Demographics and coexisting tremor, cervical dystonia and vocal fold disorders in a group of patients with spasmodic dysphonia

Dati demografici e presenza di tremore, distonia cervicale e patologie delle corde vocali in un gruppo di pazienti con disfonia spasmodica. Riassunto: L’obiettivo principale di questo studio è quello di descrivere le caratteristiche demografiche e cliniche di un gruppo di pazienti affetti da disfonia spasmodica (SD). Come obiettivo secondario, abbiamo valutato l’età dei pazienti al momento della diagnosi associandola al sesso e tremore non cordale. Sono stati valutati retrospettivamente settantaquattro pazienti consecutivi, trattati per SD alla Mayo Clinic di Jacksonville dall’1 ottobre 2015 al 31 marzo 2018. Sono stati raccolti dati riguardanti sesso, età alla diagnosi, BMI, tipo di SD, storia personale di stress maggiore/depressione, recenti infezioni delle vie aeree superiori (URTI), presenza di patologie neurologiche o delle corde vocali coesistenti. La maggioranza dei pazienti è risultata di sesso femminile con un’età media alla diagnosi di 61 anni (17-80). Il BMI medio è 25,7 (16,9-63,7). le associazioni diagnostiche più comuni sono state disfonia da iperadduzione e MTD (18,9%); disfonia da iperadduzione e tremore (17,6%). La disfonia da iperadduzione isolata è stata trovata nel 52,7% dei casi. Il 36,6% dei pazienti era affetto da tremore mentre il 15,5% da distonia cervicale. Sono state identificate patologie delle corde vocali come paresi/paralisi (3,1%), cisti (3,1%), neoformazioni (4,7%), polipi (1,6%), sinechie glottiche anteriori (1,6%). Non è stata riscontrata alcuna associazione fra sesso e distonia o tremore non cordale. L’età avanzata alla diagnosi ha mostrato un’associazione statisticamente significativa con la distonia cervicale (P = 0,049) ma non con il tremore non vocale (P = 0,22). In questo gruppo di pazienti affetti da SD la maggior parte dei casi non mostra contestuali patologie neurologiche o patologie delle corde vocali. I pazienti più anziani alla diagnosi di SD hanno più probabilità di essere affetti da distonia cervicale

Percepção dos agentes comunitários de saúde frente ao risco de infecção da tuberculose

A Tuberculose é um serio problema de saúde, os níveis mundiais no ano 2011 ocorreram 8,7 milhões de casos novos e 1,4 milhões de pessoas morreram de TB. Para horizontalizar as ações no combate da TB na atenção primaria o Agente Comunitário de Saúde assume um papel muito importante, pois eles além de trabalhar na comunidade onde mora ele é um mediador de saberes, espera-se que esse profissional seja capaz de identificar por meio de visitas domiciliares sintomáticos respiratórios. Objetivos: Conhecer a percepção que os ACS têm sobre o risco de infecção à tuberculose no cotidiano de sua prática profissional e analisar como eles se organizam e estruturam sua prática frente a essa percepção. Abordagem Metodológica: O estudo foi dividido em duas fases a primeira responde ao primer objetivo e foi escolhido o Grupo Focal e para a segunda fase que responde ao segundo objetivo foi escolhido a Observação Participante como técnicas de trabalho em campo e Analise de Conteúdo Temático como técnica de análise das informações colhidas que consiste em descobrir os núcleos de sentidos que são temas os quais são unidades de significação que se libertam naturalmente de um texto analisado. Resultados: Na primeira fase do estudo observou-se que o Agente Comunitário de Saúde percebe os riscos que estão expostos, mas muitas vezes eles não sabem como agir em situações, especificas, na segunda fase indicam que o risco não esta presente o tempo todo na vida e no trabalho deles. Conclusão: O PACS é apresentado pelo Ministério da Saúde como uma estratégia de saúde para horizontalizar as ações no controle da TB, neste estudo foi encontrado que o ACS percebe o risco que esta exposto, mas que aquele risco não esta sempre presenta na vida deles, pois eles muitas vezes minimizam os riscos pensando que nada acontece nem acontecera com eles.Tuberculosis is a serious health problem world levels in the year 2011 there were 8.7 million new cases and 1.4 million people died from TB. To flatten the actions in combating TB in the primary care community health agent plays a very important role, as they besides working in the community where he lives is a mediator of knowledge, it is expected that this professional is able to identify through home visits with respiratory symptoms. Objectives: To study the perception that the ACS have on the risk of tuberculosis infection in their daily practice and analyze how they organize and structure their practice against that perception. Methodological: The study was divided into two phases the first goal and responds to the primer was chosen the Focus Group and the second phase that responds to the second objective was selected as a Participant Observation techniques for field work and Thematic Content Analysis as a technique to analyze data that consists of discovering the core meanings are topics which are units of meaning that are released naturally from a parsed text. Results: In the first phase of the study it was observed that the Community Health Agents realize the risks they are exposed, but often they do not know how to act in situations, specific, in the second phase indicate that the risk is not present at all in life and in their work. Conclusion: The PACS is presented by the Ministry of Health as a health strategy to flatten actions in TB control, this study found that the risk ACS realizes that this exposed, but that risk is not always presents in their lives, they often minimize the risks thinking that nothing happens or happened to them.CAPE

