Plan estratégico del hotel Le Bonheur para el periodo 2023 - 2027

La presente investigación desarrolla un plan estratégico para el Hotel Le Bonheur, ubicado en el distrito de Miraflores, en Lima. El objetivo principal es proporcionar una guía para el crecimiento, la rentabilidad y la sostenibilidad de este hotel del tipo boutique entre los años 2023 y 2027. En términos de crecimiento, se propone expandir el mercado captando nuevos segmentos de clientes a través de una mayor inversión en marketing y promoción, así como establecer una alianza estratégica con un hotel de una de las regiones de mayor preferencia. Para aumentar la rentabilidad, se busca mejorar la gestión de las relaciones con los clientes y modernizar los procesos internos mediante la tecnología. En cuanto a la sostenibilidad, se implementarán medidas para minimizar el impacto ambiental del hotel y promover una cultura sostenible. Los planes funcionales de marketing, operaciones, recursos humanos y responsabilidad social se centran en acciones estratégicas para alcanzar los objetivos establecidos. En el plan de finanzas, se observa que la implementación del plan estratégico puede generar valor a la empresa con una tasa interna de retorno del 16.62% y un valor actual neto de S/ 294,219. También se destaca que la deuda agrega valor, ya que la TIR y el VAN financiero son mayores que la TIR y el VAN económico

Conocimiento y adherencia de la suplementación con ácido fólico y sulfato ferroso, con relación al número de atenciones prenatales de las gestantes atendidas en la Clínica San Bartolomé, 2022

La investigación se planteó como objetivo determinar el nivel de conocimiento y adherencia de la suplementación con ácido fólico y sulfato ferroso en gestantes según el número de atenciones prenatales atendidas en la clínica San Bartolomé, 2022. El enfoque del estudio fue cuantitativo y bajo un diseño descriptivo, correlacional, prospectivo, transversal y observacional. La población estuvo conformada por 39 gestantes, el instrumento utilizado fue el cuestionario. Se aplicó la prueba de correlación de Spearman para efectuar las pruebas de relación. En los resultados se evidenció que, el nivel de conocimiento de la suplementación con ácido fólico y sulfato ferroso es medio (48,7%), sin embargo, no presentó relación significativa con el número de atenciones prenatales (p=0,50). La adherencia de la suplementación con ácido fólico (p= 0,61) y sulfato ferroso (p= 0,79) no presentó relación significativa con el número de atenciones prenatales. En conclusión, el número de atenciones prenatales no tiene relación con el conocimiento y adherencia de la suplementación con ácido fólico y sulfato ferroso en gestantes

Primer reporte del escarabajo Acanthoderes funeraria (Bates) (Coleoptera: Cerambycidae) en el agave silvestre Agave cupreata (Trel. & Berger) en Guerrero, México

Acanthoderes funeraria, is a beetle that feeds on the leaves of agave plants and causes serious and irreversible damage to plants. A collection of insects was made on June 20, 2018, in the town of Petaquillas, Guerrero. Young and adult sick plants were checked, then 60 specimens were collected by hand and photos were taken and images were sent to CONABIO for identification, which confirmed the species as A. funeraria and it recorded the presence in the state of Guerrero; other specimens were deposited in the Entomological Collection of the Faculty of Biological Sciences of the Autonomous University of Guerrero with registration number 020219fcqb. This beetle for the first time is recorded on wild agaves of A. cupreata in the state of Guerrero, Mexico; moreover, the damage to the plants is described.Acanthoderes funeraria, es un escarabajo que se alimenta de las hojas de plantas de agave y causa daños graves e irreversibles en las plantas. Se hizo una colecta el 20 de junio de 2018, en el poblado de Petaquillas, Guerrero, para esto se revisaron plantas jóvenes y adultas enfermas, se logró colectar manualmente 60 especímenes y se tomaron fotos, las cuales se enviaron a la CONABIO para su identificación, la cual confirmó la especie como A. funeraria y registró la presencia de ésta para el estado de Guerrero; otros especímenes se encuentran depositados en la colección entomológica de la Facultad de Ciencias Químico Biológicas de la Universidad Autónoma de Guerrero con número de registro 020219fcqb. Este escarabajo se reporta por vez primera sobre agaves silvestres de A. cupreata en el estado de Guerrero, México; además, se describen los daños que éste causa a las plantas

