A Survey of Sophomore Students\u27 Impressions of Academic Advising Services at East Tennessee State University

This study of sophomore students\u27 at East Tennessee State University was conducted to determine students\u27 impressions of the institutional academic advising program, to assess students\u27 level of satisfaction with the academic advisor\u27s assistance with those topics discussed in academic advising sessions, and to determine students\u27 impressions of their academic advisor. The data collected in this study revealed that the sophomore students at ETSU were slightly dissatisfied with their advisor\u27s assistance. Data derived from comparative analyses for differences in impressions of academic advising services found that specific demographic groups were basically neutral in their satisfaction with advising. Few statistically significant differences were found in these demographic groupings. A comparative analysis of ETSU students to a national norm study revealed significant differences in the impressions of academic advising services. The ETSU students were significantly less satisfied than students from the national norm study. The data in this study indicated there was a need for improving the academic services available at ETSU. Several recommendations were made. Institutional strategies and programmatic strategies were outlined to improve academic advising at ETSU

Glaciological Mass balance of Znosko Glacier, King George Island

The present article objective is to determine the net mass balance of the glacier Znosko for periods 2018-2019 and 2019-2020. It is situated on King George Island which belongs to the groups Shetland of the South, Antarctic Peninsula region. For this objective, during February 2018 a net of 19 stakes (which were controlled once during February 2019 and 2020) were installed on the glacier ablation zone, drilling in the accumulation zone and about flights using unmanned aerial vehicles (UAV) to control the glacier zone and geomorphological changes. For the year 2020, it was determined a glacier area of 1.71 ± 0.02 km2, moreover, using five different methods of interpolation, it was obtained on average, as a result, a specific net balance of -590.7 ± 46.6 mm w.e (in water equivalent) for 2018-2019 and -686.7 ± 28.2 mm w.e for 2019-2020, being the ELA altitude 146.5 ± 18.2 m and 144.2 ± 8.3 m respectively. The two consecutive years represent negative net mass balances which are in accordance with other similar studies on this region, also glacier data were obtained on a zone that is characterized by its difficult access

Plan estratégico para la Caja Municipal de Ahorro y Crédito Microfinanzas S.A.C. – filial Ayacucho

Esta tesis propone un plan estratégico para el año 2018, cuando el CMAC Microfinanzas S.A.C. logrará posicionarse entre los cuatro principales microfinanzas Instituciones del departamento de ayacucho. La importancia de las microfinanzas CMAC SACO. es que ha dado acceso al sistema financiero nacional un tipo particular de Cliente emergente como el micro o conocido principalmente como PYMES. Este plan estratégico tiene Comenzó con el establecimiento de la visión, la misión, los valores y la ética. Luego, el análisis. está hecho del entorno de microfinanzas en el país y el departamento de Ayacucho El análisis encontró seis oportunidades y ocho amenazas que influyen en el CMAC Microfinance S.A.C. Del análisis del sector microfinanciero y En la competencia, se obtuvieron diez factores clave de éxito. Además, el análisis interno de nueve Se obtuvieron siete puntos débiles de fortalezas. El desarrollo de estos tres análisis. Nos permitió identificar y entender los mecanismos de las microfinanzas. medio ambiente y proponer dos estrategias: (a) penetración de mercado, y (b) producto desarrollo. Esto le permite cumplir con la visión propuesta a través de cinco objetivos basados ​​en: (a) mayor cantidad de préstamos; (b) mayor participación de mercado; (do) mayor valor de la empresa; (d) menor nivel predeterminado; y (e) capacitación para revisores. Estos son los objetivos a corto plazo, que permitirán a CMAC Microfinance S.A.C Conducir continuamente la revisión, evaluación y control de los resultados. Significativamente CMAC Microfinance S.A.C. También debe actuar en el proceso de evaluación de crédito y El desempeño del gerente de cuenta para lograr el plan estratégico.This thesis proposes a strategic plan for the year 2018, when the CMAC Microfinance S.A.C. will achieve position among the top four microfinance institutions of the department of Ayacucho. The importance of CMAC Microfinance S.A.C. is that it has given access to the domestic financial system a particular type of emerging client such as micro or known mainly as PYMES. This strategic plan has begun with the establishment of vision, mission, values, and ethics. Then, the analysis is made of the microfinance environment in the country and the department of Ayacucho. The analysis found six opportunties and eight threats that influence the CMAC Microfinance S.A.C. From the analysis of the microfinance sector and competition, ten key success factors were obtained. Also, the internal analysis nine seven weaknesses strengths were obtained. The development of these three analyses allowed us to identify and understand the mechanisms of the microfinance environment and propose two strategies: (a) market penetration, and (b) product development. These enable it to fulfill the vision proposed through five long-term goals based on: (a) increased amount of loans; (b) increased market share; (c) increased company value; (d) lower default level; and (e) training for reviewers. These are the short-term goals, which will allow CMAC Microfinance S.A.C to conduct continuously the review, evaluation, and control of the results. Significantly CMAC Microfinance S.A.C. must also act on the credit evaluation process and performance of the account manager to achieve the strategic plan.Tesi

Saturación sensorial y lactancia materna como métodos analgésicos no farmacológicos: estudio randomizado controlado.

