Mala relación médico paciente asociado al incumplimiento de farmacoterapia hipoglucemiante oral en diabéticos. Hospital Distrital Santa Isabel- El Porvenir- Trujillo 2022

Este proyecto. de. tesis tiene como objetivo. determinar. sí una mala relación médico paciente se relaciona con el incumplimiento de la farmacoterapia hipoglicemiante oral en diabéticos en el Hospital Distrital Santa Isabel- El Porvenir Trujillo 2022; con respecto a la metodología se trata de un estudio observacional, analítico de casos y controles. Conformado por la población de pacientes con diagnóstico de diabetes mellitus tipo 2 atendidos en el Hospital Distrital Santa Isabel en el periodo. de octubre a noviembre del 2022. Con respecto a la población. de estudio. se estima una muestra, constituida en el grupo de casos por 72 pacientes con incumplimiento al tratamiento oral con hipoglucemiantes y en el grupo control: por 144 pacientes que cumplen con el tratamiento. Se estimará la prueba Chi cuadrado para verificar si la diferencia de los porcentajes de. mala. relación médico paciente entre el grupo de casos y controles es o no significativa; se considerará significancia estadística cuando el valor de p sea menor a 0.05, se determinará el odds ratio puntual e interválico, se realizará el análisis de regresión logística multivariante para las variables intervinientes.Tesis de segunda especialida

Estrategias de redacción Flower y Hayes en la producción de textos expositivos en estudiantes de educación secundaria, Virú – 2021

El objetivo general de la investigación fue determinar si la aplicación de estrategias de redacción Flower y Hayes mejora la producción de textos expositivos en los estudiantes del quinto grado de educación secundaria de la Institución Educativa N° 80074 “María Caridad Agüero de Arresse”. Virú – 2021. La investigación es del tipo experimental de enfoque cuantitativo y diseño cuasiexperimental con dos grupos: el experimental y el control, cada uno conformado con muestra de 30 estudiantes. Se aplicó como instrumentos el cuestionario de producción te textos expositivos escritos, que fue validado por el juicio de 3 expertos y con índice de confiabilidad aceptable. En los resultados, la variable producción de textos expositivos, presenta en el nivel inicio 36.7% para el pre test experimental y 60% para el pre test control. En el nivel previsto el post test experimental ostenta el 46.7% y en el post test control el 23%. El nivel destacado el post test experimental registra el 26.7% y el post test control el 3.3%. En la prueba de comparación de resultados entre el post test del grupo control y post test del grupo experimental, el p-valor es de 0,000 (p< 0,05) demostrando diferencias estadísticas en un nivel de confianza al 95%. Se concluye que las estrategias de redacción Flower y Hayes mejoró significativamente la producción de textos expositivos en los estudiantes que participaron en la experimentación

Memorias Congreso Internacional de diseño e innovación 2014

Genera espacios en los cuales se fortalecen los lazos de cooperación entre las instituciones universitarias participantes con programas de diseño, para contribuir al desarrollo académico y empresarial en América Latina. Ejes temáticos: Diseño e innovación • Diseño y tecnologías estereoscópicas. • Innovación en la cadena productiva. • Nuevas perspectivas de la innovación. Gestión del diseño en la cadena productiva • Diseño entretejiendo cadenas de valor. El diseño en la cadena productiva. • Nuevas estrategias y estudios de consumidor. • Diseño y perspectiva desarrollo humano en América Latina. Diseño más allá de las industrias culturales empresas creativas y culturales • Nuevas industrias. • El diseño: un asunto transdiciplinar. • Impacto de la comunicación visual. • Pedagogía y empresas culturale

­Que empiece la función!

