Planeamiento estratégico del sector retail financiero

El presente Plan Estratégico del Sector Retail Financiero se ha hecho en base a la metodología del modelo secuencial del Proceso Estratégico desarrollado por el Dr. Fernando D´Alessio. Como resultado de este proceso se han formulado las estrategias de mejora para el sector y su importancia en la inclusión financiera del Perú considerando el dinamismo del Sector Financiero. De esta manera, la visión que plantea el Plan Estratégico del Sector Retail Financiero establece que al 2025, el Sector Retail Financiero pueda alcanzar el 41% de participación de la inclusión financiera del Perú, brindando acceso al crédito a niveles socioeconómicos de la población desatendidos, impulsando instrumentos financieros digitales mediante la penetración en el mercado con nuevos establecimientos en Lima dirigiéndose a NSE C y D y provincias, además del uso de redes sociales, creando alianzas estratégicas con establecimientos locales y comerciales que ofrecen productos distintos a los de las tiendas retail para obtener beneficios cruzados a través de comunicación por campañas de concientización para el uso de canales online y por las agencias. Teniendo como consigna invertir en innovación tecnológica para implementar una plataforma de ventas simple y rápida (i.e., big data) que permita incrementar la cantidad de usuarios de tarjetas y créditos elaborando mejores ofertas personalizadas incrementen los atributos de valor de los productos financieros ofrecidos. Finalmente, a lo largo del plan se establece la necesaria participación de las principales empresas del Sector Retail Financiero conjuntamente con el Estado Peruano mediante la Comisión Multisectorial de Inclusión Financiera, tomando en consideración que el crecimiento del Sector Retail Financiero es una gran oportunidad de inclusión financiera que permitirá a la sociedad peruana mejorar su calidad de vida y crecer sostenidamente.The present Strategic Plan for the Retail Financial Sector has been made based on the methodology of the sequential model of the Strategic Process developed by Dr. Fernando D'Alessio. As a result of this process, strategies have been formulated to improve the Retail Financial Sector and its importance in the financial inclusion of Peru, taking into consideration the dynamism of the Financial Sector. In this way, the vision set out in the Strategic Plan for the Retail Financial Sector establishes that by 2025, the Retail Financial Sector may reach a 41% participation in Peru's financial inclusion, providing access to credit at unattended socioeconomic levels of the population, promoting digital financial instruments. This will be achieved through penetration in the market with new establishments in Lima addressing NSE C and D and provinces, in addition to the use of social networks, creating strategic alliances with local and commercial establishments that offer products different from those of retail stores to obtain benefits crossed through communication by awareness campaigns for the use of online channels and by the agencies. With the aim of investing in technological innovation to create a simple and fast sales platform (i.e., big data) that allows increasing the number of card and credit users preparing better personalized offers, increase the value attributes of the financial products offered. Finally, throughout the plan the necessary participation of the main companies of the Retail Financial Sector is established jointly with the Peruvian State through the Multisectorial Commission of Financial Inclusion, taking into consideration that the growth of the Retail Financial Sector is a great opportunity for financial inclusion that will allow Peruvian society to improve their quality of life and grow steadily.Tesi

Onset of lupus like syndrome in patients with spondyloarthritis treated with anti-TNF-α

<p>Abstract</p> <p>Background</p> <p>The anti-TNFα therapy has been since its approval by the FDA, along with nonsteroidal antiinflammatory drugs (NSAIDs), one of the most important therapies for control of spondyloarthritis (SpA). The onset of Lupus Like Syndrome (LLS) has been described in patients with rheumatoid arthritis (RA) treated with anti-TNFα therapy but there is little literature on the occurrence of this entity in patients with SpA.</p> <p>Methods</p> <p>We studied 57 patients with SpA who received more than 1 year of anti-TNFα therapy (infliximab, adalimumab or etanercept). Patients were analyzed for the development of LLS, in addition to measuring ANA levels ≥ 1:160 and Anti-dsDNA (measured by IIF).</p> <p>Results</p> <p>In total, 7.01% of patients treated with anti-TNFα had titers of ANA ≥ 1:160, whereas 3.5% of patients had serum levels of dsDNA. However, only one patient (1.75%; n = 1) experienced clinical symptoms of LLS; this was a female patient with a history of psoriatic arthritis.</p> <p>Conclusions</p> <p>The presence of LLS secondary to anti-TNFα therapy in patients with SpA is observed less frequently compared with patients with RA. LLS was only detected in a patient with a history of psoriasis since youth, who developed psoriatic arthritis after 27 years of age and had received anti-TNFα therapy for > 2 years. This may be because LLS is an entity clearly associated with innate immunity, with little central role of B and T cells.</p

