Propuesta de mejora en la gestión de atención al cliente en una agencia de ventas de Trujillo de un All Inclusive Hotels & Resorts para mejorar la satisfacción al cliente

RESUMEN La presente investigación tuvo por objetivo, establecer una propuesta de mejora en la gestión de atención al cliente en una agencia de ventas de Trujillo de un All inclusive Hotels & Resorts que mejore la satisfacción del cliente. La muestra estuvo compuesta de los clientes que solicitaron información compren o no productos el mes de octubre (pre test) que fueron 217 y los clientes que acudieron el mes de diciembre que fueron 312 por ser temporada alta. Como instrumento se utilizó la encuesta SERVQUAL modificada y adaptada por Cabello & Chirinos, (2010), Conclusiones: Se encontró un nivel bajo de satisfacción del cliente de 44%. A nivel dimensional las otras dimensiones tuvieron puntuaciones que fueron Seguridad (47%) y Empatía (42%), las demás dimensiones mostraron valores entre 35 y 36%. Se desarrolló la propuesta de mejora de la gestión del cliente que abordo una capacitación en Conocimiento del negocio y productos, Atención al cliente, inteligencia emocional, ventas y valores empresariales, esta duró 13 días y duraron entre 60 y 90 minutos cada sesión. El nivel de satisfacción después de la propuesta de mejora en la gestión de atención al cliente fue del 65%, tuvo un incremento de +21% el primer mes después de su implementación. Se demostró estadísticamente con un nivel de confianza del 95% mediante la prueba de Chi Cuadrado que existe diferencia estadística significativa entre la satisfacción del cliente después de la intervención y la satisfacción del cliente antes de la intervención, lo que prueba la hipótesis alterna de la presente investigación: La propuesta de mejora en la gestión de atención al cliente en una agencia de ventas de Trujillo de un All inclusive Hotels & Resorts SI mejora la satisfacción del cliente.ABSTRACT The objective of the present investigation was to establish a proposal for improvement in the management of customer service in a Trujillo sales agency of an All-Inclusive Hotels & Resorts that improves customer satisfaction. The sample consisted of customers requesting information to buy or not products in the month of October (pre-test), which were 217 and customers who came in December which were 312 for high season. As an instrument the SERVQUAL survey was modified and adapted by Cabello & Chirinos, (2010), Conclusions: A low level of customer satisfaction was found 44%. At the dimensional level the dimensions of the lowest score were Security and empathy (13%), the other dimensions showed values between 43 and 44%. The proposal of improvement of the management of the client was developed that covered a training in Knowledge of the business and products, Customer service, emotional intelligence, sales and corporate values, it lasted 13 days and lasted between 60 and 90 minutes each session. The level of satisfaction after the proposed improvement in customer service management was 65%, had a + 21% increase the first month after its implementation. It was statistically demonstrated with a 95% confidence level using the Chi square test that there is a statistically significant difference between client satisfaction after the intervention and client satisfaction before the intervention, which proves the alternative hypothesis of the present Research: The proposal of improvement in the management of customer service in a Trujillo sales agency of an All Inclusive Hotels & Resorts SI improves customer satisfaction

Recovery of long-term paresis following resection of WHO grade II gliomas infiltrating the pyramidal pathway

Recent publications had reported high rates of preoperative neurological impairments in WHO grade II gliomas (GIIG) that significantly affect the quality of life. Consequently, one step further in the analysis of surgical outcome in GIIG is to evaluate if surgery is capable to improve preoperative deficits. Here are reported two cases of GIIG infiltrating the primary motor cortex and pyramidal pathway that had a long-term paresis before surgery. Both patients were operated with intraoperative electrical stimulation mapping, with identification and preservation of the primary motor cortex and pyramidal tract. Despite the long-lasting paresis, both cases had a significant improvement of motor function after surgery. Knowledge of this potential recovery before surgery is of major significance for planning the surgical strategy in GIIG. Two possible predictors of motor recovery were analyzed: 1) reconstruction of the corticospinal tract with diffusion tensor imaging tractography is indicative of anatomo-functional integrity, despite tract deviation and infiltration; 2) intraoperative identification of motor response by electrostimulation confirms the presence of an intact peritumoral tract. Thus, resection should stop at this boundary even in cases of long lasting preoperative hemiplegia

