THE EFFECT OF INDIVIDUAL CHARACTERISTICS AND DESTINATION IMAGE ON WORD OF MOUTH THROUGH VISITOR SATISFACTION AT PEMANDIAN ALAM GANTANG RANI TOURISM OBJECTS IN SIBOLANGIT SUBDISTRICT, INDONESIA

The advancement of current technological requires each sector to follow market developments especially in the tourism industry. Local tourism objects have emerged to the surface and are demanded to be able to adjust their services to the desires and needs of visitors who are expected to be able to increase visitor satisfaction and a positive image of a tourist attraction and attract potential new tourists to visit. The purpose of this study was to look at the effect of individual characteristics and destination image on word of mouth through visitor satisfaction at the Pemandian Alam Gantang Rani Sembahe in Sibolangit sub-district. This type of research is associative with quantitative methods. The population of the study was visitors who used the services of the Pemandian Alam Gantang Rani in the designated research time. However, by using a predetermined formula, a total sample of 100 respondents was obtained. The sampling technique used in this study is nonprobability sampling with accidental sampling type. Data collection techniques used questionnaires and interviews. The results of the first sub structure test in this study shows that individual characteristics have a positive and significant effect on visitor satisfaction. Destination image has a positive and significant effect on visitor satisfaction. The results of the second sub-structure test show that individual characteristics have no positive and significant influence on word of mouth. Destination image has a positive and significant effect on word of mouth. Visitor satisfaction has a positive and significant impact on word of mouth. Furthermore, visitor satisfaction is able to mediate between individual characteristic variables with word of mouth. The last hypothesis shows that the visitor satisfaction variable is not able to mediate between destination image variables and word of mouth. Based on the results of this study, the Pemandian Alam Gantang Rani Sembahe has the potential to be the preeminent tourist attraction in the Sibolangit Region because it is able to follow trends and continue to innovate in accordance with the development of the situation. JEL: L80; L83; L89  Article visualizations

Relación entre inteligencia emocional y suicidio: una revisión sistemática

En Colombia actualmente existen numerosas problemáticas de salud pública, sin embargo, el suicidio es uno de los más prevalentes. Este problema es precedido por un conjunto de eventos que buscan de forma intencional acabar con la vida, y esto se conoce como comportamiento o conducta suicida, el cual es consecuencia de reacciones emocionales mal gestionadas que entrañan un déficit en la inteligencia emocional de un individuo; es por eso que esta es de vital importancia, ya que permite que un sujeto conozca, comprenda y gestione de manera asertiva las diferentes emociones que experimenta a lo largo de su existencia. Objetivo: Conocer/identificar la relación que existe entre el suicidio y la inteligencia emocional.In Colombia there are currently numerous public health problems, however, suicide is one of the most prevalent. This problem is preceded by a set of events that intentionally seek to end life, and this is known as suicidal behavior or behavior, which is a consequence of poorly managed emotional reactions that entail a deficit in the emotional intelligence of an individual; that is why this is of vital importance, since it allows a subject to know, understand and assertively manage the different emotions that he experiences throughout his existence. Objective: To know/identify the relationship between suicide and emotional intelligence

Influencia del uso de un sistema integrado Arduino para mejorar el control de ventas en la Empresa Safari Drive Lima – 2021

La investigación tiene el objetivo general de determinar la influencia del uso de un sistema integrado Arduino para mejorar el control de ventas en la empresa Safari Drive Lima – 2021. Para ello se estableció una metodología descriptiva – no experimental de enfoque cuantitativo. Bajo el análisis de factores se consideró como muestra el proceso de recolección de ventas; el análisis inicial permitió evaluar el sistema ventas mostrando una deficiencia en el cumplimiento en un 65%, lo que causa una tendencia negativa en las ventas y desperdicio de tiempos que suman 16085 soles en pérdidas. La evaluación de los distintos sistemas evaluados indicó que el sistema Arduino es el más adecuado para ser implementado ya que cumple con el 72% de las necesidades de la empresa; aun así, se hace necesario la implementación de distintos complementos que ayuden al tratamiento y análisis de información para superar 83% de confiabilidad. La evaluación determinó una inversión de 35 mil con un costo beneficio de 1,2. Bajo los resultados obtenidos con la prueba piloto se presenta un ahorro por venta de 0,093 por lo que se puede concluir una mejora en el control de ventas con la aplicación del sistema Arduino

Buenas Prácticas para la Comprensión y Producción Textual en Estudiantes de Básica Secundaria de las Instituciones Educativas Públicas

