composition of uroliths obtained from the low urinary tract of dogs in Mexico City. One hundred and five cases of urolithiasis were studied in which stones were surgically obtained from the low urinary tracts of dogs treated in different hospitals. The chemical composition of the uroliths was quantita- tively and qualitatively determined by stereoscopic microscopy, IR-spectroscopy, scanning electron micros- copy and X-ray microanalysis. Age of animals ranged from 4 months to 14 years, with a median of 5 years. Compo- sition and distribution of the uroliths were struvite 38.1%,calcium oxalate 26.7%, silica 13.3%, urate 7.6%, mixed 11.4%, compounds 1.9%, and cystine 1%. Most uroliths were found in pure breed dogs (75.2%); 23 different breeds were identified, and more than half of the submissions were from breeds of small size. In our study, the frequency of struvite, calcium oxalate, cystine, urates, mixed and com- pounds stones are in agreement with papers that report on dog populations in America and Europe, but a higher fre- quency of silica uroliths was observed in Mexico City dogs.This work has been partially supported by a project of Waltham Foundation in Mexico

The role of multimorbidity in short-term mortality of lung cancer patients in Spain: a population-based cohort study

M.A.L.F. received support from the Instituto de Salud Carlos III, Madrid, Spain (grant/award no. CP17/00206-EU-FEDER). This work was supported by the Instituto de Salud Carlos III, Madrid, Spain [EU-FEDER-FIS PI-18/01593], the Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiologia y Salud Publica), the Cancer Epidemiological Surveillance Subprogram (VICA) from the Instituto de Salud Carlos III, Madrid, Spain, and the Andalusian Department of Health [PI-0152/2017]. The funders had no role in the design and conduct of the study, data collection, management, analysis, and interpretation of the data, the preparation, review, or approval of the manuscript or the decision to submit the manuscript for publication.Aim: Chronic diseases often occur simultaneously and tend to be associated with adverse health outcomes, but limited research has been undertaken to understand their role in lung cancer mortality. Therefore, this study aims to describe the prevalence and patterns of having one (comorbidity) or ≥ 2 chronic diseases (multimorbidity) among lung cancer patients in Spain, and to examine the association between comorbidity or multimorbidity and short-term mortality risk at six months after cancer diagnosis. Methods: In this population-based cohort study, data were drawn from two Spanish population-based cancer registries, Girona and Granada, and electronic health records. We identified 1259 adult lung cancer patients, diagnosed from 1st January 2011 to 31st December 2012. We identified the most common patterns of individual comorbidities and their pairwise correlations. We used a flexible parametric modelling approach to assess the overall short-term mortality risk 6 months after cancer diagnosis by levels of comorbidity after adjusting for age, sex, smoking status, province of residence, surgery, cancer stage, histology, and body mass index. Results: We found high prevalence of comorbidity in lung cancer patients, especially among the elderly, men, those diagnosed with advanced-stage tumours, smokers, and obese patients. The most frequent comorbidities were chronic obstructive pulmonary disease (36.6%), diabetes (20.7%) and heart failure (16.8%). The strongest pairwise correlation was the combination of heart failure with renal disease (r = 0.20, p < 0.01), and heart failure with diabetes (r = 0.16, p < 0.01). Patients with either one or two or more comorbidities had 40% higher overall mortality risk than those without comorbidities (aHR for comorbidity: 1.4, 95%CI: 1.1–1.7; aHR for multimorbidity: 1.4, 95%CI: 1.1–1.8), when relevant confounding factors were considered. Conclusions: The presence of comorbid diseases, rather than the number of comorbidities, was associated with increasing the risk of short-term lung cancer mortality in Spain. Comorbidity was a consistent and independent predictor of mortality among lung cancer patients, six months after diagnosis. The most common comorbid conditions were age-, obesity- and tobacco-related diseases. Our findings highlight the need to develop targeted preventive interventions and more personalised clinical guidelines to address the needs of lung cancer patients with one or more comorbidities in Spain.Instituto de Salud Carlos III CP17/00206-EU-FEDER EU-FEDER-FIS PI-18/01593Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiologia y Salud Publica)Cancer Epidemiological Surveillance Subprogram (VICA) from the Instituto de Salud Carlos III, Madrid, SpainAndalusian Department of Health PI-0152/201

C-Terminal Binding Protein 2 Is a Novel Tumor Suppressor Targeting the Myc-Irf4 axis in Multiple Myeloma

Multiple myeloma (MM) cells are addicted to MYC and its direct transactivation targets IRF4 for proliferation and survival. MYC and IRF4 are still considered undruggable, as most small-molecule inhibitors suffer from low potency, suboptimal pharmacokinetic properties, and undesirable off-target effects. Indirect inhibition of MYC/IRF4 emerges as a therapeutic vulnerability in MM. Here, we uncovered an unappreciated tumor-suppressive role of C-terminal binding protein 2 (CTBP2) in MM via strong inhibition of the MYC-IRF4 axis. In contrast to epithelial cancers, CTBP2 is frequently downregulated in MM, in association with shortened survival, hyperproliferative features, and adverse clinical outcomes. Restoration of CTBP2 exhibited potent antitumor effects against MM in vitro and in vivo, with marked repression of the MYC-IRF4 network genes. Mechanistically, CTBP2 impeded the transcription of MYC and IRF4 by histone H3 lysine 27 deacetylation (H3K27ac) and indirectly via activation of the MYC repressor IFIT3. In addition, activation of the interferon gene signature by CTBP2 suggested its concomitant immunomodulatory role in MM. Epigenetic studies have revealed the contribution of polycomb-mediated silencing and DNA methylation to CTBP2 inactivation in MM. Notably, inhibitors of Enhance of zeste homolog 2, histone deacetylase, and DNA methyltransferase, currently under evaluation in clinical trials, were effective in restoring CTBP2 expression in MM. Our findings indicated that the loss of CTBP2 plays an essential role in myelomagenesis and deciphers an additional mechanistic link to MYC-IRF4 dysregulation in MM. We envision that the identification of novel critical regulators will facilitate the development of selective and effective approaches for treating this MYC/IRF4-addicted malignancy