Retinosis pigmentaria en Cuba

A retrospective observational research was conducted during the period 1990-2010 in order to determine the prevalence of retinitis pigmentosa in the Cuban population. The universe consisted of the 5 209 patients with retinitis pigmentosa who were screened and diagnosed by multidisciplinary groups located in the 14 Provincial Retinitis Pigmentosa Centers in the country. Each patient had a general and ophthalmology medical history, according to standards established by the Ministry of Public Health. The information needed to comply with the objectives was obtained from the national registry of patients at the Camilo Cienfuegos International Center of Retinitis Pigmentosa. To analyse the data, the prevalence rates of retinitis pigmentosa per 10 000 inhabitants per year were calculated for each province and for the country. The prevalence rate of the disease in Cuba was analyzed, and its variations in the period from 1990 to 2010. The prevalence rate obtained in 1990 was 1.40 per 10 000 inhabitants. In 2010, the rate was of 4,61 x 10 000, increasing its initial value at 3.21, which represented a 228.5% increase. In the period 1994-2010, there were a total of 2544 new diagnoses, comparing the 2665 patients diagnosed in 1994, for a prevalence of the disease of 1 x 4082, with 5209 patients screened so far in the country, for a current prevalence of the disease in Cuba of 1 x 2164. Results like this support the effectiveness of the multidisciplinary approach and of the family study as a method for the screening and early diagnosis of hereditary and dystrophic diseases of the retina, facilitated by the existence of a national network of centers and the total coverage and accessibility the Cubans have guaranteed with our health care system.Se realizó una investigación observacional y retrospectiva durante el período de 1990-2010 con el objetivo de conocer la prevalencia de la retinosis pigmentaria en la población cubana. El universo de estudio estuvo constituido por los 5 209 pacientes con esta enfermedad que fueron pesquisados y diagnosticados por los grupos multidisciplinarios que radican en los 14 Centros Provinciales de retinosis pigmentaria del país. A cada paciente se le confeccionó una historia clínica oftalmológica y general según las normas establecidas por el Ministerio de Salud Pública; la información necesaria para dar cumplimiento a los objetivos se obtuvo del Registro Nacional de pacientes del Centro Internacional de Retinosis  Pigmentaria “Camilo Cienfuegos”. Para el análisis de la información se calcularon las tasas de prevalencia de retinosis pigmentaria anuales por 10 000 habitantes para cada provincia y el país. Se analizaron las tasas de prevalencia de la enfermedad en Cuba y sus variaciones en el período de 1990 a 2010; la tasa de prevalencia obtenida en 1990 fue de 1,40x10 000 habitantes y en 2010 de 4,61x10 000, se incrementó en 3.21 su valor inicial, que representó un 228.5% de incremento porcentual. En el período de 1994-2010 se realizaron un total de 2 544 nuevos diagnósticos, si se comparan los 2 665 enfermos diagnosticados en 1994, para una prevalencia de la enfermedad de 1x4082, con los 5 209 pacientes pesquisados hasta la fecha en el país, la prevalencia actual de esta enfermedad en Cuba es de 1x2164. Resultados como este (facilitados por la existencia de una red nacional de centros y la accesibilidad y la cobertura totales que los cubanos tienen garantizadas con el Sistema de Salud) avalan la efectividad del abordaje multidisciplinario y del estudio familiar como método de pesquisa y diagnóstico precoz de las enfermedades hereditarias y distróficas de la retina

Mitofusins modulate the increase in mitochondrial length, bioenergetics and secretory phenotype in therapy-induced senescent melanoma cells