Análisis a la docencia del área de recreación en la licenciatura en educación física

La recreación es una oportunidad laboral para los Educadores Físicos, atender la calidad de los aprendizajes es un compromiso del quehacer educativo, como es el caso del área de recreación. El presente estudio es una observación al desempeño docente de la Licenciatura en Educación Física, de la Universidad Autónoma de Chihuahua. Se observó el desempeño docente de cinco programas analíticos: recreación industrial, eco-recreación, danza recreativa; planeación y organización de actividades físico-recreativas; juego y educación física. Utilizando metodos mixtos se llevaron a cabo 35 observaciones de sesiones de clase, considerando cinco variables de estudio: a).- planeación didáctica, b).- estrategias didácticas, c).- desarrollo de competencias, d).- comunicación, e).- actitudes y valores, obteniendo frecuencias y porcentajes de cada una de ellas utilizando un diario de campo y un formato de caracterización de variables. Encontrando que la planeación didáctica, estrategias didácticas y desarrollo de competencias se observaron como áreas de oportunidad (debilidades), en tanto que la comunicación; actitudes y valores se reportaron con índices de satisfacción elevados y óptimos. Las asignaturas de recreación industrial;  juego y recreación mostraron valores bajos y nulos en varios indicadores

A human reproductive approach to the study of infertility in chimpanzees : An experience at Leon's Zoological Park, Mexico

Peer reviewedPublisher PD

Epidemiology of social phobia in Andalusia.

Introducción: Los estudios poblacionales sobre trastorno de ansiedad social (TAS) son relativamente infrecuentes no habiendo información sobre prevalencia y correlatos del TAS en la población general andaluza. Material y métodos: Se estudió una muestra aleatoria y representativa de la población general andaluza identificada previamente por métodos estandarizados de estratificación. Así, se incluyeron un total de 4.507 participantes (tasa de respuesta el 83,7%) a los que se administró una batería de pruebas que incluyó: variables sociodemográficas, clínicas y psicosociales (acontecimientos vitales amenazantes, experiencia previa de abusos, presencia de trastorno de personalidad, rasgos de neuroticismo, impulsividad y paranoia, autonomía global, salud física, consumo de tóxicos). El diagnóstico de TAS se realizó con la MINI International Diagnostic Interview. Se identificaron prevalencias de TAS con un IC 95% y correlatos y comorbilidades con TAS testados mediante regresión logística binaria. Resultados: La prevalencia de TAS encontrada fue del 1,1% (IC 95% = 0,8-1,4). El diagnóstico de fobia social se asoció independiente y significativamente con una menor edad, menor nivel de autonomía global, presentar trastorno de personalidad, tener niveles más elevados de neuroticismo y de paranoia, haber sufrido maltrato en la infancia y haber tenido acontecimientos vitales amenazantes. Además, el TAS se asoció comórbidamente con depresión mayor, trastorno de pánico y abuso de alcohol. Conclusiones: La prevalencia y los factores asociados a TAS en la población andaluza son relativamente similares a los encontrados en estudios internacionales, aunque la asociación entre TAS y paranoia no había sido reportada anteriormente.Introduction: Population studies on social anxiety disorder (SAD) are relatively scarce and there is no previous reported evidence on prevalence or correlates of SAD in an Andalusian general population sample. Material and methods: We used a random representative sample previously identified via standard stratification procedures. Thus, a final sample of 4507 participants were included (response rate 83.7%). Interviewees were thoroughly assessed on sociodemographic, clinical and psychosocial factors, including: exposures to threatening life events (TLEs), childhood abuse, personality disorder and traits (neuroticism, impulsivity, paranoia), global functioning, physical health and toxics consumption. SAD diagnosis was ascertained using the Mini International Neuropsychiatric Interview. Both, pooled prevalences (with 95% confidence intervals) and risk correlates for SAD were estimated using binary logistic regression. Results: Estimated prevalence for SAD was 1.1% (95%CI=0.8-1.4). Having a SAD diagnosis was independently and significantly associated with younger age, poorer global functioning, higher neuroticism and paranoia personality traits, having suffered childhood abuse and exposure to previous TLEs. Furthermore, SAD was significantly associated with comorbid personality disorder, major depression, panic disorder and alcohol abuse. Conclusions: Among this large Andalusian population sample, prevalence of SAD and its associated factors are relatively similar to previously reported international studies, although no population study had reported earlier such a strong association with paranoia.Introduction: Population studies on social anxiety disorder (SAD) are relatively scarce and there is no previous reported evidence on prevalence or correlates of SAD in an Andalusian general population sample. Material and methods: We used a random representative sample previously identified via standard stratification procedures. Thus, a final sample of 4507 participants were included (response rate 83.7%). Interviewees were thoroughly assessed on sociodemographic, clinical and psychosocial factors, including: exposures to threatening life events (TLEs), childhood abuse, personality disorder and traits (neuroticism, impulsivity, paranoia), global functioning, physical health and toxics consumption. SAD diagnosis was ascertained using the Mini International Neuropsychiatric Interview. Both, pooled prevalences (with 95% confidence intervals) and risk correlates for SAD were estimated using binary logistic regression. Results: Estimated prevalence for SAD was 1.1% (95%CI=0.8-1.4). Having a SAD diagnosis was independently and significantly associated with younger age, poorer global functioning, higher neuroticism and paranoia personality traits, having suffered childhood abuse and exposure to previous TLEs. Furthermore, SAD was significantly associated with comorbid personality disorder, major depression, panic disorder and alcohol abuse. Conclusions: Among this large Andalusian population sample, prevalence of SAD and its associated factors are relatively similar to previously reported international studies, although no population study had reported earlier such a strong association with paranoia.El trabajo fue financiado, sin beneficio económico alguno para los autores, por las siguientes becas públicas de la Consejería de Innovación (Proyectos de Excelencia n.◦ 10- CTS-6682) y por el ministerio de ciencia e innovación ISCIII (Proyecto # ISCIII PI18/00467) y ISCIII, Proyectos de Investigación en Salud (Ref. PI18/00467) FEDER/Junta de Andalucía-Consejería de Economía y Conocimiento/ Proyecto B-CTS-361-UGR18. La financiación para open access corrió a cargo de Universidad de Granada / CBUA

Chronic fatigue syndrome: aetiology, diagnosis and treatment

Chronic fatigue syndrome is characterised by intense fatigue, with duration of over six months and associated to other related symptoms. The latter include asthenia and easily induced tiredness that is not recovered after a night's sleep. The fatigue becomes so severe that it forces a 50% reduction in daily activities. Given its unknown aetiology, different hypotheses have been considered to explain the origin of the condition (from immunological disorders to the presence of post-traumatic oxidative stress), although there are no conclusive diagnostic tests. Diagnosis is established through the exclusion of other diseases causing fatigue. This syndrome is rare in childhood and adolescence, although the fatigue symptom per se is quite common in paediatric patients. Currently, no curative treatment exists for patients with chronic fatigue syndrome. The therapeutic approach to this syndrome requires a combination of different therapeutic modalities. The specific characteristics of the symptomatology of patients with chronic fatigue require a rapid adaptation of the educational, healthcare and social systems to prevent the problems derived from current systems. Such patients require multidisciplinary management due to the multiple and different issues affecting them. This document was realized by one of the Interdisciplinary Work Groups from the Institute for Rare Diseases, and its aim is to point out the main social and care needs for people affected with Chronic Fatigue Syndrome. For this, it includes not only the view of representatives for different scientific societies, but also the patient associations view, because they know the true history of their social and sanitary needs. In an interdisciplinary approach, this work also reviews the principal scientific, medical, socio-sanitary and psychological aspects of Chronic Fatigue Syndrome