精神病及癌症照顧者的社會支持及需要研究報告

本研究旨在探討非正式照顧者在照顧60歲或以上受精神病或癌症困擾的家庭成員時遇到的困難、長時間照顧工作帶來的問題和他們的非正式社會支持。同時亦針對他們的需要提出相關建議。受精神問題及癌症困擾的年長患者數字持續上升，這兩類患者的非正式照顧者(下文統稱為照顧者)多面對因患者的情緒起伏和病情轉變化而帶來的巨大壓力。為深入了解他們的現況和為制定相關政策及服務提供參考，研究團隊以半結構性訪談的方法搜集了15位精神病及癌症患者的照顧者和17位服務提供者的意見。 研究結果發現，精神病患者照顧者常遇到的困難包括：缺乏私人空間、經濟壓力大、對相關疾病資訊不了解和因社會的負面標籤不願向外界求助。同時，他們因要長時間照顧患者，人際關係、身體狀況和就業狀況均受到負面影響。對於照顧癌症家屬的照顧者，他們多不了解現有的支援服務，而且需要面對沉重的經濟壓力。由於需要長時間照顧患者，照顧者的日常生活和心理狀況皆受到影響，他們與患者的關係轉差。這兩類照顧者的非正式社會支援網絡主要為家人、朋友及教會會友。 針對照顧者的需要，研究團隊提出了五個建議。一、加強公眾教育以去除社會對精神病患者的負面標籤，減低患者家人及照顧者對尋求外界協助的顧慮。二、增加暫託服務的資源和人手以縮短輪候時間，並推行以地區為本的照顧者「社區保姆」計劃，提供空間予照顧者暫時離開患者，以處理突發或私人事務。三、設立地區性照顧者服務中心，提供輔導服務，推行照顧者技巧培訓、經濟諮詢、喘息活動和「社區保姆」計劃，令到照顧者可以在同一個服務單位獲得所需的服務。四、政府可透過線上資源整合平台為照顧者提供相關照顧資訊，讓照顧者及其家庭更易知悉社會支援服務。對於年長的照顧者，建議政府可以在他們常出現或較容易接觸到的地方擺設攤位街站，派發相關小冊子。五、增加照顧者的經濟支援，提供「喘息及活動津貼」，並且將「照顧元素」融入經濟援助項目，使到綜援申請人和長者生活津貼領取人可獲得一定比率的照顧者津貼金額

Effects of Probiotics and Synbiotics on Obesity, Insulin Resistance Syndrome, Type 2 Diabetes and Non-Alcoholic Fatty Liver Disease: A Review of Human Clinical Trials

The use of probiotics and synbiotics in the prevention and treatment of different disorders has dramatically increased over the last decade. Both probiotics and synbiotics are well known ingredients of functional foods and nutraceuticals and may provide beneficial health effects because they can influence the intestinal microbial ecology and immunity. The present study reviews the effects of probiotics and synbiotics on obesity, insulin resistance syndrome (IRS), type 2 diabetes (T2D) and non-alcoholic fatty liver disease (NAFLD) in human randomized clinical trials. Select probiotics and synbiotics provided beneficial effects in patients with obesity, mainly affecting the body mass index and fat mass. Some probiotics had beneficial effects on IRS, decreasing the cell adhesion molecule-1 levels, and the synbiotics decreased the insulin resistance and plasma lipid levels. Moreover, select probiotics improved the carbohydrate metabolism, fasting blood glucose, insulin sensitivity and antioxidant status and also reduced metabolic stress in subjects with T2D. Some probiotics and synbiotics improved the liver and metabolic parameters in patients with NAFLD. The oral intake of probiotics and synbiotics as co-adjuvants for the prevention and treatment of obesity, IRS, T2D and NAFLD is partially supported by the data shown in the present review. However, further studies are required to understand the precise mechanism of how probiotics and synbiotics affect these metabolic disorders

Socioeconomic Inequalities in Colorectal Cancer Survival in Southern Spain: A Multilevel Population-Based Cohort Study.

BACKGROUND: Colorectal cancer (CRC) is the most frequently diagnosed cancer in Spain. Socioeconomic inequalities in cancer survival are not documented in Spain. We aim to study the association of socioeconomic inequalities with overall mortality and survival among CRC patients in southern Spain. METHODS: We conducted a multilevel population-based cohort study, including CRC cases for the period 2011-2013. The study time-to-event outcome was death, and the primary exposure was CRC patients' socioeconomic status assessed by the Spanish deprivation index at the census tract level. We used a mixed-effects flexible hazard model, including census tract as a random intercept, to derive overall survival estimates by deprivation. RESULTS: Among 3589 CRC patients and 12,148 person-years at risk (pyr), 964 patients died before the end of the follow-up. Mortality by deprivation showed the highest mortality rate for the most deprived group (96.2 per 1000 pyr, 95% CI: 84.0-110.2). After adjusting for sex, age, cancer stage, and the area of residence, the most deprived had a 60% higher excess mortality risk than the less deprived group (excess mortality risk ratio: 1.6, 95% CI: 1.1-2.3). CONCLUSIONS: We found a consistent association between deprivation and CRC excess mortality and survival. The reasons behind these inequalities need further investigation in order to improve equality cancer outcomes in all social groups

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London