Cellular senescence is an endpoint of chemotherapy, and targeted therapies in melanoma and the senescence-associated secretory phenotype (SASP) can affect tumor growth and microenvironment, influencing treatment outcomes. Metabolic interventions can modulate the SASP, and an enhanced mitochondrial energy metabolism supports resistance to therapy in melanoma cells. Herein, we assessed the mitochondrial function of therapy-induced senescent melanoma cells obtained after exposing the cells to temozolomide (TMZ), a methylating chemotherapeutic agent. Senescence induction in melanoma was accompanied by a substantial increase in mitochondrial basal, ATP-linked, and maximum respiration rates and in coupling efficiency, spare respiratory capacity, and respiratory control ratio. Further examinations revealed an increase in mitochondrial mass and length. Alterations in mitochondrial function and morphology were confirmed in isolated senescent cells, obtained by cell-size sorting. An increase in mitofusin 1 and 2 (MFN1 and 2) expression and levels was observed in senescent cells, pointing to alterations in mitochondrial fusion. Silencing mitofusin expression with short hairpin RNA (shRNA) prevented the increase in mitochondrial length, oxygen consumption rate and secretion of interleukin 6 (IL-6), a component of the SASP, in melanoma senescent cells. Our results represent the first in-depth study of mitochondrial function in therapy-induced senescence in melanoma. They indicate that senescence increases mitochondrial mass, length and energy metabolism; and highlight mitochondria as potential pharmacological targets to modulate senescence and the SASP.Agencia Nacional de Investigación e Innovación FCE_1_2017_1_13602

Fundamentos teórico-metodológicos sobre gestión de riesgos asociados al cuidado de Enfermería al paciente crítico

Introduction: the scientific development regarding the medical technology achieved in recent years, the multiple procedures and invasive techniques to which patients are subjected during their stay in intensive care units, associated with risks and adverse events. In a general sense, the role of nursing professionals is considered of vital importance in this topic, especially in the ICU, where they can contribute in an efficient and effective way to the management of health care risks.Objective: to base the theoretical-methodological and ethical referents of risk management associated with nursing care in Intensive Care Units.Methods: in the research Materialistic-Dialectic method was applied as the main one. In the theoretical order, the method of historical-logical analysis was analyzed applying theoretical-methodological and ethical references of the risk management process related to the nursing care of patient, as well as the analysis-synthesis and induction-deduction procedures.Development: the term risk management was conceptualized, determining the stages, importance and role of nursing in the development of this process, establishing the relationship with the principles of ethics and bioethics.Conclusions: clinical risk management in emergency care is an important methodological tool for the early identification and management of such events, a space in which nursing personnel play an essential role, with deep ethical and bioethical implications in the act of caring.Introducción: el desarrollo científico relativo a la tecnología médica alcanzado en los últimos años, los múltiples procederes y técnicas invasivas a que son sometidos los pacientes durante la estadía en las unidades de cuidados intensivos, conllevan riesgos y eventos adversos. En sentido general, se considera de vital importancia el rol de los profesionales de Enfermería en este tópico, especialmente en las UCI, donde pueden contribuir de un modo eficiente y eficaz a gestionar los riesgos de la atención sanitaria.Objetivo: fundamentar los referentes teórico-metodológicos y éticos de la gestión de riesgos asociados al cuidado de Enfermería en las Unidades de Cuidados Intensivos.Métodos: la investigación empleó como método principal el Dialéctico Materialista. En el orden teórico se utilizó el método de análisis histórico- lógico para analizar los referentes teórico-metodológicos y éticos del proceso de gestión de riesgos asociados al cuidado de enfermería al paciente, así como los procedimientos análisis-síntesis y la inducción-deducción.Desarrollo: se conceptualizó el término gestión de riesgos, determinándose las etapas, importancia y el rol de enfermería en el desarrollo de este proceso, estableciéndose la relación con los principios de la ética y bioética.Conclusiones: la gestión de riesgos clínicos se perfila como importante herramienta metodológica para la identificación precoz y manejo de dichos eventos, espacio en que el personal de Enfermería juega un rol fundamental, con profundas implicaciones éticas y bioéticas en el acto del cuidar

Incidence of urinary incontinence after hip fracture surgery and associated risk factors: a prospective study

