Smoking Status, Changes in Smoking Status and Health-Related Quality of Life: Findings from the SUN (“Seguimiento Universidad de Navarra”) Cohort

We aimed to evaluate the association between smoking, changes in smoking, and quality of life in a cohort of Spanish university graduates. Smoking habits were self-reported at baseline and four years later. Quality of life was assessed using the Short Form-36 (SF-36) at year 4. Statistical differences in SF-36 scores between groups were determined using ANCOVA with age and sex as covariates. Out of 5,234 eligible participants over 2000–2006, there were 2,639 non-smoker participants, 1,419 ex-smokers, and 1,048 smokers. Within the previous four years, 435 participants became recent quitters and 205 starters. Comparing smoking and health status in year 4, non-smokers showed better scores than the other categories of ever smoking in all dimensions except in the vitality scale value, which was similar in non-smokers and in those smoking less than 15 cigarettes/day. Comparing changes in smoking and health in year 4, continuing smokers had statistically significant worse scores than non-smokers in general health, social functioning, role-emotional and mental health, whereas recent quitters showed statistically significant improvements in role-emotional and mental health over those who had continued smoking or those who became smokers. Our findings support a dose-response relationship between cigarette consumption and a worse quality of life in general and mental health in particular. They also support that changes in smoking have an impact on health

Programas de carga en la tendinopatía aquílea:revisión sistemática

La tendinopatía aquílea es un síndrome clínico que se caracteriza por presentar dolor, inflamación y discapacidad funcional. Además de diversos factores externos e internos, la carga mecánica desempeña un papel fundamental; cuando no se respetan los períodos de descanso del tendón y se ve sometido a cargas repetitivas se produce un desequilibrio entre síntesis y degradación de colágeno, desencadenándose esta tendinopatía. Los programas de carga (excéntricos, concéntricos, isométricos, HSR) con diferentes tipos de ejercicios son la opción con mejor evidencia para su tratamiento frente a otras terapias pasivas.<br /

Plan de negocio productos Dupree en san José Costa Rica

El presente plan de negocios se refiere a la expansión de venta directa de los productos Dupree en el país de Costa Rica, como visión de la compañía tener presencia en 5 países de sur América y teniendo como objetivo este país siendo el cuarto como cubrimiento en este continente para el año 2017. En consecuencia sus directivas están conscientes de acoger este nuevo mercado como reto administrativo y financiero para el fortalecimiento y reconocimiento de la marca Dupree en Centro América. La característica principal de este proceso es expandir la marca e incentivando a las empresas colombianas en hacer inversión extranjera directa con el fin de aumentar la producción de otros países en especial Colombia como bienes y servicios de valor agregado. Es necesario revisar las causas de la compañía como son los activos, propuestas, productos, servicios, utilidades, el área financiera para acceder a otro mercado y obtener rentabilidad en el futuro mercado objetivo. El estudio se realizó con el interés profesional de acceder a un mercado nuevo con los productos o servicios actualmente ofrecidos en el mercado local, conociendo las oportunidades, accesos directos y restricciones que enfrenta una compañía para expandir su mercado y dar a conocer su marca en otros países, además de conocer los intereses, nuevas industrias y comportamientos competitivos comparativos con las similitudes de ofertas, demandas de productos con valores agregados el ofrecimiento de distintos servicios, el incremento de empleo permitiendo que Dupree acceda a la contratación indirecta de personas para vender e incentivar a la persona en emprendimiento empresarial en donde su segmentación principal es la mujer.CONTENIDO RESUMEN EJECUTIVO INTRODUCCION RAZONES DE ELABORACION MATRIX DE PRESELECCION DE MERCADO ANALISIS LOGISTICO Determinación de la estrategia de distribución Canales propios o ajenos La venta directa desde el fabricante Canales propios o ajenos La venta directa desde el fabricante Misión de la logística COMERCIO ELECTRONICO DUPREE COMO PROCESO DE EXPANSION EN SAN JOSE COSTA RICA MODELO COMERCIO ELECTRONICO DUPREE CADENA DE VALOR EMPRESA DUPREE PRIMERA FASE CADENA DE VALOR DUPREE PARA LA DISTRIBUCION DE PRODUCTOS MARCA DUPREE SEGUNDA FASE CADENA DE VALOR PROVEEDORES ACTIVIDADES PRIMARIAS ACTIVIDADES DE APOYO ORGANIGRAMA COMO FUNCIONA Departamento de operaciones Departamento de Mercado y diseño Departamento de Logística y DFI Se encarga del transporte internacional de la mercancía desde su producción hasta la entrega del producto hasta el cliente final ALIANZAS ESTRATEGICAS EMPRESARIALES CONTRATO DE AGENCIA Y REPRESENTACIÒN INTERNACIONAL APLICACIÓN JOINT VENTURE PARA FUTURAS EXPANSIONES DE MERCADO BENEFICIOS DEL JOINT VENTURE CONTRACTUAL PLANEACION AGREGADA DE LA PRODUCCION PLANEACION DE REQUISITOS DE MATERIALES (MRP) MECANICA DEL MRP FLUJOGRAMA INVENTARIO FLUJOGRAMA PICKING ANALISIS DE LA CADENA LOGISTICA INTERNACIONAL DESDE COLOMBIA HACIA COSTA RICA LOGISTICA Y TRANSPORTE Acceso Marítimo Acceso Aéreo Tiempos de Nacionalización Vía Aérea Vía Marítima: Vía Terrestre: DISTRIBUCION FISICA INTERNACIONAL PARA LA EXPORTACION Distribución Cadena de distribución en Costa Rica ETAPAS DEL PROCESO DFI Puertos en Colombia Frecuencias y tiempo de tránsito desde los puertos colombianos TRANSPORTE NACIONAL La ruta más común para esta operación es Bogotá- Cartagena-Puerto Limón-San José de Costa Rica AGENTE ADUANERO TRANSPORTE INTERNACIONAL DOCUMENTOS REQUERIDOS PARA LA ENTRADA DEL PRODUCTO A COSTA RICA ENVIO DE MUESTRAS ACUERDOS INTERNACIONALES ENTRE COLOMBIA Y COSTA RICA ESTRATEGIA LOGISTICA GLOBAL TIPOS DE ESTRATEGIAS DE LA LOGISTICA GLOBAL ESTRATEGIA DE ABASTECIMIENTO Paso 1 – Total entendimiento de la categoría del gasto Las 5 áreas de análisis son Paso 2 – Evaluación del mercado del proveedor Paso 3 – Preparar una encuesta de proveedor Paso 4 – Construyendo la estrategia Competitividad del mercado de suministro Apoyo de los usuarios de la organización para relaciones con los principales proveedores Alternativas para la evaluación de competencias Paso Cinco – RFx Solicitudes Sexto paso – Selección PRESUPUESTO LOGÍSTICO PARA LA EXPORTACIÓN AL MERCADO OBJETIVO AQUÍ VA LAS DEL EXCEL QUE DICE PRESUPUESTO EVALUACIÓN DEL PROYECTO TIPOS DE IMPACTO Impacto social Impacto interno Contratación del personal Prevención de riesgos laborales Impacto ambiental EVALUACIÓN FINANCIERA Criterios de Rentabilidad usados en la evaluación de Proyectos / Propuestas EVALUACION INTEGRAL ERRORES MÁS FRECUENTES OTRAS VERSIONES SOBRE PLAN DE NEGOCIOS Grupos empresariales CONTEXTO RIESGOS Y RECOMPENSAS PALABRAS CLAVE CONCLUSIONES AGRADECIMIENTOS BIBLIOGRAFIAPregradoProfesional en Comercio InternacionalComercio Internaciona

Empirically-derived food pattern and total ortality in the PREDIMED study

[Background]: There has been growing interest in the last years in assessing the relationship between diet and disease through the study of whole dietary patterris and not only focusing on single nutrients or foods. Though several studies have assessed the relationship between a posteriori dietary patterns and different health outcomes, there is little evidence on post hoc dietary patterns and all cause mortality in Southern European populations.[Objective]: To identify the association between a posteriori defined major dietary patterns and total mortality in the PREDIMED study. Methods We followed-up 7,340 participants (57.5 percent women, mean age: 67 years) during a median follow-up time of 4.8 years. To assess dietary exposures, a validated 137-item semi-quantitative food- frequency questionnaire was administered. Dietary patterns were ascertained through a factor analysis based on 30 predefined food groups. Participants were classified according to tertiles of adherence to dietary pattern scores at baseline. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) for mortality. Deaths were confirmed by review of medical records and consultation of the National Death Index.[Results]: We identified two major dietary patterns: the “Western” dietary pattern and “Mediterranean” dietary pattern. During follow- up, 337 participants died. Among deceased participants, the median age of death was 70 (6.5). After controlling for potential confounders including the intervention group, higher baseline adherence to a “Mediterranean” dietary pattern was associated with lower risk of all- cause mortality (adjusted HR for third tertile vs. first textile: 0.68; 95 la CI: 0.49—0.95) (p for trend 0.028). [Conclusion]: Higher adherence to a Mediterranean-type diet may reduce the risk of all-cause mortality in elderly people at high cardiovascular risk

Prevalence and distribution of intestinal parasites in stray dogs in the northwest area of Mexico