OBJETIVOVerificar el efecto analgésico de la saturación sensorial (Sat) y compararlo con la lactancia materna (LM) y un grupo control.MATERIAL Y MÉTODOSEnsayo clínico, randomizado con 167 recién nacidos a término sanos, en quiénes se cuantificó la intensidad de dolor agudo al recibir una vacuna (hepatitis  B) a las 48 horas de vida. Se formaron tres grupos de manera aleatoria: grupo 1 (control, sin método analgésico), grupo 2 (analgesia con LM) y grupo 3 (analgesia con Sat); los estímulos sensoriales fueron: táctil (caricias de la madre sobre el rostro y espalda), olfatorio (colonia sin alcohol), auditivo (voz de la madre), gustativo (lactancia materna), visual (rostro de la madre frente a su bebé). Se utilizó la Escala para Dolor Agudo Neonatal (DAN: Douleur Aiguë du Nouveau-né), con un score de dolor del 1 al 10 y 7 categorías de dolor.RESULTADOSEl grupo con saturación sensorial tuvo menos dolor (3.02 en la escala de DAN); el grupo dos (lactancia materna): 4.15, y control: 9.02.   Hubo diferencia significativa entre grupos. Dolor extremo, se presentó en 60% del grupo control, 3,8% en el grupo lactancia materna y 0% en el grupo con saturación sensorial. La categoría NO DOLOR fue más frecuente en el grupo tres (Sat): 33,3% versus 16,9% del grupo con LM y 0% grupo control, p<0.0001.CONCLUSIONESLa saturación sensorial tuvo mayor efecto analgésico que la lactancia materna. Ambas demostraron buen efecto analgésico, comparadas con el grupo control. (Rev Horiz Med 2011;11(2):80

NikaFrut jaleas: Porque lo nuestro sabe Mejor

Seminario Desarrollo de Emprendedores. 2011. Carrera Administración de Empresas. Docente Lic. Rivera, Marlon.Empresa pequeña semi-industrial dedicada a la fabricación de jalea a base de productos no tradicionales. La empresa produce diferentes sabores y presentación de la jalea. La empresa inicia los procesos productivos y de comercialización con un pequeño capital. Está ubicada en el municipio de Ticuantepe, en el departamento de Managua. La producción de jaleas inicia con cuatro frutas, manzana, limón, naranja y guayaba; pero en su proceso aparecerán más sabores que interesen a la población

Fiebre prolongada como manifestación de aspergiloma pulmonar en un paciente con antecedente de tuberculosis

We report the case of a 50-year-old male with antecedent of pulmonary tuberculosis who presents with fever syndrome for 66 days, without cough, hemoptisis or thoracic pain. The presence of fever and general symptoms (dyspnea, loss of weight) has been associated with less than 7 % of cases of pulmonary aspergilloma, and the long fever syndrome as the only way of presentation has not been described adequately before. Therefore, this case constitutes a form of infrequent presentation of pulmonary aspergiloma. An upper right lobectomy was practiced as definitive treatment with remission of the fever.Reportamos el caso de un varón de 50 años con antecedente de tuberculosis pulmonar que presenta síndrome febril durante 66 días, sin tos, hemoptisis o dolor torácico. La presencia de fiebre y síntomas generales (disnea, baja de peso) se ha asociado a menos del 7% de casos de aspergiloma pulmonar, y el síndrome febril prolongado como única forma de presentación no ha sido descrita adecuadamente con anterioridad. Por lo que el caso que presentamos constituye una forma de presentación infrecuente de aspergiloma pulmonar. Al paciente se le practicó lobectomía superior derecha como tratamiento definitivo con remisión del cuadro febril

Fiebre prolongada como manifestación de Aspergiloma pulmonar en un paciente con antecedente de tuberculosis

Reportamos el caso de un varón de 50 años con antecedente de tuberculosis pulmonar que presenta síndrome febril durante 66 días, sin tos, hemoptisis o dolor torácico. La presencia de fiebre y síntomas generales (disnea, baja de peso) se ha asociado a menos del 7% de casos de aspergiloma pulmonar, y el síndrome febril prolongado como única forma de presentación no ha sido descrita adecuadamente con anterioridad. Por lo que el caso que presentamos constituye una forma de presentación infrecuente de aspergiloma pulmonar. Al paciente se le practicó lobectomía superior derecha como tratamiento definitivo con remisión del cuadro febril

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit