Calidad Percibida en los Hoteles de Tres Estrellas utilizando el Modelo Hotelqual en la Ciudad de Huánuco - 2018

La calidad del servicio ofrecido es un factor determinante para la satisfacción del visitante y el aumento del flujo turístico. Por ello, en los últimos tiempos, se han desarrollado modelos de medición de la calidad de los servicios, que son aplicados a diferentes áreas del sector productivo, e incluso en el sector hotelero se tienen escalas de medición de la calidad especialmente diseñadas para este tipo de servicio; no obstante, actualmente no se cuenta con un modelo de medición de la calidad validado en el sector hotelero en el Perú. El propósito de la investigación fue determinar el nivel de calidad del servicio percibida por los visitantes, en los hoteles de tres estrellas en la ciudad de Huánuco aplicando el modelo HOTELQUAL. El estudio es un enfoque cuantitativo, de tipo descriptivo, no experimental de corte transversal. Como resultado se reflejó la percepción de la calidad del servicio por parte de los visitantes de los hoteles tres estrellas en la ciudad de Huánuco, que evidencia un buen nivel de percepción de calidad con respecto a las instalaciones y organización, mientras que con la dimensión personal el nivel de percepción es regular

Relationship between premature ventricular complexes and depressive symptoms in non-ST-elevation acute coronary syndrome

Aims: Depression is a recognized risk marker for mortality among acute coronary syndrome (ACS) patients. We hypothesized that ventricular arrhythmia detected by inpatient telemetry monitoring is more frequent among ACS patients with elevated depressive symptoms compared to those without depressive symptoms. Methods and results: We analysed data from patients enrolled in a prospective observational study of depression in ACS. Telemetry recordings during the index admission (average recording 21.3±3.0 hours) were analysed for frequent premature ventricular complexes (PVCs), defined as ≥10 per hour. The self-report Beck Depression Inventory (BDI) was used to assess depressive symptoms. Among 200 ACS patients, frequent PVCs were observed in 29% of patients with moderate depressive symptoms (BDI ≥10), 27% of those with mild symptoms (BDI 5–9), and only 11% of those with no/minimal symptoms (p=0.02). Log-transformed PVCs per hour were associated with depressive symptom category (p=0.008). In a multivariable logistic regression model that included age, gender, left ventricular ejection fraction, cardiovascular risk score, heart rate, and QT interval, mild symptoms (OR 3.02, 95% 0.97–9.43, p=0.058) and moderate-severe symptoms (OR 3.94, 95% CI 1.27–12.22, p=0.018) were associated with frequent PVCs. Conclusions: In this sample of ACS patients, depressive symptoms were independently associated with frequent PVCs during inpatient telemetry monitoring

Experiences of Using the Mindset Self-Management Mobile Health App Among Hispanic Patients: Results of a Qualitative Study

BACKGROUND: Interventions focusing on epilepsy self-management (ESM) are vital for promoting the health of people living with epilepsy. E-technology and mobile health (mHealth) tools are becoming increasingly integrated into practice to promote self-management strategies for chronic diseases, enhance care delivery, and reduce health disparities. Management Information and Decision Support Epilepsy Tool (MINDSET), a bilingual decision support tool (available in English and Spanish), was found to be both feasible and effective in facilitating goal-based ESM in the clinic. PURPOSE: To assess the experience of using MINDSET as an ESM intervention among Hispanic patients with epilepsy to inform future interventional studies. METHODS: This study used a Qualitative Descriptive (QD) framework to provide a rich and straightforward description of patients\u27 subjective experiences using MINDSET. Participants were enrolled in the intervention group of a larger parent study (RCT) to assess the efficacy of MINDSET among Hispanic People with Epilepsy (PWE). The purposive, convenient, criterion-based sample for this qualitative analysis comprised of 42 patients who agreed to participate in a semi-structured interview at the end of the larger RCT. This RCT was conducted between August 2017 and January 2019. Spanish and English-speaking Hispanic adult patients (n = 94) with epilepsy in Arizona (n = 53) and Texas (n = 41) were randomly assigned within 6 neurology clinics to treatment (MINDSET plus Usual Care, hereafter referred to as MINDSET; n = 46) and comparison (Usual Care Only; n = 48) conditions. RESULTS: Patient demographics, epilepsy conditions, and ESM behavioral characteristics were representative of the intervention group. Study participants were Hispanic, mainly of Mexican descent (94 %), with a mean age of 39 years, mostly female (53 %), and most of the participants reported having had one or more seizures per month (54 %). The MINDSET intervention revealed five ESM themes: (1) Awareness and Realization of Epilepsy Self-Management, (2) Communication and Partnership with Health Care Providers HCP, (3) Epilepsy Self-Management and Quality of Life, (4) Seizure Control, and (5) Optimism and Agency. CONCLUSION: The participants who used MINDSET as a self-management intervention reported an overall positive experience. Qualitative data in this study show that MINDSET is a valuable ESM tool for Hispanic patients with epilepsy. Findings from this qualitative study were consistent with results from a larger parent study that recognized MINDSET as an effective platform for improving epilepsy self-management adherence

Emotional Distress of Patients at End-of-Life and Their Caregivers: Interrelation and Predictors

Background: Patients at the end of life and their families experience a strong emotional impact. The well-being of these patients and that of their family caregiver are related.Aim: To study the variables related with the emotional well-being of patients with and without cognitive impairment at the end of life and that of their primary family caregivers.Design: Cross- sectional study.Participants: Data was collected from 202 patients at the end of life with different diagnosis (COPD, cancer, and frail elderly) as well as from their respective 202 primary family caregivers.Results: Structural equation models indicated that the emotional state of the patients was best predicted by their functional independence and the burden of their family caregivers. In addition, the emotional state of the primary family caregiver was predicted by their burden and not by the cognitive state or the functional independence of the patient. Nevertheless, the burden of the family caregiver, which is the only variable predicting both the emotional state of the patient and that of the caregiver, was directly related with the functional independence of the patient and indirectly with the patient’s cognitive state.Conclusion: The family caregiver’s burden is an important factor to take into consideration when aiming to reduce the emotional distress of patients at the end of life with different diagnosis -whether or not they present significant cognitive impairment- and that of their family caregivers

Ketosis Suppression and Ageing (KetoSAge): The Effects of Suppressing Ketosis in Long Term Keto-Adapted Non-Athletic Females

Most studies on ketosis have focused on short-term effects, male athletes, or weight loss. Hereby, we studied the effects of short-term ketosis suppression in healthy women on long-standing ketosis. Ten lean (BMI 20.5 ± 1.4), metabolically healthy, pre-menopausal women (age 32.3 ± 8.9) maintaining nutritional ketosis (NK) for > 1 year (3.9 years ± 2.3) underwent three 21-day phases: nutritional ketosis (NK; P1), suppressed ketosis (SuK; P2), and returned to NK (P3). Adherence to each phase was confirmed with daily capillary D-beta-hydroxybutyrate (BHB) tests (P1 = 1.9 ± 0.7; P2 = 0.1 ± 0.1; and P3 = 1.9 ± 0.6 mmol/L). Ageing biomarkers and anthropometrics were evaluated at the end of each phase. Ketosis suppression significantly increased: insulin, 1.78-fold from 33.60 (± 8.63) to 59.80 (± 14.69) mmol/L (p = 0.0002); IGF1, 1.83-fold from 149.30 (± 32.96) to 273.40 (± 85.66) µg/L (p = 0.0045); glucose, 1.17-fold from 78.6 (± 9.5) to 92.2 (± 10.6) mg/dL (p = 0.0088); respiratory quotient (RQ), 1.09-fold 0.66 (± 0.05) to 0.72 (± 0.06; p = 0.0427); and PAI-1, 13.34 (± 6.85) to 16.69 (± 6.26) ng/mL (p = 0.0428). VEGF, EGF, and monocyte chemotactic protein also significantly increased, indicating a pro-inflammatory shift. Sustained ketosis showed no adverse health effects, and may mitigate hyperinsulinemia without impairing metabolic flexibility in metabolically healthy women

Calidad del servicio en el real hotel de la ciudad de Huánuco

The research aimed to determine the perception of guests about the quality of service at the Real Hotel, one of the most prestigious hotels in the Huánuco region. The type of study was, through the application of the instrument that measured aspects related to: tangibility, reliability, responsiveness, security and empathy, dimensions associated with the Servperf model. The results show according to the statistical evidence the level of quality of the services offered by the Royal Hotel has experienced a favorable change, due to the improvements that were made based on the first results there was a substantial improvement in the quality of services product of the preexperimental treatment, through the T-student statistic a significant positive change was evidenced; also aspects such as reliability 26%, responsiveness 16%; Safety 36% and empathy experienced improvements of 26%, 16%, 36% and 30% respectively in the perception of quality.La investigación tuvo como objetivo determinar la percepción de los huéspedes sobre la calidad de servicio en el Real Hotel uno de los hoteles más prestigiosos de la región Huánuco. El tipo de estudio fue, para lo cual a través de la aplicación del instrumento que midieron aspectos relacionados a: tangibilidad, confiabilidad, capacidad de respuesta, seguridad y empatía, dimensiones asociadas al modelo Servperf. Los resultados demuestran según la evidencia estadística el nivel de calidad de los servicios ofrecidos por el Real Hotel ha experimentado un cambio favorable, debido a las mejoras que se hizo en función a los primeros resultados se observó una mejora sustancial de la calidad de servicios producto del tratamiento preexperimental, a través del estadístico T-student se evidenció un cambio positivo significativo; asimismo los aspectos como confiabilidad 26%, capacidad de respuesta 16%; seguridad 36% y empatía experimentaron mejoras del 26%, 16%, 36% y 30% respectivamente en la percepción de la calidad

Collapsing Lesions and Focal Segmental Glomerulosclerosis in Pregnancy: A Report of 3 Cases

The relationship between focal segmental glomerulosclerosis (FSGS) and pregnancy is complex and not completely elucidated. Pregnancy in patients with FSGS poses a high risk for complications, possibly due to hemodynamic factors, imbalance between angiogenic and antiangiogenic factors, and hormonal conditioning. Although poor clinical outcomes associated with collapsing FSGS are common outside of pregnancy, the prognosis during pregnancy is not well documented. We report 3 patients who developed collapsing FSGS during pregnancy, 2 of whom had presumed underlying FSGS. Two patients underwent biopsy during pregnancy, and 1, during the puerperium. None of the 3 patients improved spontaneously after delivery, and 1 experienced a rapid deterioration in kidney function and proteinuria after delivery. Aggressive immunosuppressive therapy led to a full response in 1 case (without chronic lesions) and to partial responses in the remaining 2 cases. These cases suggest that collapsing lesions should be considered in patients with FSGS who develop a rapid increase in serum creatinine level or proteinuria during pregnancy and that these lesions may at least partially respond to treatment

Dise?o de un plan de negocios para una empresa de servicios de estancia y club de d?a para adultos mayores en los NSE B y C en Lima Metropolitana

En el presente trabajo, se busca determinar la viabilidad comercial, operativa y econ?mica, as? como las estrategias para la implementaci?n del servicio de Estancia y Club de D?a para adultos mayores en los NSE B y C. El Servicio del Club operar? en un local de 1,600mts, su infraestructura estar? dise?ada seg?n las condiciones f?sicas de los adultos mayores; en donde se realizar?n diversas actividades f?sicas, l?dicas y mentales, en un ambiente divertido a fin de mantener al m?ximo sus facultades durante el proceso de envejecimiento. Pensando en aquellos adultos mayores que requieren de asistencia en sus actividades diarias, pero deseoso de socializar, se ha pensado en el servicio de ?Estancia? que adem?s de los anteriormente descritos se brindar? el servicio de cuidado no medico asistido por enfermeras

Modelado 3D en bordes destructivos de placas: relaciones entre Geología e Historia. El caso de Nueva Zelanda

En este Proyecto INNOVA-DOCENCIA, "Modelado 3D en bordes destructivo de placas: relaciones entre Geología e Historia. El caso de Nueva Zelanda" se ha realizado la película "Nueva Zelanda: un país en el Anillo de Fuego del Pacífico", una nueva contribución al Canal de Vídeo "Geología e Historia (G&H)". Nueva Zelanda es una zona de la Tierra ideal para la comprensión de fenómenos geológicos: Tectónica de placas, vulcanismo, seísmos, geotermalismo y mineralogía y su relación con la Historia