Plan de negocio para determinar la viabilidad de un bar after office que comercializa cerveza artesanal con frutas de la regi?n

El bar after office ?Marbella 27? surge a partir de una necesidad insatisfecha por parte de los j?venes de Lima Moderna, los cuales buscan despu?s de trabajar un bar que tenga: un servicio diferenciado, espacio amplio y con atenci?n especializada con conocimiento de cerveza artesanal. La propuesta de valor de ?Marbella 27? se enfoca en ofrecer entretenimiento y un servicio diferenciado a trav?s de promociones after office, conocimiento de las bebidas, as? como gran variedad de ?stas combinados con deliciosos aperitivos. El posicionamiento del bar se establece sobre estos atributos valorados. La rentabilidad del bar ?Marbella 27? se ve reflejado en el an?lisis financiero realizado en el que se aprecian las estimaciones de los indicadores financieros analizados con resultados positivos que demuestran la viabilidad del bar after office

Diagn?stico, an?lisis y propuesta de mejora del dise?o del programa nacional de alimentaci?n escolar Qali Warma

Muchos pa?ses cuentan con programas de alimentaci?n escolar; sin embargo no existe una f?rmula ?nica para gestionarlos puesto que son dise?ados en funci?n a distintos factores, tales como, los objetivos que busca cumplir el gobierno, los recursos con los que cuenta, la organizaci?n de las instituciones p?blicas, la influencia de otros programas sociales, la realidad social y econ?mica del pa?s y de la regi?n. En nuestro pa?s, el programa de alimentaci?n escolar vigente ha sido seriamente cuestionado no solo por la deficiente cadena de inocuidad de los alimentos sino por problemas en su dise?o inicial, los cuales se arrastran hasta el d?a de hoy. Sobre la base del diagn?stico y an?lisis realizado, se plantean propuestas de mejoras al dise?o del Programa Nacional de Alimentaci?n Escolar Qali Warma con el uso de herramientas de gesti?n, adem?s de informaci?n obtenida de diversas fuentes primarias y secundarias, para obtener propuestas concretas que a la larga contribuyan a la eficacia y eficiencia en la gesti?n del Programa. Estas propuestas de mejora planteadas buscan un cambio dr?stico pero progresivo de la gesti?n del Programa, que permita no s?lo cumplir sus objetivos sino tambi?n generar valor p?blico

Prevention of infections related to health care in primary care. Lessons from the pandemic

El sistema sanitario fall? a la hora de garantizar la seguridad tanto de los profesionales como de las personas que acudieron a los centros al inicio de la pandemia. La falta de materiales y directrices para la prevenci?n de infecciones provoc? en Espa?a la peor cat?strofe de la historia de la seguridad del paciente y de la salud laboral en el ?mbito sanitario. Sucedi? tambi?n en otros pa?ses, pero Espa?a tuvo las mayores tasas de sanitarios infectados del mundo. Fue una cat?strofe, en buena parte, evitable. Revisamos qu? medidas se han tomado para la prevenci?n de infecciones en los centros de atenci?n primaria, como la higiene de manos, las mascarillas y el material de protecci?n personal o el mantenimiento de la distancia interpersonal, entre otras. Actualizamos las recomendaciones y planteamos las perspectivas en una situaci?n que exige flexibilidad y capacidad de adaptaci?n para mantener una atenci?n de calidad y segura.The health system failed to guarantee the safety of both professionals and citizens who came to the centers at the beginning of the pandemic. The lack of materials and guidelines for the prevention of infections caused in Spain the worst catastrophe in the history of patient safety and occupational health in healthcare. It also happened in other countries but Spain had the highest rates of infected health workers in the world. It was a largely avoidable event. We review what measures have been taken to prevent infections in primary care centers, such as hand hygiene, masks and personal protection material or the maintenance of social distance, among others. We update the recommendations and raise the perspectives in a situation that requires flexibility and adaptability to maintain quality and safe care

Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation?