Background The contribution of the postoperative process to developing or worsening urinary incontinence (UI) after hip fracture surgery (HFS) remains unclear. We aimed to evaluate UI incidence and worsening among older patients undergoing HFS, and explore associated risk factors.Methods This prospective cohort study included patients >= 75 years admitted between October 2019 and October 2021 to the Traumatology Service of three hospitals in the Consorci Sanitari de Alt-Pened & egrave;s i Garraf (Barcelona, Spain) with hip fracture requiring surgical treatment. UI was assessed using the first two questions of the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) at baseline and at days 30 (+/- 3 days) and 90 (+/- 3 days) after HFS. Surgery-related data and post-surgical complications were recorded.Results A total of 248 patients with a mean (SD) age of 85.8 (6.78) years were included; 77.8% were female and 154 (62.1%) had UI at baseline. After HFS, 3.24% experienced urinary tract infections (UTIs), 3.64%, acute urinary retention (AUR), 8.57%, constipation, and 53.9%, prolonged catheterization (> 24 h). Fifty-eight patients without baseline UI developed UI at 30 days, resulting in a UI incidence of 61.7% (95% CI 51.1-71.54) between days 0 and 30. Of the 248 patients, 146 (59.1%) experienced worsening of UI. AUR and UTIs were identified as risk factors for UI development and worsening after HFS, respectively.Conclusion The incidence of UI in older patients after HFS is significant. Patient management protocols should consider AUR and UTIs to reduce or eliminate the incidence of UI in older patients undergoing HFS

Competiciones de programación. Estímulo y salida laboral para los alumnos

Las competiciones de programación son un estímulo importante para los alumnos de informática. Durante los últimos años ha crecido el número de estas competiciones en su mayoría promovidas por grandes empresas con el propósito de reclutar alumnos brillantes. La International Collegiate Programming Contest es la más antigua de ellas, promovida por la ACM y patrocinada por IBM. A la final mundial van los mejores equipos de cada una de las más de 90 competiciones regionales que tienen lugar por todo el mundo. La regional en la que pueden participar las universidades españolas es la Southwestern Europe Regional Contest (España, Italia, Portugal, Suiza, Francia y Austria). Esta regional fue organizada por la Escola Tècnica Superior d’Enginyeria Informàtica de la Universitat Politècnica de València en su edición de 2012 y lo será también en 2013. En este trabajo se presenta la experiencia de planificación de una regional, tanto a nivel organizativo como de planteamiento de los problemas para la competición. Asimismo, se destaca la importancia de este tipo de competiciones en cuanto al desarrollo de habilidades y destrezas en los alumnos, pues su dedicación a solucionar distintos tipos de problemas, combinando conocimientos de matemáticas con técnicas algorítmicas, les da una formación adicional que saben apreciar las grandes empresas. Algunos alumnos de la ETSInf que han participado en estas competiciones están en proceso o ya han sido contratados por empresas del sector como es Google.SUMMARY -- Programming contests are a good stimulus for computer engineering students. These contests have experienced an expansion during last years thanks to the interest of big companies for hiring brilliant students. The International Collegiate Programming Contest is the oldest one, promoted by ACM and sponsored by IBM. The ACM-ICPC World Final takes place every year, only the best teams can participate, which are selected from the ones who compete in the more than 90 regional contests celebrated around the world. Spanish universities can participate in the Southwestern Europe Regional Contest (Spain, Italy, Portugal, France and Austria). The 2012 edition of this regional contest took place in Valencia, organised by the School of Computer Engineering at the Universitat Politècnica de València. The 2013 edition will be organised in Valencia as well. In this paper it is presented the experience of planning a regional contest, both from the point of view of organisation as from posing the problems. Additionally, it is pointed out the value of this sort of programming contests as they foster the development of some abilities and skills in students, because the time they spend solving problems where the knowledge of mathematical concepts and of algorithmic techniques is very important. This fact gives students a special training very appreciated by big software companies. Some former students from ETSInf who participated in international programming contests were hired or are in process of being hired by Google

Whole-Blood Mitochondrial DNA Copies Are Associated With the Prognosis of Acute Respiratory Distress Syndrome After Sepsis.

https://pubmed.ncbi.nlm.nih.gov/34557198/#:~:text=Resumen-,El%20s%C3%ADndrome%20de%20dificultad%20respiratoria%20aguda%20(SDRA)%20es%20un%20proceso,v%C3%ADnculos%20mec%C3%A1nicos%20de%20esta%20observaci%C3%B3n%20con%20la%20patogenia%20del%20SDRA.,-Palabras%20clave%3A%20SDR

