Applications of molecular spectroscopy

Imperial Users onl

Desempeño del personal y su incidencia en la atención al cliente de la empresa Corporación de Bienes y Servicios T & N S.R. Ltda. 2018

El trabajo de investigación titulado DESEMPEÑO DEL PERSONAL Y SU INCIDENCIA EN LA ATENCION AL CLIENTE DE LA EMPRESA CORPORACION DE BIENES Y SERVICIOS T & N S.R. Ltda. 2018. Se realizó con el objetivo de: determinar la incidencia del desempeño del personal en la calidad de atención al cliente la empresa Corporación de Bienes y Servicios y lograr los objetivos específicos siguientes:1) Identificar las capacidades con las que cuentan el personal y su incidencia en la calidad de atención al cliente. 2) Identificar la dedicación que tiene el personal y su incidencia en la calidad de atención al cliente. 3) Desarrollar estrategias que permitan mejorar el desempeño del personal orientadas a la calidad de atención al cliente. En la teoría de la investigación se desarrolló la evaluación del desempeño que se determina a través de las capacidades y dedicación, también se identificó la capacidades y como potenciarlas, como medir la dedicación del personal y la orientación y estrategias para la calidad en la atención al cliente. El método aplicado en la investigación fue deductivo, el diseño fue no experimental de tipo descriptivo. La población de estudio está constituido por el total del personal el cual cuenta con 18 trabajadores.Tesi

Fever and Infection in the Neurosurgical Intensive Care Unit

Fever is an adaptive response to a variety of infectious, inflammatory, and foreign stimuli. The “febrile response” confers an immunological advantage to the host over invading microorganisms – bacterial, fungal and viral. Fever results from a cytokine-mediated reaction that results in the generation of acute phase reactants and controlled elevation of core body temperature. The anterior hypothalamus coordinates the “febrile response” in reaction to the release of endogenous pyrogenes and subsequent up-regulation of prostaglandin synthesis. An ensuing change in the hypothalamic set point for temperature regulation advances a synchronized physiologic response from CNS to periphery, on a microscopic and macroscopic level, throughout the entire human organism. This differs from hyperthermia which refers to heat retention attributable to unregulated readjustment of the thermoregulatory mechanism. Clinically, an elevation of core body temperature, whether in fever or hyperthermia, is only the most apparent manifestation of an intricate mechanism that orchestrates activation of autonomic, immunologic, neurologic, hematologic, endocrine and behavioral responses

A comparative and exploratory study of motor oil branding in Nigeria and the UK

A thesis submitted to the University of Bedfordshire, in partial fulfilment of the requirements for the degree of Doctor of PhilosophyThe importance of branding in the consumer market has been emphasised in many studies. In contrast, branding in the industrial markets is under researched. Even so, few researches on motor oil have been conducted. Motor oil is a good example of an important industrial brand due to its use in the production of other goods. Thus, by studying branded motor oil products in two distinct economies, Nigeria and the UK, the thesis aims to understand the nature and extent of branding industrial products, based on comparing and contrasting aspects of motor oil branding in the two contrasting economies. The choice of comparing the two economies is significant bearing in mind that global brands operate globally, hence the need for a more appropriate global strategic orientation. The dearth of studies in this area supports the rational for the use of grounded theory as research strategy. To fill this gap, the study employed a multi methods research approach by employing the use of exploratory qualitative approach. The thesis utilised a longitudinal archival study to gain insight of motor oil branding. Participant observations in the supply chain of the two countries allowed gaining understanding of motor oil branding. Interviews and documents contributed to knowledge to allow triangulation of the findings. The findings suggest that a collection of branding strategies are done by focusing on inter firm relationships, purchase behaviour, effective distribution and various supporting services in the aftermarket. The thesis reveals motor oil functions between the consumer and the business markets with several branding strategies to attract awareness and differentiation. Additionally, the thesis develops a model of the branding strategies of low involvement, branded motor oil products. The model shows various branding strategies through the middlemen to the two markets (i.e. garages (B2B) and retail (B2C)). This research contributes to the literature by identifying the branding behaviour of a hybrid brand from the supply chain perspectives, showing an inter link of branding in both markets. The research further extends understanding of market behaviour of low involvement, business brands. The study further contributes to literature by understanding the effect of foreign brands operating in developing economies like Nigeria. In practice, the findings offer improvement of branding strategy especially with global brands that cross borders to operate in different economies

Racial Disparities in the Association Between Stress and Preterm Birth

Background: High levels of maternal stress have been linked to preterm births. However, findings from previous studies are inconsistent due to the varied use of stress measures. This study examined the effect of maternal stress on preterm birth, using both psychosocial and physiological measures. Methods: This study was conducted among 231 pregnant women enrolled during their first prenatal care visit. Presence of stress was assessed at enrollment using the Perceived Stress Scale (PSS) and Stressful Life Events Inventory (SLEI). Samples of maternal salivary cortisol were obtained during the first trimester and birth outcomes were ascertained at delivery. Multiple logistic regression was conducted to assess the association between stress and preterm birth. Results: The majority of the study participants were Black, not married, less educated and low income. There was an association between cortisol level and preterm birth. Per 1µg/dL increase in cortisol level, the odds of preterm birth increased by 26%. The increase was accentuated in Blacks where a unit increase in cortisol level was associated with higher odds of preterm birth (29%). Conclusions: Stress measures using PSS and SLEI did not reveal a statistically significant association with preterm birth. Health care and public health professionals should be aware of the association between increased cortisol level and preterm birth. Salivary cortisol may be a better predictor of preterm birth than PSS and SLEI

Nociceptive neuropeptide increases and periorbital allodynia in a model of traumatic brain injury.

OBJECTIVE: This study tests the hypothesis that injury to the somatosensory cortex is associated with periorbital allodynia and increases in nociceptive neuropeptides in the brainstem in a mouse model of controlled cortical impact (CCI) injury. METHODS: Male C57BL/6 mice received either CCI or craniotomy-only followed by weekly periorbital von Frey (mechanical) sensory testing for up to 28 days post-injury. Mice receiving an incision only and naïve mice were included as control groups. Changes in calcitonin gene-related peptide (CGRP) and substance P (SP) within the brainstem were determined using enzyme-linked immunosorbent assay and immunohistochemistry, respectively. Activation of ionized calcium-binding adaptor molecule-1-labeled macrophages/microglia and glial fibrillary acidic protein (GFAP)-positive astrocytes were evaluated using immunohistochemistry because of their potential involvement in nociceptor sensitization. RESULTS: Incision-only control mice showed no changes from baseline periorbital von Frey mechanical thresholds. CCI significantly reduced mean periorbital von Frey thresholds (periorbital allodynia) compared with baseline and craniotomy-only at each endpoint, analysis of variance P \u3c .0001. Craniotomy significantly reduced periorbital threshold at 14 days but not 7, 21, or 28 days compared with baseline threshold, P \u3c .01. CCI significantly increased SP immunoreactivity in the brainstem at 7 and 14 days but not 28 days compared with craniotomy-only and controls, P \u3c .001. CGRP levels in brainstem tissues were significantly increased in CCI groups compared with controls (incision-only and naïve mice) or craniotomy-only mice at each endpoint examined, P \u3c .0001. There was a significant correlation between CGRP and periorbital allodynia (P \u3c .0001, r = -0.65) but not for SP (r = 0.20). CCI significantly increased the number of macrophage/microglia in the injured cortex at each endpoint up to 28 days, although cell numbers declined over weeks post-injury, P \u3c .001. GFAP(+) immunoreactivity was significantly increased at 7 but not 14 or 28 days after CCI, P \u3c .001. Craniotomy resulted in transient periorbital allodynia accompanied by transient increases in SP, CGRP, and GFAP immunoreactivity compared with control mice. There was no increase in the number of macrophage/microglia cells compared with controls after craniotomy. CONCLUSION: Injury to the somatosensory cortex results in persistent periorbital allodynia and increases in brainstem nociceptive neuropeptides. Findings suggest that persistent allodynia and increased neuropeptides are maintained by mechanisms other than activation of macrophage/microglia or astrocyte in the injured somatosensory cortex

Etiology and Surgical Management of Cervical Spinal Epidural Abscess (SEA):: A Systematic Review.

Study Design: Systematic analysis and review. Objective: Evaluation of the presentation, etiology, management strategies (including both surgical and nonsurgical options), and neurological functional outcomes in patients with cervical spinal epidural abscess (SEA). Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were used to create a framework based on which articles pertaining to cervical SEA were chosen for review following a search of the Ovid and PubMed databases using the search terms epidural abscess and cervical. Included studies needed to have at least 4 patients aged 18 years or older, and to have been published within the past 20 years. Results: Database searches yielded 521 potential articles in PubMed and 974 potential articles in Ovid. After review, 11 studies were ultimately identified for inclusion in this systematic review. Surgery appears to be a well-tolerated management strategy with limited complications for patients with cervical SEA. However, the quantity of data comparing medical and surgical treatment of cervical SEA is limited and the bulk of the data is derived from low quality studies. Conclusion: Data reporting was heterogeneous among studies making it difficult to draw discrete conclusions. Early surgical intervention may be appropriate in selected patients with cervical epidural abscess, but it is not clear what distinguishes these patients from those who are successfully managed nonoperatively

The Intensivist

The intensivist is the primary care physician of the ICU. Critically ill patients often have multiple acute and chronic illnesses requiring the careful integration of information and recommendations from multiple consultants. In addition to acting as a physician, intensivists commonly are administrators of an ICU. In 1992, the Society of Critical Care Medicine1 published its guidelines for the definition of an intensivist and the intensivist’s role in an ICU (Table 1)