La experiencia consiste, fundamentalmente, en que a partir del estudio del teatro y de la actividad circense se conozcan y valoren manifestaciones artísticas distintas a las que se trabajan habitualmente en el currículum. El objetivo principal es que el alumno aprecie la riqueza cultural y lingüística con el fin de poder mantener más relaciones interpersonales y comunicativas adecuadas a la sociedad cambiante en la que está inmerso. Otros objetivos son potenciar la autoestima a través del juego teatral; fomentar actitudes de respeto hacia otras culturas; y conocer el patrimonio cultural mediante la asistencia a distintos teatros y a representaciones de obras teatrales. Las actividades se desarrollan a través de talleres, a lo largo de todo el curso, y se trabajan, sobre todo, producciones artísticas y ensayos de obras teatrales. Entre los talleres, dirigidos a los tres ciclos de Primaria, destacan la elaboración de decorados, taller de máscaras, títeres, guiñol, teatros de sombras, diaporamas o talleres de grabación, maquillaje y marquetería. Se elaboran, además, unidades didácticas para cada nivel y actividades complementarias de asistencia a manifestaciones teatrales y circenses. La experiencia termina con la realización de una semana cultural en la que se exponen los materiales elaborados, se llevan a cabo las actividades complementarias y extraescolares y se representan diferentes obras teatrales. Se incluyen, en anexos, materiales y unidades didácticas por áreas y ciclos.Madrid (Comunidad Autónoma). Consejería de EducaciónMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Systematic screening of ubiquitin/p62 aggregates in cerebellar cortex expands the neuropathological phenotype of the C9orf72 expansion mutation

The neuropathological hallmark of the C9orf72 intronic hexanucleotide expansion in frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS) is the presence of small ubiquitin/p62-positive and transactive response DNA binding protein 43 kDa (TDP-43)-negative cytoplasmic inclusions in several brain areas. The identification of this histopathological signature is highly predictive of an underlying mutation. In this study, we screened 1800 cases of the Barcelona IDIBAPS Brain Bank, independently of the clinical and final neuropathological diagnosis of the brain donor, for the presence of ubiquitin/p62-positive inclusions in the cerebellum (UPPI). Positive cases were also stained for dipeptide repeats. We identified a total of 21 donors with UPPI and in all of them the C9orf72 hexanucleotide expansion was genetically confirmed. Most donors had an FTLD or to a lesser extent ALS clinico-pathological phenotype. However, 3 cases had been previously classified as having clinically and neuropathologically Lewy body disease. Other co-existing pathologies, especially of the PART-type, were also frequently encountered. This study highlights the importance of the evaluation of ubiquitin/p62-positive cytoplasmic inclusions in all neurodegenerative diseases as a good screening method for the detection of C9orf72 expansion mutation, since this mutation is not rare and can overlap with other neurodegenerative entities

Paisaje UM VS Sierra Espuña

Catálogo de la exposición de alumnos del curso 2009/201

Methods to control the pharmaceutical cost impact of chronic conditions in the elderly