Modelo de gestión financiera para el Minimarket 4Buy, ubicado en la parroquia Tumbaco, del cantón Quito

El presente trabajo de titulación denominado diseñar un Modelo de Gestión Financiera para el Minimarket 4Buy, ubicado en la parroquia Tumbaco, del cantón Quito, con la finalidad de optimizar el manejo de los recursos económicos y financieros de la entidad. La metodología utilizada fue la investigación de campo, documental, mediante técnicas como la observación directa, encuesta aplicada al personal y una entrevista al gerente general, lo que permitió recolectar información necesaria para conocer la situación real del minimarket; gracias a esto se logró identificar que la entidad, no cuenta con un modelo de gestión financiera; se realizó un análisis FODA donde se hallaron las falencias dentro de inventarios, ineficiencia en el manejo del efectivo, gestión de cobranza a clientes no propicias, métodos de análisis horizontal, vertical no propicios. Después de realizar el diagnóstico se planteó el diseñar el Modelo de Gestión Financiera partiendo de la información básica de la empresa, propuesto un organigrama estructural, manual de funciones, el diseño de objetivos, estrategias, actividades y metas descritos en el POA, se efectuó políticas empresariales y financieras para incrementar su nivel económico, optimizando costo de ventas, período de cobro, período de pago, rotación de inventarios e incrementar efectivo con la finalidad de que contribuyan al desarrollo continuo de la empresa. Por lo que, se recomienda ejecutar el modelo de gestión financiera propuesto ya que contribuirá al mejoramiento de la gestión administrativa, financiera y refleja el crecimiento económico de la entidad en los próximos años.The present research work called designing a Financial Management Model for 4Buy Minimarket, located in Tumbaco parish of the Quito canton, has the purpose of optimize the management of economic and financial resources of the entity. The methodology used was the field research, documentary, using techniques such as direct observation, survey applied to the staff and an interview to the general manager, which allowed to collect information necessary to know the real situation of the minimarket; thanks to this, it was possible to identify that the business does not have financial management model. A SWOT analysis was applied where shortcomings within inventories, inefficiency in the cash management, customers’ not conductive collection management, horizontal analysis methods, and unfavorable vertical were found. After carrying out the diagnosis, it was proposed to design the Financial Management Model based on the basic information of the company, proposing a structural organization chart, functions manual, the design of objectives, strategies, activities and goals described in the POA. Furthermore, business and financial policies were carried out to increase its economic level, optimizing the cost of sales, collection period, payment period, inventory turnover and increase cash in order to contribute to the continuous development of the company. Therefore, it is recommended that the proposed financial management model be implemented since it will contribute to the improvement of administrative and financial management and reflects entity's economic growth in the coming years

Comparative Use of the Ages and Stages Questionnaires in Low‐ and Middle‐Income Countries