Aims: The prognostic impact of heart rate (HR) in acute heart failure (AHF) patients is not well known especially in atrial fibrillation (AF) patients. The aim of the study was to evaluate the impact of admission HR, discharge HR, HR difference (admission-discharge) in AHF patients with sinus rhythm (SR) or AF on long- term outcomes. Methods: We included 1398 patients consecutively admitted with AHF between October 2013 and December 2014 from a national multicentre, prospective registry. Logistic regression models were used to estimate the association between admission HR, discharge HR and HR difference and one- year all-cause mortality and HF readmission. Results: The mean age of the study population was 72+/-12years. Of these, 594 (42.4%) were female, 655 (77.8%) were hypertensive and 655 (46.8%) had diabetes. Among all included patients, 745 (53.2%) had sinus rhythm and 653 (46.7%) had atrial fibrillation. Only discharge HR was associated with one year all-cause mortality (Relative risk (RR)=1.182, confidence interval (CI) 95% 1.024-1.366, p=0.022) in SR. In AF patients discharge HR was associated with one year all cause mortality (RR=1.276, CI 95% 1.115-1.459, p</=0.001). We did not observe a prognostic effect of admission HR or HRD on long-term outcomes in both groups. This relationship is not dependent on left ventricular ejection fraction. Conclusions: In AHF patients lower discharge HR, neither the admission nor the difference, is associated with better long-term outcomes especially in AF patients

Plan de negocios para la puesta en marcha de un Resto-market saludable en la ciudad de Arequipa - 2021

El presente plan de negocio sobre la creaci?n de un resto-market saludable ha sido desarrollado con el prop?sito incentivar la cultura de consumo de productos saludables en la ciudad de Arequipa y a su vez apoyar a los productores locales promoviendo el crecimiento econ?mico de la regi?n. Considerando la coyuntura actual por la pandemia mundial por el COVID-19 la salud y los h?bitos alimenticios han tomado mayor relevancia en la vida de las personas; los residentes de Arequipa no son ajenos a esto. Si bien se identifican opciones que ofrecen alimentos saludables, notamos que a?n hay demanda insatisfecha; esto representa una gran oportunidad de negocio para el rubro de restaurantes y tiendas que provean los insumos para la preparaci?n de alimentos en casa. La investigaci?n que se realiz? es mixta (Cualitativo ? Cuantitativo). Con la informaci?n obtenida de la investigaci?n de mercado se elaboraron los planes de marketing, operaciones, capital humano y econ?mico-financiero, con la meta de llevar a la viabilidad el plan propuesto; esta viabilidad se sustenta a trav?s del an?lisis con un horizonte de 5 a?os donde considerando una participaci?n de mercado del 5% y una inversi?n inicial de S/ 148 023.62 se obtiene como resultado un VAN de S/ 39,538.35 y una TIR de 57.33% respaldando as? el proyecto

Effect of central nervous system (CNS) metastases in a real-world multicenter cohort study of Spanish ALK-positive non-small cell lung cancer (NSCLC) patients (p)

Background: CNS is a common site of metastases in patients with ALK-positive NSCLC. CNS metastases are associated with a number of deleterious effects, such as reduction in quality of life. However, the relationship between brain metastases and prognosis remains unclear. We aimed to evaluate the effect of CNS metastases on overall survival (OS) in a multicenter cohort of Spanish ALK-positive NSCLC patients diagnosed between 2008 and 2017. Methods: We included patients with stage IV at diagnoses, followed up to April 2018; OS (months [m]) was estimated with the Kaplan-Meier method. Survival curves were compared between groups of patients using the log-rank test. Hazard risk (HR) to death was estimated with multivariable Cox model. Results: Out of 163 patients in the cohort, a total of 116 were evaluated, with a median of follow-up of 29.2 m and 59 deaths reported. Characteristics at diagnosis were a median age of 58 years, 50% female, 58.6% never-smokers, 54.3% with comorbidities, PS by ECOG 0-1 93.1%. CNS metastases (median number of lesions 6) were present in 43.1% of patients and 34% of patients with CNS metastases were treated with local therapy (11.8 % local radiotherapy and 76.5% holocraneal radiotherapy). ALK inhibitors as first line and second line treatment were administered to 45.5% and 78.6% of patients, respectively. The median OS was 39 months; OS in patients with CNS metastases at diagnosis was 34.4 m and 39.0 m in those without CNS metastases at diagnosis (p=.9). In patients without CNS metastases at baseline (n=60), 22 developed CNS, with a median OS greater than in those without CNS metastases during follow-up, although the difference is not significant (45.5 m vs 33.3 m; p=.9). There were 81 patients who presented with metastases in more than one organ and 33 patients with metastases in a single organ. The risk of death increased as the number of metastatic organs at diagnoses increased (HR=1.26, p=.0305), with worse OS in those presenting with liver metastases at diagnoses (21.1%, OS: 20 m), compared to those without tumor involvement (OS: 45.4 m; p =.008). Conclusions: OS was similar for ALK-positive NSCLC patients with and without CNS metastases at diagnoses. OS was worse as the number of metastatic organs at diagnosis increased, with liver metastases being associated with the highest risk of mortality