The formative mediating role of teacher and student from the linguistic environment of the classroom is studied through methodological actions. This requires studying changes from a strategic approach in classes where the main purpose is to reflect on the impact of a didactic model as good practices in the improvement of comprehension and textual production in high school students of public educational institutions. The objective of this research is to know into theoretical level the good practices of textual production and comprehension of students in basic education, therefore, it is well known that learning is impoverished as they advance from school level which reflects continuous shortcomings in the development of reading and functional errors of the language due to lack of comprehension. The research is framed within the line of education and society research in the area of teaching and curriculum of the axis didactic tools, environment and resources for learning. To achieve the proposed goals at the methodological level, it starts from the critical social paradigm under an action research (AI) method with a mixed approach. Finally, this generates an alternative theory of solution to the problem of textual production and comprehension in high school students.Se estudia el rol mediador formativo del docente y estudiante desde el entorno lingüístico del aula a través de acciones metodológicas. Esto requiere estudiar cambios desde un enfoque estratégico en clases, donde se establece como propósito principal reflexionar el impacto de un modelo didáctico como buenas prácticas en el mejoramiento de la comprensión y producción textual en estudiantes de básica secundaria de instituciones educativas públicas. El objetivo de esta investigación es conocer a nivel teórico las buenas prácticas de producción y comprensión textual de educandos en educación básica, por tanto, es notorio que el aprendizaje se empobrece a medida que avanzan de nivel escolar, el cual refleja falencias continúas en el desarrollo de la lectura y errores funcionales del idioma por falta de comprensión. La investigación está enmarcada dentro de la línea de investigación educación y sociedad en el área docencia y currículo del eje herramientas didácticas, ambiente y recursos para el aprendizaje. Para alcanzar las metas propuestas, a nivel metodológico se inicia desde el paradigma crítico social bajo un método de investigación acción (IA) con enfoque mixto. Finalmente, esto genera una teoría alternativa de solución sobre la problemática de la producción y comprensión textual en estudiantes de básica secundaria

Erysipelas or cellulitis with a prosthetic joint in situ

We describe a case of a 60-year old male who developed an acute prosthetic joint infection (PJI) of the knee, secondary to erysipelas of the lower leg due to beta-hemolytic Group G streptococci. As it is unknown how often this phenomenon occurs in patients with prosthetic implants and which patients are most prone to develop this complication, we analyzed: i) the incidence of the development of a PJI in these patients and ii) the clinical characteristics of streptococcal PJI during an episode of erysipelas/cellulitis. Based on a retrospective analysis of patients with a prosthetic implant in situ presenting at the emergency department with erysipelas/cellulitis, 1 out of 10 patients developed a PJI. An additional analysis within a multicenter cohort on streptococcal PJI demonstrated in 22 patients that a secondary PJI due to erysipelas/cellulitis mostly develops in young implants (<5 years old). In 20 cases (91%), the skin infection was in the same limb as the joint prosthesis suggesting contiguous spread of bacteria. These data emphasizes the importance of preventive measures to reduce the occurrence of skin infections in patients with prosthetic implants, and if an erysipelas or cellulitis does occur, to monitor patients carefully

Mild-to-Moderate Kidney Dysfunction and Cardiovascular Disease: Observational and Mendelian Randomization Analyses

BACKGROUND: End-stage renal disease is associated with a high risk of cardiovascular events. It is unknown, however, whether mild-to-moderate kidney dysfunction is causally related to coronary heart disease (CHD) and stroke. METHODS: Observational analyses were conducted using individual-level data from 4 population data sources (Emerging Risk Factors Collaboration, EPIC-CVD [European Prospective Investigation into Cancer and Nutrition-Cardiovascular Disease Study], Million Veteran Program, and UK Biobank), comprising 648 135 participants with no history of cardiovascular disease or diabetes at baseline, yielding 42 858 and 15 693 incident CHD and stroke events, respectively, during 6.8 million personyears of follow-up. Using a genetic risk score of 218 variants for estimated glomerular filtration rate (eGFR), we conducted Mendelian randomization analyses involving 413 718 participants (25917 CHD and 8622 strokes) in EPIC-CVD, Million Veteran Program, and UK Biobank. RESULTS: There were U-shaped observational associations of creatinine-based eGFR with CHD and stroke, with higher risk in participants with eG FR values 105 mL.min(-1).1.73 m(-2), compared with those with eG FR between 60 and 105 mL.min(-1).1.73 m(-2). Mendelian randomization analyses for CHD showed an association among participants with eGFR 105 mL.min(-1).1.73 m(-2). Results were not materially different after adjustment for factors associated with the eGFR genetic risk score, such as lipoprotein(a), triglycerides, hemoglobin Alc, and blood pressure. Mendelian randomization results for stroke were nonsignificant but broadly similar to those for CHD. CONCLUSIONS: In people without manifest cardiovascular disease or diabetes, mild-to-moderate kidney dysfunction is causally related to risk of CHD, highlighting the potential value of preventive approaches that preserve and modulate kidney function