Clinical guidelines for late-onset Pompe disease

English version available at www.neurologia.comHasta 2006, la enfermedad de Pompe o glucogenosis tipo II era una enfermedad incurable y con tratamiento meramente paliativo. El desarrollo de la terapia de sustitución con la enzima α-glucosidasa recombinante humana ha constituido el primer tratamiento específico para esta enfermedad. El objetivo de esta guía es servir de referencia en el manejo de la variedad de inicio tardío de la enfermedad de Pompe, es decir, la que aparece después del primer año de vida. En la guía, un grupo de expertos españoles hace recomendaciones específicas en cuanto a diagnóstico, seguimiento y tratamiento de esta enfermedad. En cuanto al diagnóstico, el método de la muestra en sangre seca es imprescindible como primer paso para el diagnóstico de la enfermedad de Pompe, y el diagnóstico de confirmación de la enfermedad de Pompe debe realizarse mediante un estudio de la actividad enzimática en muestra líquida en linfocitos aislados o mediante el análisis mutacional del gen de la alfa-glucosidasa. En cuanto al tratamiento de la enfermedad con terapia de sustitución enzimática, los expertos afirman que es eficaz en la mejoría o estabilización de la función motora y pulmonar, y debe iniciarse cuando aparezcan los síntomas atribuibles a la enfermedad de PompeBefore 2006, Pompe disease or glycogenosis storage disease type II was an incurable disease whose treatment was merely palliative. The development of a recombinant human alpha-glucosidase enzymatic replacement therapy has become the first specific treatment for this illness. The aim of this guide is to serve as reference for the management of the late-onset Pompe disease, the type of Pompe disease that develops after one year of age. In the guide a group of Spanish experts make specific recommendations about diagnosis, follow-up and treatment of this illness. With regard to diagnosis, the dried blood spots method is essential as the first step for the diagnosis of Pompe disease. The confirmation of the diagnosis of Pompe disease must be made by means of an study of enzymatic activity in isolated lymphocytes or a mutation analysis of the alpha-glucosidase gene. With regard to treatment with enzymatic replacement therapy, the experts say that is effective improving or stabilizating the motor function and the respiratory function and it must be introduced when the first symptoms attributable to Pompe disease appea

Does Confinement Affect Treatment Dropout Rates in Patients With Gambling Disorder? A Nine-Month Observational Study

Background and Aims: COVID-19 pandemic and confinement have represented a challenge for patients with gambling disorder (GD). Regarding treatment outcome, dropout may have been influenced by these adverse circumstances. The aims of this study were: (a) to analyze treatment dropout rates in patients with GD throughout two periods: during and after the lockdown and (b) to assess clinical features that could represent vulnerability factors for treatment dropout. Methods: The sample consisted of n=86 adults, mostly men (n=79, 91.9%) and with a mean age of 45years old (SD=16.85). Patients were diagnosed with GD according to DSM-5 criteria and were undergoing therapy at a Behavioral Addiction Unit when confinement started. Clinical data were collected through a semi-structured interview and protocolized psychometric assessment. A brief telephone survey related to COVID-19 concerns was also administered at the beginning of the lockdown. Dropout data were evaluated at two moments throughout a nine-month observational period (T1: during the lockdown, and T2: after the lockdown). Results: The risk of dropout during the complete observational period was R=32/86=0.372 (37.2%), the Incidence Density Rate (IDR) ratio T2/T1 being equal to 0.052/0.033=1.60 (p=0.252). Shorter treatment duration (p=0.007), lower anxiety (p=0.025), depressive symptoms (p=0.045) and lower use of adaptive coping strategies (p=0.046) characterized patients who abandoned treatment during the lockdown. Briefer duration of treatment Baenas et al. Lockdown and GD: Treatment Dropout Frontiers in Psychology | www.frontiersin.org 2 December 2021 | Volume 12 | Article 761802 (p=0.001) and higher employment concerns (p=0.044) were highlighted in the individuals who dropped out after the lockdown. Treatment duration was a predictor of dropout in both periods (p=0.005 and p<0.001, respectively). Conclusion: The present results suggest an impact of the COVID-19 pandemic on treatment dropout among patients with GD during and after the lockdown, being treatment duration a predictor of dropout. Assessing vulnerability features in GD may help clinicians identify high-risk individuals and enhance prevention and treatment approaches in future similar situations