Aim: To map the breadth of use of the Ages and Stages Questionnaires (ASQ) in low‐ and middle‐income countries (LMICs) across world regions, and examine procedures for ASQ translation, adaptation, psychometric evaluation, and administration. Method: We conducted a review of all original, peer‐reviewed studies written in English referencing use of the ASQ in LMICs. We used a consensus rating procedure to classify each article into one of four categories: feasibility study, psychometric study, prevalence study, or research study. Results: We analysed 53 peer‐reviewed articles written in English detailing use of the ASQ in LMICs. We found evidence of ASQ use in 23 LMICs distributed across all world regions. The ASQ was translated into 16 languages. Just over half of the studies reported parent completion of the ASQ (50.9%). We identified eight feasibility studies, 12 psychometric studies, and nine prevalence studies. Study type varied by economy and region. Interpretation: Findings suggest broad global use of the ASQ in a range of countries and cultural and linguistic contexts. There is need for further validation studies across all cited regions and countries and in countries ready to begin to design systems for providing universal developmental screening services

Special Libraries, April 1919

Volume 10, Issue 3https://scholarworks.sjsu.edu/sla_sl_1919/1002/thumbnail.jp

Underlying correlation between the social representation of the EFL subject and assessment results

Tesis (Pedagogía en Inglés)There is a negative predisposition of some primary and secondary students towards the English as a Foreign Language (EFL) subject. In this research, we intend to discover if there is any direct underlying correlation between Chilean EFL students’ social representation of the EFL subject, and their assessment results of named subject throughout the first term. The participants chosen for this study were 115 from 4 different private and subsidized schools. A questionnaire and a focus group were applied, which were later analyzed qualitatively under speech analysis, considering the connotations of the expressed statements to identify the participants’ social representation of the EFL subject which were then correlated with the participants’ assessment results of the EFL subject throughout the first term of the year. In addition, the focus group results were utilized to identify the participant’s social representation’s central core regarding the EFL subject. Finally, the results from the questionnaire showed an indirect correlation between the participants’ social representation of the EFL subject and their assessment results. Nonetheless, the identification of participants’ central core revealed four different areas that merge when referring to the EFL subject: Purpose of learning English, Teacher’s Influence, Communicative Competence and Motivation.En esta investigación, se tiene la intención de descubrir si hay alguna correlación subyacente directa entre la representación social de los estudiantes chilenos hacia la asignatura de Idioma Extranjero Inglés y sus resultados académicos del primer semestre en tal asignatura, la razón de esta es la negativa predisposición de algunos alumnos de enseñanza básica y media hacia dicha asignatura. Los participantes elegidos para este estudio fueron un total de 115 estudiantes de 4 diferentes colegios -privados y subvencionados-. Un cuestionario y un grupo focal fueron llevados a cabo, los cuales fueron analizados cualitativamente bajo análisis de discurso, tomando en cuenta la connotación de las declaraciones para identificar la representación social de los participantes acerca de la asignatura de Idioma Extranjero Inglés. Estas fueron luego correlacionadas con el promedio de notas de la asignatura obtenido en el primer semestre del año. Finalmente, los resultados obtenidos del cuestionario mostraron una correlación indirecta entre la representación social de los participantes de la asignatura de Idioma Extranjero Inglés y sus resultados académicos. Por otro lado, la identificación del núcleo central de los participantes reveló cuatro áreas diferentes que se conjugan al referirse a la asignatura de Inglés: El propósito de aprender Ingles, Influencia del profesor, Competencia Comunicativa y Motivación

Sesgos cognitivos en las sentencias por los procesos de violación sexual en el juzgado penal colegiado de Tarapoto; 2021

La investigación tuvo como objetivo general analizar de qué manera los sesgos cognitivos se presentan en las sentencias por los procesos violación sexual en el Juzgado Penal Colegiado de Tarapoto; 2021. La existencia de los sesgos frente a una decisión del operador jurídica se ve reflejada en el proceso de presentación de la prueba, esto como contenido esencial del derecho a la presentación de la prueba analizado a través del delito de violación sexual. La metodología fue de tipo básica con diseño en teoría fundamentada, el enfoque aplicado en la investigación fue cualitativa, los instrumentos de recolección de datos fueron la guía de análisis documental y entrevista a expertos. El resultado principal indicó que el alcance de los sesgos cognitivos dentro del delito de violación sexual es sorpresivo, los operadores jurídicos se encuentran sesgados en demasía con estos atajos mentales que nublan el buen juicio, llegando a actuar y valorar incorrectamente medios probatorios y actos procesales de toda índole. Llegando a concluir que los sesgos cognitivos se presentan de forma encriptada dentro de las sentencias por los procesos en los delitos de violación sexual, hay que lograr identificarlas, esto lográndolo desde el análisis exhaustivo y el conocimiento de los sesgos