Study on the Acceptability of an ICT Platform for Older Adults with Mild Cognitive Impairment

EhcoBUTLER is an Information and Communication Technology (ICT) solution funded by the EuropeanUnion (H2020; ID: 643566)and intended especially for elderly people with mild cognitive impairment (MCI) to improve their health, independence and quality oflife, particularly at the social level. The purpose of this study is to assess the acceptability of ehcoBUTLER based on a survey deliveredto potential users and actors involved in their care, exploring theirexpectations and preferences, while anticipating the system'sfunctional requirements. The survey was delivered online to 313participants (11% end users, 25% informal caregivers, 48% formalcaregivers and 16% administration/management staff) from eight countries. Participants rated the different functionalities ofehcoBUTLER positively, 86.1% perceiving it as an interesting and useful system. Likewise, they assessed it as a commerciallyattractive product (75.1%). End users expressed a stronger preference for the social module. Nevertheless, they would be ready topay a low monthly price for ehcoBUTLER. Professionals would be willing to pay choosing its functionalities modularly, but theywould also expect it to be funded by the National Health System, centres or businesses. The conclusion is that all participants foundehcoBUTLER interesting, useful and ergonomic. However, to effectively implement it, it is necessary to bridge the digital gap andaddress the issue of insufficient investment in products aimed atolder adults with cognitive impairment. To supplement cognitivetraining systems with social, emotional or entertainment functionalities could improve adherence to their use

A systematic review on the use of action research methods in mental health nursing care

Aims: To identify and synthesize evidence on the use of action research methods in mental health nursing care. Design: Systematic review. Data sources: CINAHL, Web of Science, PubMed and Scopus databases were searched in January 2021. Review methods: Data were selected using the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Two reviewers independently conducted the study selection, and quality appraisal using Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, data extraction and data analysis procedures. Results: Sixteen studies, half of which used participatory action research, were included in this review. Nurses, along with other stakeholders, were an active part of the action research process. The main topics of interest addressed were categorized as improving the adoption of a person-centred approach to care and improving decision-making procedures. The use of action research helped the participants to identify the meaning they attached to the topic of interest to be improved. Moreover, this method helped to identify needs and strategies for improving care. The studies concurred that the use of action research enabled participants to gain awareness, improve attitudes and acquire knowledge. In addition, it enabled participants to gain confidence and security in the group context, as key aspects of their empowerment. Conclusion: This review shows the usefulness of action research in any mental health nursing context, contributing to the improvement of care at both the individual and collective levels. Impact: This paper demonstrates the use of the action research method in the field of mental health nursing. Its use has improved the clinical practice of nurses as well as that of teams in both community and hospital settings, addressing issues of the person-centred approach to care and decision-making procedures

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Identification of the top TESS objects of interest for atmospheric characterization of transiting exoplanets with JWST

Funding: Funding for the TESS mission is provided by NASA's Science Mission Directorate. This work makes use of observations from the LCOGT network. Part of the LCOGT telescope time was granted by NOIRLab through the Mid-Scale Innovations Program (MSIP). MSIP is funded by NSF. This paper is based on observations made with the MuSCAT3 instrument, developed by the Astrobiology Center and under financial support by JSPS KAKENHI (grant No. JP18H05439) and JST PRESTO (grant No. JPMJPR1775), at Faulkes Telescope North on Maui, HI, operated by the Las Cumbres Observatory. This paper makes use of data from the MEarth Project, which is a collaboration between Harvard University and the Smithsonian Astrophysical Observatory. The MEarth Project acknowledges funding from the David and Lucile Packard Fellowship for Science and Engineering, the National Science Foundation under grant Nos. AST-0807690, AST-1109468, AST-1616624 and AST-1004488 (Alan T. Waterman Award), the National Aeronautics and Space Administration under grant No. 80NSSC18K0476 issued through the XRP Program, and the John Templeton Foundation. C.M. would like to gratefully acknowledge the entire Dragonfly Telephoto Array team, and Bob Abraham in particular, for allowing their telescope bright time to be put to use observing exoplanets. B.J.H. acknowledges support from the Future Investigators in NASA Earth and Space Science and Technology (FINESST) program (grant No. 80NSSC20K1551) and support by NASA under grant No. 80GSFC21M0002. K.A.C. and C.N.W. acknowledge support from the TESS mission via subaward s3449 from MIT. D.R.C. and C.A.C. acknowledge support from NASA through the XRP grant No. 18-2XRP18_2-0007. C.A.C. acknowledges that this research was carried out at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration (80NM0018D0004). S.Z. and A.B. acknowledge support from the Israel Ministry of Science and Technology (grant No. 3-18143). The research leading to these results has received funding from the ARC grant for Concerted Research Actions, financed by the Wallonia-Brussels Federation. TRAPPIST is funded by the Belgian Fund for Scientific Research (Fond National de la Recherche Scientifique, FNRS) under the grant No. PDR T.0120.21. The postdoctoral fellowship of K.B. is funded by F.R.S.-FNRS grant No. T.0109.20 and by the Francqui Foundation. H.P.O.'s contribution has been carried out within the framework of the NCCR PlanetS supported by the Swiss National Science Foundation under grant Nos. 51NF40_182901 and 51NF40_205606. F.J.P. acknowledges financial support from the grant No. CEX2021-001131-S funded by MCIN/AEI/ 10.13039/501100011033. A.J. acknowledges support from ANID—Millennium Science Initiative—ICN12_009 and from FONDECYT project 1210718. Z.L.D. acknowledges the MIT Presidential Fellowship and that this material is based upon work supported by the National Science Foundation Graduate Research Fellowship under grant No. 1745302. P.R. acknowledges support from the National Science Foundation grant No. 1952545. This work is partly supported by JSPS KAKENHI grant Nos. JP17H04574, JP18H05439, JP21K20376; JST CREST grant No. JPMJCR1761; and Astrobiology Center SATELLITE Research project AB022006. This publication benefits from the support of the French Community of Belgium in the context of the FRIA Doctoral Grant awarded to M.T. D.D. acknowledges support from TESS Guest Investigator Program grant Nos. 80NSSC22K1353, 80NSSC22K0185, and 80NSSC23K0769. A.B. acknowledges the support of M.V. Lomonosov Moscow State University Program of Development. T.D. was supported in part by the McDonnell Center for the Space Sciences. V.K. acknowledges support from the youth scientific laboratory project, topic FEUZ-2020-0038.JWST has ushered in an era of unprecedented ability to characterize exoplanetary atmospheres. While there are over 5000 confirmed planets, more than 4000 Transiting Exoplanet Survey Satellite (TESS) planet candidates are still unconfirmed and many of the best planets for atmospheric characterization may remain to be identified. We present a sample of TESS planets and planet candidates that we identify as “best-in-class” for transmission and emission spectroscopy with JWST. These targets are sorted into bins across equilibrium temperature Teq and planetary radius Rp and are ranked by a transmission and an emission spectroscopy metric (TSM and ESM, respectively) within each bin. We perform cuts for expected signal size and stellar brightness to remove suboptimal targets for JWST. Of the 194 targets in the resulting sample, 103 are unconfirmed TESS planet candidates, also known as TESS Objects of Interest (TOIs). We perform vetting and statistical validation analyses on these 103 targets to determine which are likely planets and which are likely false positives, incorporating ground-based follow-up from the TESS Follow-up Observation Program to aid the vetting and validation process. We statistically validate 18 TOIs, marginally validate 31 TOIs to varying levels of confidence, deem 29 TOIs likely false positives, and leave the dispositions for four TOIs as inconclusive. Twenty-one of the 103 TOIs were confirmed independently over the course of our analysis. We intend for this work to serve as a community resource and motivate formal confirmation and mass measurements of each validated planet. We encourage more detailed analysis of individual targets by the community.Peer reviewe

Identification of novel risk loci, causal insights, and heritable risk for Parkinson's disease: a meta-analysis of genome-wide association studies

Background Genome-wide association studies (GWAS) in Parkinson's disease have increased the scope of biological knowledge about the disease over the past decade. We aimed to use the largest aggregate of GWAS data to identify novel risk loci and gain further insight into the causes of Parkinson's disease. Methods We did a meta-analysis of 17 datasets from Parkinson's disease GWAS available from European ancestry samples to nominate novel loci for disease risk. These datasets incorporated all available data. We then used these data to estimate heritable risk and develop predictive models of this heritability. We also used large gene expression and methylation resources to examine possible functional consequences as well as tissue, cell type, and biological pathway enrichments for the identified risk factors. Additionally, we examined shared genetic risk between Parkinson's disease and other phenotypes of interest via genetic correlations followed by Mendelian randomisation. Findings Between Oct 1, 2017, and Aug 9, 2018, we analysed 7·8 million single nucleotide polymorphisms in 37 688 cases, 18 618 UK Biobank proxy-cases (ie, individuals who do not have Parkinson's disease but have a first degree relative that does), and 1·4 million controls. We identified 90 independent genome-wide significant risk signals across 78 genomic regions, including 38 novel independent risk signals in 37 loci. These 90 variants explained 16–36% of the heritable risk of Parkinson's disease depending on prevalence. Integrating methylation and expression data within a Mendelian randomisation framework identified putatively associated genes at 70 risk signals underlying GWAS loci for follow-up functional studies. Tissue-specific expression enrichment analyses suggested Parkinson's disease loci were heavily brain-enriched, with specific neuronal cell types being implicated from single cell data. We found significant genetic correlations with brain volumes (false discovery rate-adjusted p=0·0035 for intracranial volume, p=0·024 for putamen volume), smoking status (p=0·024), and educational attainment (p=0·038). Mendelian randomisation between cognitive performance and Parkinson's disease risk showed a robust association (p=8·00 × 10−7). Interpretation These data provide the most comprehensive survey of genetic risk within Parkinson's disease to date, to the best of our knowledge, by revealing many additional Parkinson's disease risk loci, providing a biological context for these risk factors, and showing that a considerable genetic component of this disease remains unidentified. These associations derived from European ancestry datasets will need to be followed-up with more diverse data. Funding The National Institute on Aging at the National Institutes of Health (USA), The Michael J Fox Foundation, and The Parkinson's Foundation (see appendix for full list of funding sources)

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Mejora del proceso para la atención de la demanda de proyectos de construcción de software mediante la gestión de procesos en la Oficina de Tecnología del Ministerio de la Producción

El documento digital no refiere asesorEstablece lineamientos para el proceso de la gestión de la demanda que permitirá realizar estimación de recursos, plazos y costos de los requerimientos de construcción de software mediante la aplicación de métodos de secuenciación y coordinación, para la Oficina de Tecnología del Ministerio de la Producción. Establece lineamientos para la gestión de la demanda que permitan enmarcar las funciones que desarrollará la dirección ejecutiva de TI y los usuarios gestores de la construcción del software. Establece un marco de relaciones y responsabilidades entre TI y los usuarios gestores de la construcción del software. Proporciona a la dirección ejecutiva de TI información y conocimiento para la comprensión de los costes regulares en la atención de requerimientos para la construcción de software y los costos ocultos de una inadecuada gestión de la demanda.Trabajo de suficiencia profesionalPublicación a texto completo no autorizada por el auto