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Os principais tipos e manifestações da Cirrose Hepática: uma atualização clínica

Introdução: A cirrose hepática é um processo patológica crônico, considerado a hepatopatia mais comum, definido como a conversão difusa morfoestrutural por nódulos de arquitetura anômalo envoltos por fibrose. Objetivou-se&nbsp;descrever os tipos mais relevantes de cirrose e suas devidas manifestações. Metodologia: Trata-se de uma revisão bibliográfica, fundamentada nas plataformas do SciELO, PubMed, Scopus, utilizando os termos “hepatical cirrhosis”, “liver disease” e “hepatocellular insufficiency” a qual através da revisão narrativa, abordou amplamente a respeito da contextualização da cirrose e as principais etiologias. Resultados e Discussão: Foi analisado que tal condição afeta qualquer faixa etária, sexo, etnia e independe da classe socioeconômica, mas as diversas etiologias impõem um perfil epidemiológico específico conforme a aparição. As principais origens abordam o tipo alcoólico, hepatite, aplicação crônica de alguns fármacos e esteatose gordurosa ou não. Ademais, estima-se que estas afetam a anatomofuncionalidade do órgão responsável por grande parte da homeostase, culminando em diversas manifestações clínicas.&nbsp; Conclusão: A cirrose é uma consequência grave de fatores de base em estágio avançado, a qual devido ao seu curso geralmente silencioso culmina no desenvolvimento e progressão clínica. Neste contexto, a atenção aos fatores predisponentes como alimentação rica em lipídios, estilismo, negligência a exames de rotina, sedentarismo e obesidade contribuem constituem medidas eficazes de prevenção primária.&nbsp

Assessment of Omega-3 Fatty Acid Food Intakes and Their Association with Socioeconomic Status and Acculturation in Midwestern Latinas

The purpose of this study was to assess the validity and reliability of a culturally appropriate food frequency questionnaire (FFQ) to measure total omega-3 (n-3) fatty acid, ALA, EPA and DHA intakes of Midwestern Latinas. In addition, the study examined the association of age, socioeconomic status (SES) and acculturation with intake of n-3 fatty acids. The n-3 FFQ was developed from preliminary interviews, analyzed for content validity and pilot tested. The final instrument containing 209 items (15 culturally-specific dishes) was tested with 162 first-generation Latinas. One-on-one interviews in Spanish were conducted to validate the FFQ. In addition, women provided sociodemographic information, and completed an acculturation questionnaire. The validity and reliability of the FFQ was assessed by Pearson correlation coefficient and Bland-Altman plots were constructed to assess agreement between the two methods and to increase the robustness of the validation. Correlation and regression analysis were conducted to test the association of age, SES and acculturation with n-3 fatty acid intakes. Mean daily intakes (±SD) of Total n-3, ALA, EPA and DHA (g) estimated by the mean of the two FFQs were 1.2±0.7, 1.1±0.6, 0.1±0.8, 0.1±0.1 respectively. Reliability of the n-3FFQ was 0.71 for Total n-3, 0.65 for ALA, 0.74 for EPA, 0.54 for DHA (P\u3c 0.01). Validity correlation coefficients were 0.42 for Total n-3, 0.44 for ALA, 0.27 for EPA, and 0.24 for DHA (P\u3c 0.05). Participant’s age was negatively correlated with intakes of Total n-3 and ALA. Education, income and acculturation were positively correlated with intakes of EPA+DHA (P\u3c0.05). Participant’s age was related to intake of Total n-3 and ALA after accounting for variation in education, income and acculturation. Income was related to intake of EPA+DHA when the other variables were taken into account (P\u3c0.05). Findings from the present study suggest that the n-3 FFQ had acceptable reliability and adequate validity for the type of nutrients studied and may perform better to assess Total n-3 and ALA than to assess LC n-3 PUFA intakes in the study population. Advisor: Nancy M. Lewi