Global socio-economic impacts of changes in natural capital and ecosystem services:State of play and new modeling approaches

The year 2020 is a critical year for sustainable development policy and practice with the review and renewal of various international commitments including the Sustainable Development Goals, the Convention on Biological Diversity and the Paris Agreement. The post-2020 agenda needs to be informed by more robust analytical approaches that capture the interactions between the economy, society and the environment. In this paper, we review the state of the art in available models and datasets that lay the groundwork for future analytical work to inform this agenda. Based on this review, we propose an integrated modeling approach for global analysis to underpin international policy discourse and advocacy, and; a sub-global approach focusing on evaluating specific strategies and policy portfolios to make progress toward sustainability commitments considering detailed local country context. Both approaches rely on integrating whole of economy computable general equilibrium models with spatial land use land cover and ecosystem services models. Endogenizing feedbacks between modeling system components ensures that evidence is based on interactions between all system components. Recent advances in methods, data and available tools discussed herein reduce barriers to entry for this type of complex systems analysis and increases the timeliness of policy advice

Las Tic en la toma de decisiones en la empresa C-Agro en el cantón Mejía.

This research work is focused on determining the use of ICT for decision-making in the company C-Agro of Canton Mejia, in order to know the current situation on how ICT is used in different areas of work and based on the existing problems, to propose strategies that benefit the work performance of employees. The research is of quantitative approach because it is based on the collection of detailed data to develop a deep and complete understanding of the reality of an object of study, It also allows to collection of information to be used in the statistical analysis of the population; as a technique the survey was used to collect representative data through a structured questionnaire that addresses key aspects of the research topic that was developed using the Likert scale with 24 items in order to obtain detailed information. The population is the total set of individuals, objects, or measures that possess some common observable characteristics in a given place and at a given time because we worked with the totality of employees and not with the sample. In addition, the results showed that 68% of the employees mentioned that the management of information, procedures, and customer service is not efficient, 64% do not use ICTs for decision-making, either due to lack of knowledge or do not have adequate technological resources, and 68% of the employees do not know about these data analysis tools. Additionally, the direct beneficiaries will be the company's employees and the indirect beneficiaries will be the customers who come to the company to make purchases.El presente trabajo investigativo está enfocado en determinar el uso de las TIC para la toma de decisiones en la empresa C-Agro del Cantón Mejía, con el fin de conocer la situación actual sobre cómo se utiliza las TIC en las diferentes áreas de trabajo y en base a la problemática existente plantear estrategias que beneficie al desempeño laboral de los empleados. La investigación es de enfoque cuantitativo debido a que se basa en la recopilación de datos detallados para desarrollar una comprensión profunda y completa de la realidad de un objeto de estudio, también permite recopilar información para ser utilizada en el análisis estadístico de la población; como técnica se empleó la encuesta para recopilar datos representativos mediante un cuestionario estructurado que aborda aspectos clave del tema de investigación que fue elaborado mediante la escala de Likert con 24 ítems con el propósito de obtener información detallada. La población es el conjunto total de individuos, objetos o medidas que poseen algunas características comunes observables en un lugar y en un momento determinado, porque trabajamos con la totalidad de los empleados y no con la muestra. Además, en los resultados se comprobó que 68% de los empleados mencionan que la gestión de la información, los trámites y la atención al cliente no es eficiente, un 64% no utilizan las TIC para la toma de decisiones, ya sea por falta de conocimiento o no cuentan con recursos tecnológicos adecuados, y un 68% de los empleados desconocen sobre estas herramientas de análisis de datos. Adicionalmente, los beneficiarios directos serán los empleados de la empresa y los beneficiarios indirectos son los clientes que acuden a la empresa para realizar las compras