A global effort to dissect the human genetic basis of resistance to SARS-CoV-2 infection

SARS-CoV-2 infections display tremendous interindividual variability, ranging from asymptomatic infections to life-threatening disease. Inborn errors of, and autoantibodies directed against, type I interferons (IFNs) account for about 20% of critical COVID-19 cases among SARS-CoV-2-infected individuals. By contrast, the genetic and immunological determinants of resistance to infection per se remain unknown. Following the discovery that autosomal recessive deficiency in the DARC chemokine receptor confers resistance to Plasmodium vivax, autosomal recessive deficiencies of chemokine receptor 5 (CCR5) and the enzyme FUT2 were shown to underlie resistance to HIV-1 and noroviruses, respectively. Along the same lines, we propose a strategy for identifying, recruiting, and genetically analyzing individuals who are naturally resistant to SARS-CoV-2 infection.The Laboratory of Human Genetics of Infectious Diseases is supported by the National Institutes of Health (NIH) (R01AI088364), the National Center for Advancing Translational Sciences (NCATS), NIH Clinical and Translational Science Award (CTSA) program (UL1TR001866), a Fast Grant from Emergent Ventures, Mercatus Center at George Mason University, the Yale Center for Mendelian Genomics and the GSP Coordinating Center funded by the National Human Genome Research Institute (NHGRI) (UM1HG006504 and U24HG008956), the Fisher Center for Alzheimer’s Research Foundation, the Meyer Foundation, the French National Research Agency (ANR) under the Investments for the Future program (ANR-10-IAHU-01), the Integrative Biology of Emerging Infectious Diseases Laboratory of Excellence (ANR-10-LABX-62-IBEID), the French Foundation for Medical Research (FRM) (EQU201903007798), the FRM and ANR GENCOVID project (ANR-20-COVI-0003), ANRS-COV05, the Fondation du Souffle, the Square Foundation, Grandir - Fonds de solidarité pour l’enfance, the SCOR Corporate Foundation for Science, the Howard Hughes Medical Institute, the Rockefeller University, the St. Giles Foundation, Institut National de la Santé et de la Recherche Médicale (INSERM), and the University of Paris. E.A. is supported by research grants from the European Commission’s Horizon 2020 research and innovation program (IMMUNAID, grant no. 779295, CURE, grant no. 767015 and TO_AITION grant no. 848146) and the Hellenic Foundation for Research and Innovation (INTERFLU, no. 1574). C.O.F. is supported in part by the Science Foundation Ireland COVID-19 Program. G.N. is supported by a grant awarded to Regione Lazio (Research Group Projects 2020) no. A0375-2020-36663, GecoBiomark. A.P. is supported in part by the Horizon 2020 program under grant no. 824110 (EasiGenomics grant no. COVID-19/PID12342) and the CERCA Program/Generalitat de Catalunya. H.S. is supported in part by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases, National Institutes of Health. A.S. is supported in part by the European Union’s Horizon 2020 research and innovation program (Marie Sklodowska-Curie grant no. 789645)

RINT1 deficiency disrupts lipid metabolism and underlies a complex hereditary spastic paraplegia

The Rad50 interacting protein 1 (Rint1) is a key player in vesicular trafficking between the ER and Golgi apparatus. Biallelic variants in RINT1 cause infantile-onset episodic acute liver failure (ALF). Here, we describe 3 individuals from 2 unrelated families with novel biallelic RINT1loss-of-function variants who presented with early onset spastic paraplegia, ataxia, optic nerve hypoplasia, and dysmorphic features, broadening the previously described phenotype. Our functional and lipidomic analyses provided evidence that pathogenic RINT1 variants induce defective lipid-droplet biogenesis and profound lipid abnormalities in fibroblasts and plasma that impact both neutral lipid and phospholipid metabolism, including decreased triglycerides and diglycerides, phosphatidylcholine/phosphatidylserine ratios, and inhibited Lands cycle. Further, RINT1 mutations induced intracellular ROS production and reduced ATP synthesis, affecting mitochondria with membrane depolarization, aberrant cristae ultrastructure, and increased fission. Altogether, our results highlighted the pivotal role of RINT1 in lipid metabolism and mitochondria function, with a profound effect in central nervous system development