Valor pronóstico del índice de riesgo nutricional en receptores de trasplante cardiaco

[Abstract] Introduction and objectives. To study the prognostic impact of preoperative nutritional status, as assessed through the nutritional risk index (NRI), on postoperative outcomes after heart transplantation (HT). Methods. We conducted a retrospective, single-center study of 574 patients who underwent HT from 1991 to 2014. Preoperative NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (body weight [kg] / ideal body weight [kg]). The association between preoperative NRI and postoperative outcomes was analyzed by means of multivariable logistic regression and multivariable Cox regression. Results. Mean NRI before HT was 100.9 ± 9.9. According to this parameter, the prevalence of severe nutritional risk (NRI < 83.5), moderate nutritional risk (83.5 ≤ NRI < 97.5), and mild nutritional risk (97.5 ≤ NRI < 100) was 5%, 22%, and 10%, respectively. One year post-transplant mortality rates in these 4 categories were 18.2%, 25.3%, 7.9% and 10.2% (P < .001), respectively. The NRI was independently associated with a lower risk of postoperative infection (adjusted OR, 0.97; 95%CI, 0.95-1.00; P = .027) and prolonged postoperative ventilator support (adjusted OR, 0.96; 95%CI, 0.94-0.98; P = .001). Patients at moderate or severe nutritional risk had significantly higher 1-year post-HT mortality (adjusted HR, 1.55; 95%CI, 1.22-1.97; P < .001). Conclusions. Malnourished patients have a higher risk of postoperative complications and mortality after HT. Preoperative NRI determination may help to identify HT candidates who might benefit from nutritional intervention.[Resumen] Introducción y objetivos. Analizar el impacto del estado nutricional preoperatorio, evaluado mediante el índice de riesgo nutricional (IRN), en el pronóstico tras el trasplante cardiaco (TxC). Métodos. Se realizó un estudio retrospectivo de 574 pacientes que recibieron un TxC entre 1991 y 2014 en un centro. El IRN preoperatorio se calculó como 1,519 × albúmina (g/l) + 41,7 × (peso real [kg] / peso ideal [kg]). La asociación entre IRN preoperatorio y eventos clínicos posoperatorios se analizó mediante modelos multivariables de regresión logística y regresión de Cox. Resultados. El IRN preoperatorio medio de la población del estudio era de 100,9 ± 9,9. Según este parámetro, las prevalencias de riesgo nutricional grave (IRN < 83,5), moderado (83,5 ≤ IRN < 97,5) y leve (97,5 ≤ IRN < 100) antes del TxC eran el 5, el 22 y el 10% respectivamente. Las tasas de mortalidad a 1 año tras el TxC en estas 4 categorías fueron del 18,2, el 25,3, el 7,9 y el 10,2% (p < 0,001) respectivamente. El IRN preoperatorio resultó predictor independiente de menor riesgo de infección posoperatoria (odds ratio ajustada [ORa] = 0,97; intervalo de confianza del 95% [IC95%], 0,95-1,00; p = 0,027) y ventilación mecánica prolongada posoperatoria (ORa = 0,96; IC95%, 0,94-0,98; p = 0,001). Los pacientes con riesgo nutricional moderado a grave mostraron mayor mortalidad a 1 año tras el TxC (hazard ratio ajustada = 1,55; IC95%, 1,22-1,97; p < 0,001). Conclusiones. Los pacientes desnutridos tienen mayor riesgo de complicaciones posoperatorias y muerte tras el TxC. La determinación del IRN podría facilitar la identificación de candidatos a TxC que se beneficien de intervenciones nutricionales en espera del órgano