Multimorbidity is the main cause of polypharmacy in elderly people, with the consequent increment in cost and use of inappropriate medication. To control cost, specific strategies have been implemented in healthcare services to reduce potentially inappropriate prescription. Many interventions are applied online during the prescription process using computerized decision support systems, for example, therapeutic algorithms and alerts. Other interventions can be categorized as offline due to their application before or after the prescription process, the main strategies being financial incentives, medication reviews and organizational change. All these strategies are complementary and multifaceted. There is evidence that some of these interventions are effective, but further research should be directed in this field, including investigation of patient cost and outcomes.Vivas Consuelo, DJJ.; Usó Talamantes, R.; Trillo Mata, JL.; Mendez Valera, P. (2015). 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Medical Care Research and Review, 68(4), 387-420. doi:10.1177/1077558711399580Mueller, C., Schur, C., & O’Connell, J. (1997). Prescription drug spending: the impact of age and chronic disease status. American Journal of Public Health, 87(10), 1626-1629. doi:10.2105/ajph.87.10.1626Sambamoorthi, U., Shea, D., & Crystal, S. (2003). Total and Out-of-Pocket Expenditures for Prescription Drugs Among Older Persons. The Gerontologist, 43(3), 345-359. doi:10.1093/geront/43.3.345Rogowski, J., Lillard, L. A., & Kington, R. (1997). The Financial Burden of Prescription Drug Use Among Elderly Persons. The Gerontologist, 37(4), 475-482. doi:10.1093/geront/37.4.475Fahlman, C., Lynn, J., Doberman, D., Gabel, J., & Finch, M. (2006). Prescription Drug Spending for Medicare+Choice Beneficiaries in the Last Year of Life. Journal of Palliative Medicine, 9(4), 884-893. doi:10.1089/jpm.2006.9.884Vivas, D., Guadalajara, N., Barrachina, I., Trillo, J.-L., Usó, R., & de-la-Poza, E. (2011). Explaining primary healthcare pharmacy expenditure using classification of medications for chronic conditions. Health Policy, 103(1), 9-15. doi:10.1016/j.healthpol.2011.08.014Kaufman, D. W., Kelly, J. P., Rosenberg, L., Anderson, T. E., & Mitchell, A. A. (2002). Recent Patterns of Medication Use in the Ambulatory Adult Population of the United States. JAMA, 287(3), 337. doi:10.1001/jama.287.3.337Fortin, M., Stewart, M., Poitras, M.-E., Almirall, J., & Maddocks, H. (2012). A Systematic Review of Prevalence Studies on Multimorbidity: Toward a More Uniform Methodology. The Annals of Family Medicine, 10(2), 142-151. doi:10.1370/afm.1337Rollason, V., & Vogt, N. (2003). Reduction of Polypharmacy in the Elderly. Drugs & Aging, 20(11), 817-832. doi:10.2165/00002512-200320110-00003Bradley, M. C., Fahey, T., Cahir, C., Bennett, K., O’Reilly, D., Parsons, C., & Hughes, C. M. (2012). 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Journal of Clinical Epidemiology, 51(5), 367-375. doi:10.1016/s0895-4356(97)00306-5Bayliss, E. A., Ellis, J. L., & Steiner, J. F. (2005). Health and Quality of Life Outcomes, 3(1), 51. doi:10.1186/1477-7525-3-51Valderas, J. M., Starfield, B., Sibbald, B., Salisbury, C., & Roland, M. (2009). Defining Comorbidity: Implications for Understanding Health and Health Services. The Annals of Family Medicine, 7(4), 357-363. doi:10.1370/afm.983Starfield, B. (2006). Threads and Yarns: Weaving the Tapestry of Comorbidity. The Annals of Family Medicine, 4(2), 101-103. doi:10.1370/afm.524Diederichs, C., Berger, K., & Bartels, D. B. (2010). The Measurement of Multiple Chronic Diseases--A Systematic Review on Existing Multimorbidity Indices. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 66A(3), 301-311. doi:10.1093/gerona/glq208Smith, S. M., Soubhi, H., Fortin, M., Hudon, C., & O’Dowd, T. (2012). 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M., Healy, P., Burke, E., Newell, J., Gillespie, P., & Murphy, A. W. (2011). The prevalence of multimorbidity in primary care and its effect on health care utilization and cost. Family Practice, 28(5), 516-523. doi:10.1093/fampra/cmr013Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. The Lancet, 380(9836), 37-43. doi:10.1016/s0140-6736(12)60240-2Holden, L., Scuffham, P. A., Hilton, M. F., Muspratt, A., Ng, S.-K., & Whiteford, H. A. (2011). Patterns of multimorbidity in working Australians. Population Health Metrics, 9(1). doi:10.1186/1478-7954-9-15Fortin, M., Lapointe, L., Hudon, C., Vanasse, A., Ntetu, A. L., & Maltais, D. (2004). Health and Quality of Life Outcomes, 2(1), 51. doi:10.1186/1477-7525-2-51Schellevis, F. G., van der Velden, J., van de Lisdonk, E., van Eijk, J. T. M., & van Weel, C. (1993). Comorbidity of chronic diseases in general practice. Journal of Clinical Epidemiology, 46(5), 469-473. doi:10.1016/0895-4356(93)90024-uSchäfer, I., Hansen, H., Schön, G., Maier, W., Höfels, S., Altiner, A., … van den Bussche, H. (2009). The German MultiCare-study: Patterns of multimorbidity in primary health care – protocol of a prospective cohort study. BMC Health Services Research, 9(1). doi:10.1186/1472-6963-9-145Schäfer, I., von Leitner, E.-C., Schön, G., Koller, D., Hansen, H., Kolonko, T., … van den Bussche, H. (2010). Multimorbidity Patterns in the Elderly: A New Approach of Disease Clustering Identifies Complex Interrelations between Chronic Conditions. PLoS ONE, 5(12), e15941. doi:10.1371/journal.pone.0015941Van den Bussche, H., Koller, D., Kolonko, T., Hansen, H., Wegscheider, K., Glaeske, G., … Schön, G. (2011). Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in Germany. BMC Public Health, 11(1). doi:10.1186/1471-2458-11-101König, H.-H., Leicht, H., Bickel, H., Fuchs, A., Gensichen, J., … Eckardt, M. (2013). Effects of multiple chronic conditions on health care costs: an analysis based on an advanced tree-based regression model. BMC Health Services Research, 13(1). doi:10.1186/1472-6963-13-219Teljeur, C., Smith, S. M., Paul, G., Kelly, A., & O’Dowd, T. (2013). Multimorbidity in a cohort of patients with type 2 diabetes. European Journal of General Practice, 19(1), 17-22. doi:10.3109/13814788.2012.714768Poblador-Plou, B., van den Akker, M., Vos, R., Calderón-Larrañaga, A., Metsemakers, J., & Prados-Torres, A. (2014). Similar Multimorbidity Patterns in Primary Care Patients from Two European Regions: Results of a Factor Analysis. PLoS ONE, 9(6), e100375. doi:10.1371/journal.pone.0100375Fulton, M. M., & Riley Allen, E. (2005). Polypharmacy in the elderly: A literature review. Journal of the American Academy of Nurse Practitioners, 17(4), 123-132. doi:10.1111/j.1041-2972.2005.0020.xBoudreau, D. M., Yu, O., Gray, S. L., Raebel, M. A., Johnson, J., & Larson, E. B. (2011). Concomitant Use of Cholinesterase Inhibitors and Anticholinergics: Prevalence and Outcomes. Journal of the American Geriatrics Society, 59(11), 2069-2076. doi:10.1111/j.1532-5415.2011.03654.xVeehof, L., Stewart, R., Haaijer-Ruskamp, F., & Jong, B. M. -d. (2000). The development of polypharmacy. A longitudinal study. Family Practice, 17(3), 261-267. doi:10.1093/fampra/17.3.261Rollason, V., & Vogt, N. (2003). Reduction of Polypharmacy in the Elderly. Drugs & Aging, 20(11), 817-832. doi:10.2165/00002512-200320110-00003Fialová, D. (2005). Potentially Inappropriate Medication Use Among Elderly Home Care Patients in Europe. JAMA, 293(11), 1348. doi:10.1001/jama.293.11.1348Bjerrum, L., Rosholm, J. U., Hallas, J., & Kragstrup, J. (1997). Methods for estimating the occurrence of polypharmacy by means of a prescription database. European Journal of Clinical Pharmacology, 53(1), 7-11. doi:10.1007/s002280050329Moen, J., Antonov, K., Larsson, C. A., Lindblad, U., Nilsson, J. L. G., Råstam, L., & Ring, L. (2009). Factors Associated with Multiple Medication Use in Different Age Groups. Annals of Pharmacotherapy, 43(12), 1978-1985. doi:10.1345/aph.1m354Orueta Sánchez, R., Santos Rodríguez, C., González Hidalgo, E., Fagundo Becerra, E. M., Alejandre Lázaro, G., Carmona de la Morena, J., … Butrón Gómez, T. (2011). Medicalización de la vida (I). Revista Clínica de Medicina de Familia, 4(2). doi:10.4321/s1699-695x2011000200011Onder, G., Petrovic, M., Tangiisuran, B., Meinardi, M. C., Markito-Notenboom, W. P., Somers, A., … van der Cammen, T. J. M. (2010). Development and Validation of a Score to Assess Risk of Adverse Drug Reactions Among In-Hospital Patients 65 Years or Older. 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Drugs & Aging, 22(1), 69-82. doi:10.2165/00002512-200522010-00005Incalzi, A. R., Capparella, O., Gemma, A., Porcedda, P., Raccis, G., Sommella, L., & Carbonin, P. U. (1992). A Simple Method of Recognizing Geriatric Patients at Risk for Death and Disability. Journal of the American Geriatrics Society, 40(1), 34-38. doi:10.1111/j.1532-5415.1992.tb01826.xCampbell, S. E., Seymour, D. G., & Primrose, W. R. (2004). A systematic literature review of factors affecting outcome in older medical patients admitted to hospital. Age and Ageing, 33(2), 110-115. doi:10.1093/ageing/afh036Sotoca Momblona, J. M., Canivell Fusté, S., Alemany Vilches, L., Sisó Almirall, A., Codina Jané, C., & Ribas Sala, J. (2009). Problemas relacionados con la medicación que causan ingresos hospitalarios. Atención Primaria, 41(3), 141-146. doi:10.1016/j.aprim.2008.07.002Martín Martínez, M. A., Alférez, R. C., Escortell Mayor, E., Rico Blázquez, M., & Sarría Santamera, A. (2011). 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