Biotic aspects involved in the control of damping-off producing agents: The role of the thermotolerant microbiota isolated from composting of plant waste

Along with the high temperatures generated during the composting process, the microbial community of a compost pile collaborates actively in the control of damping-off producing agents. Such collaboration could be justified on the basis of the ability of the microbiota to produce fungicide substances that are involved in the control of damping-off or other bioactive compounds that affect the growth promotion of plants. Thanks to ex situ experiments, a remarkable suppressive effect was corroborated against different agents producing damping-off. The microbial strains involved in this effect were detected mainly in the bio-oxidative and maturation phases of the composting process. However, only 3% of the total collection of strains proved to have a multipotential character with respect to its spectrum of action against the damping-off producing agents, as well as in relation to its capacity to produce substances of agronomic interest. It is worth mentioning the presence of two thermophilic isolates identified as Geobacillus thermodenitrificans and Bacillus aerius that showed the ability to inhibit the symptoms caused by Phytophthora capsici in vivo. Both strains were able to produce siderophores, salicylic acid and chitinase enzymes in vitro, but only G. thermodenitrificans was able to stimulate the development of the root in pepper seedlings. In this sense, it is suspected that the production of cyanide by this thermophilic bacteria could be related to this latter effect

Immunomodulatory properties of carvone inhalation and Its effects on contextual fear memory in mice

A complex network of interactions exists between the immune, the olfactory, and the central nervous system (CNS). Inhalation of different fragrances can affect immunological reactions in response to an antigen but also may have effects on the CNS and cognitive activity. We performed an exploratory study of the immunomodulatory ability of a series of compounds representing each of the 10 odor categories or clusters described previously. We evaluated the impact of each particular odor on the immune response after immunization with the model antigen ovalbumin in combination with the TLR3 agonist poly I:C. We found that some odors behave as immunostimulatory agents, whereas others might be considered as potential immunosuppressant odors. Interestingly, the immunomodulatory capacity was, in some cases, strain-specific. In particular, one of the fragrances, carvone, was found to be immunostimulatory in BALB/c mice and immunosuppressive in C57BL/6J mice, facilitating or impairing viral clearance, respectively, in a model of a viral infection with a recombinant adenovirus. Importantly, inhalation of the odor improved the memory capacity in BALB/c mice in a fear-conditioning test, while it impaired this same capacity in C57BL/6J mice. The improvement in memory capacity in BALB/c was associated with higher CD3+ T cell infiltration into the hippocampus and increased local expression of mRNA coding for IL-1β, TNF-α, and IL-6 cytokines. In contrast, the memory impairment in C57BL/6 was associated with a reduction in CD3 numbers and an increase in IFN-γ. These data suggest an association between the immunomodulatory capacity of smells and their impact on the cognitive functions of the animals. These results highlight the potential of studying odors as therapeutic agents for CNS-related diseases

Conclusions of the II International and IV Spanish Hydration Congress. Toledo, Spain, 2nd-4th December, 2015

Water is the major component of our organism representing about 60% of total body weight in adults and has to be obtained through the consumption of different foods and beverages as part of our diet. Water is an essential nutrient performing important functions, including transport of other nutrients, elimination of waste products, temperature regulation, lubrication and structural support. In this context, hydration through water has an essential role in health and wellness, which has been highly acknowledged in recent years among the health community experts such as nutritionists, dietitians, general practitioners, pharmacists, educators, as well as by physical activity and sport sciences experts and the general population

Innovación y estrategias de intervención en acoso escolar

Los problemas de convivencia escolar, violencia escolar, bullying y cyberbullying, en los centros españoles son una realidad y, por tanto, es necesario que los futuros docentes cuenten con estrategias específicas para el abordaje de estas situaciones cuando se enfrenten a la realidad de las aulas. En este manual, profesionales del área de la convivencia escolar presentan las actuaciones, programas y herramientas disponibles que en estos momentos se están poniendo en práctica en los centros escolares con resultados positivos. Así, se pretende ampliar el conocimiento teórico-práctico en el ámbito de la convivencia, gestión de conflictos y violencia escolar.EducaciónPsicologí