Zoonotic parasitic infections are a major global public and veterinary health problem and widespread among stray dogs. The objective of this study was to establish the prevalence of intestinal parasites in stray dogs in the urban, rural and coastal areas of Mexicali County in northwest Mexico. In 2014, from January to December, 380 stray dogs were captured. The entire small intestine, cecum and faeces samples were collected and examined by using simple zinc sulfate flotation and Lugol’s solution staining. Data were statistically analysed. Overall, about 21.5% of examined dogs were found positive for intestinal parasites. Toxocara canis was the most frequent detected parasite, with a prevalence of 7.1%, followed by Toxascaris leonina (5.5%), Cystoisospora spp. (5.0%), Taenia spp. (3.9%) and Dipylidium caninum (2.8%). Dogs were more frequently found to be infected with a single genus of intestinal parasite (18.7%) than co-infected (2.8%). Intestinal parasites were more prevalent in samples from the coastal area (25%) than in those from the rural (24.4%) and urban (20.6%) areas, however, only statistical association was found between capture area and specific intestinal parasitic infection. There were significant differences in the prevalence of taeniasis among two age groups (P&lt;0.01). A seasonal peak of prevalence for intestinal parasitic infections was found during spring (P&lt;0.05), corresponding with a seasonal peak of prevalence of T. canis (P&lt;0.05). The wide range of isolated parasites indicated that people residing in this area are at risk of exposure to these potentially hazardous zoonotic pathogens

Primary prevention of cardiovascular disease with a Mediterranean diet

© 2013 Massachusetts Medical Society[Background]: Observational cohort studies and a secondary prevention trial have shown an inverse association between adherence to the Mediterranean diet and cardiovascular risk. We conducted a randomized trial of this diet pattern for the primary prevention of cardiovascular events.[Methods]: In a multicenter trial in Spain, we randomly assigned participants who were at high cardiovascular risk, but with no cardiovascular disease at enrollment, to one of three diets: a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Participants received quarterly individual and group educational sessions and, depending on group assignment, free provision of extra-virgin olive oil, mixed nuts, or small nonfood gifts. The primary end point was the rate of major cardiovascular events (myocardial infarction, stroke, or death from cardiovascular causes). On the basis of the results of an interim analysis, the trial was stopped after a median follow-up of 4.8 years.[Results]: A total of 7447 persons were enrolled (age range, 55 to 80 years); 57% were women. The two Mediterranean-diet groups had good adherence to the intervention, according to self-reported intake and biomarker analyses. A primary end-point event occurred in 288 participants. The multivariable-adjusted hazard ratios were 0.70 (95% confidence interval [CI], 0.54 to 0.92) and 0.72 (95% CI, 0.54 to 0.96) for the group assigned to a Mediterranean diet with extra-virgin olive oil (96 events) and the group assigned to a Mediterranean diet with nuts (83 events), respectively, versus the control group (109 events). No diet-related adverse effects were reported.[Conclusions]: Among persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events.Supported by the official funding agency for biomedical research of the Spanish government, Instituto de Salud Carlos III (ISCIII), through grants provided to research networks specifically developed for the trial (RTIC G03/140, to Dr. Estruch; RTIC RD 06/0045, to Dr. Martínez-González and through Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición [CIBERobn]), and by grants from Centro Nacional de Investigaciones Cardiovasculares (CNIC 06/2007), Fondo de Investigación Sanitaria–Fondo Europeo de Desarrollo Regional (PI04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, and P11/02505), Ministerio de Ciencia e Innovación (AGL-2009-13906-C02 and AGL2010-22319-C03), Fundación Mapfre 2010, Consejería de Salud de la Junta de Andalucía (PI0105/2007), Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana (ACOMP06109, GVACOMP2010-181, GVACOMP2011-151, CS2010-AP-111, and CS2011-AP-042), and Regional Government of Navarra (P27/2011)

Association between adherence to the Mediterranean diet and waist-to-height ratio among high-risk subjects: the PREDIMED trial.

Trabajo presentado en European Congress of Epidemiology EUROEPI2012, celebrado en Oporto (Portugal) del 05 al 08 de septiembre de 2012.Association between adherence to the Mediterranean diet and waist-to-height ratio among high-risk subjects: the PREDIMED trial

Effects of a Mediterranean Eating Plan on the Need for Glucose-Lowering Medications in Participants With Type 2 Diabetes: A Subgroup Analysis of the PREDIMED Trial

[Objective]: To examine the effects of two Mediterranean eating plans (Med-EatPlans) versus a low-fat eating plan on the need for glucose-lowering medications. [Research design and methods]: From the Prevención con Dieta Mediterránea (PREDIMED) trial, we selected 3,230 participants with type 2 diabetes at baseline. These participants were randomly assigned to one of three eating plans: Med-EatPlan supplemented with extra-virgin olive oil (EVOO), Med-EatPlan supplemented with mixed nuts, or a low-fat eating plan (control). In a subgroup (15%), the allocation was done in small clusters instead of using individual randomization, and the clustering effect was taken into account in the statistical analysis. In multivariable time-to-event survival models, we assessed two outcomes: 1) introduction of the first glucose-lowering medication (oral or injectable) among participants on lifestyle management at enrollment and 2) insulin initiation. [Results]: After a median follow-up of 3.2 years, in multivariable analyses adjusting for baseline characteristics and propensity scores, the hazard ratios (HRs) of starting a first glucose-lowering medication were 0.78 (95% CI 0.62–0.98) for Med-EatPlan + EVOO and 0.89 (0.71–1.12) for Med-EatPlan + nuts, compared with the control eating plan. After a median follow-up of 5.1 years, the adjusted HRs of starting insulin treatment were 0.87 (0.68–1.11) for Med-EatPlan + EVOO and 0.89 (0.69–1.14) for Med-EatPlan + nuts compared with the control eating plan. [Conclusions]: Among participants with type 2 diabetes, a Med-EatPlan + EVOO may delay the introduction of new-onset glucose-lowering medications. The Med-EatPlan did not result in a significantly lower need for insulin

Mediterranean Diet and Atherothrombosis Biomarkers: A Randomized Controlled Trial

Scope To assess whether following a Mediterranean diet (MedDiet) improves atherothrombosis biomarkers in high cardiovascular risk individuals. Methods and results In 358 random volunteers from the PREvención con DIeta MEDiterránea trial, the 1‐year effects on atherothrombosis markers of an intervention with MedDiet, enriched with virgin olive oil (MedDiet‐VOO; n = 120) or nuts (MedDiet‐Nuts; n = 119) versus a low‐fat control diet (n = 119), and whether large increments in MedDiet adherence (≥3 score points, versus compliance decreases) and intake changes in key food items are associated with 1‐year differences in biomarkers. Differences are observed between 1‐year changes in the MedDiet‐VOO intervention and control diet on the activity of platelet activating factor acetylhydrolase in high‐density lipoproteins (HDLs) (+7.5% [95% confidence interval: 0.17; 14.8]) and HDL‐bound α1‐antitrypsin levels (−6.1% [−11.8; −0.29]), and between the MedDiet‐Nuts intervention and the control arm on non‐esterified fatty acid concentrations (−9.3% [−18.1; −0.53]). Large MedDiet adherence increments are associated with less fibrinogen (−9.5% [−18.3; −0.60]) and non‐esterified fatty acid concentrations (−16.7% [−31.7; −1.74]). Increases in nut, fruit, vegetable, and fatty fish consumption, and decreases in processed meat intake are linked to enhancements in biomarkers. Conclusion MedDiet improves atherothrombosis biomarkers in high cardiovascular risk individuals.This work was supported by grants of Instituto de Salud Carlos III [OBN17PI02, PIE14/00045_INFLAMES, CB06/03/0019, CB06/03/0028, and CD17/00122 (A.H.)], and Agència de Gestió d'Ajuts Universitaris i de Recerca (2017 SGR 222)

A provegetarian food pattern and reduction in total mortality in the Prevención con Dieta Mediterránea

[Background]: Vegetarian diets have been associated with reduced mortality. Because a pure vegetarian diet might not easily be embraced by many individuals, consuming preferentially plant-derived foods would be a more easily understood message. A provegetarian food pattern (FP) emphasizing preference for plant-derived foods might reduce all-cause mortality.[Objective]: The objective was to identify the association between an a priori–defined provegetarian FP and all-cause mortality.[Design]: We followed 7216 participants (57% women; mean age: 67 y) at high cardiovascular risk for a median of 4.8 y. A validated 137-item semiquantitative food-frequency questionnaire was administered at baseline and yearly thereafter. Fruit, vegetables, nuts, cereals, legumes, olive oil, and potatoes were positively weighted. Added animal fats, eggs, fish, dairy products, and meats or meat products were negatively weighted. Energy-adjusted quintiles were used to assign points to build the provegetarian FP (range: 12–60 points). Deaths were confirmed by review of medical records and the National Death Index.[Results]: There were 323 deaths during the follow-up period (76 from cardiovascular causes, 130 from cancer, 117 for noncancer, noncardiovascular causes). Higher baseline conformity with the provegetarian FP was associated with lower mortality (multivariable-adjusted HR for ≥40 compared with <30 points: 0.59; 95% CI: 0.40, 0.88). Similar results were found with the use of updated information on diet (RR: 0.59; 95% CI: 0.39, 0.89).[Conclusions]: Among omnivorous subjects at high cardiovascular risk, better conformity with an FP that emphasized plant-derived foods was associated with a reduced risk of all-cause mortality. This trial was registered at www.controlled-trials.com as ISRCTN35739639