Estrategias de cobranza para disminuir la morosidad en la institución educativa particular University College, Túcume Lambayeque 2019

La presente investigación tuvo como objetivo determinar las estrategias de cobranza para disminuir la morosidad en la Institución Educativa Particular University College, Túcume, 2019. El tipo de investigación fue descriptivoexplicativo, con un diseño no experimental. La población fue constituida por 100 personas, las cuales son dos del personal administrativo (directora y asistente) y 98 padres de familia morosos de la institución educativa. La muestra estuvo conformado por la directora y la asistente (secretaria) a quien se le aplico la entrevista sobre estrategias de cobranza; y 41 padres de familia morosos de la institución educativa aplicando en ellos la encuesta sobre morosidad. Los resultados encontrados fueron que la morosidad se presenta a inicios y a mediados de año ya que aplica como estrategia la carta de compromiso de pago, encontrando así que los padres se descuidan en obtener información acerca de la deuda que pueden tener con la institución educativa. La conclusión es que la institución le falta aplicar adecuadamente sus estrategias de cobranzas por la falta de esta área con el personal idóneo, los padres de familia tiene desinterés de saber cuál es la deuda que tienen en el año escolar y el no tener la información de los plazos para pagar.TesisGestión empresarial y emprendimient

La influencia de las artes marciales en el diseño de la estrategia corporativa

Durante siglos, las artes marciales han producido cambios significativos y profundos en las personas y organizaciones que las practican alrededor de todo el mundo. El conocimiento de uno mismo, el control de las fuerzas propias y de las que nos rodean y el desarrollo de habilidades especiales de negociación pueden ser aplicadas en el ambiente corporativo como escenario de combate moderno, son los pilares en los que se sustenta el Programa de DO Martial Management

Formas de comunicación del personal de enfermería ante pacientes con discapacidad auditiva

El ser humano es sociable por naturaleza, la comunicación con sus pares es muy importante, ésta se lleva a cabo a través del lenguaje verbal y no verbal. El personal de enfermería se capacita en distintas áreas, realiza cursos y aprende idiomas, con el fin de obtener mayores conocimientos y brindar un mejor servicio a la población, pero muy pocos se capacita para mejorar la atención de enfermería hacia personas con capacidades diferentes. El proceso de la comunicación siendo tan fundamental a veces se ve impedido cuando se trata con personas con discapacidad auditiva, es importante tener en cuenta que estas personas también se enferman y por lo tanto requieren atención de salud. El problema surge cuando llega a la guardia del hospital un paciente con discapacidad auditiva y no viene acompañado de un intérprete, quien pueda servir de nexo para poder comprenderlo, es muy difícil lograr una comunicación en la forma correcta. Es necesario que los miembros del equipo de salud posean conocimiento básico para lograr entender al no oyente. Enfermería juega un papel fundamental en la promoción del acceso a los servicios de salud, pero se enfrentan a barreras lingüísticas y culturales, por lo que se pone en juego las estrategias de enfermería para facilitar y mejorar el acceso de la comunidad de personas con discapacidad a los servicios de salud. El propósito de este trabajo de investigación es determinar cuáles son las formas de comunicación que adopta el personal de enfermería en los servicios de Guardia y Unidad de Terapia Intensiva del Hospital Alfredo Ítalo Perrupato, del departamento de San Martín, Provincia de Mendoza, para abordar a pacientes con discapacidad auditiva en el primer semestre del año 2012.Fil: Andrade, Romina Vanesa. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..Fil: Distefano, Maira Alejandra. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..Fil: Quiroga, Mónica Ceferina. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería.

Perfiles psicosociales de adultos con TDAH: un estudio comparativo con muestras reclusa y clínica

ADHD; Prison; Outpatient psychiatric patients; Legal consequencesTDAH; Carcelarios; Muestra clínica; Consecuencias legalesTDAH; Presó; Pacients psiquiàtrics ambulatoris; Conseqüències legalsThis study aimed to describe and compare the educational, social, and family profiles of adults with and without ADHD from two different settings: a prison and an outpatient psychiatric setting. A total of 542 participants, aged between 17 and 69 years, took part in the study. The participants consisted of four groups: a prison sample with ADHD (n = 69) and without ADHD (n = 183), and an outpatient psychiatric sample with ADHD (n = 218) and without ADHD (n = 72). The results showed that, firstly, there were some statistically significant differences between the groups in academic history, social and family situation, and the adoption of risk behaviors during adolescence and early adulthood. Secondly, some of these differences were related to diagnosis (ADHD versus non-ADHD) while others were related to the sample being examined (prison versus psychiatric). The findings from the study showed the presence of significant implications in social, family, educational, and employment achievements both for adults with ADHD (both prison and psychiatric samples) and for adults without ADHD.Este estudio tiene como objetivo describir y comparar los perfiles educativos, sociales y familiares de un grupo de adultos con y sin TDAH de dos muestras diferentes: una de carcelarios y una población clínica. Formaron parte del estudio 542 participantes, con edades comprendidas entre los 17 y 69 años. La muestra se dividió en cuatro grupos, un grupo de carcelarios con TDAH (n = 69) y sin TDAH (n = 183) y un grupo clínico con TDAH (n = 218) y sin TDAH (n = 72). Los resultados apoyan la hipótesis inicial, que establece que, primero, hay diferencias estadísticamente significativas entre los grupos en cuanto a historial académico, situación social y familiar y la adopción de conductas de riesgo durante la adolescencia y la adultez temprana; en segundo lugar, algunas de las diferencias se relacionarán con el diagnóstico de TDAH, mientras que otras estarán más vinculadas a la población examinada. Los hallazgos del estudio mostraron la presencia de consecuencias significativas para los contextos sociales, familiares, educativos y laborales tanto en poblaciones adultas con TDAH (pacientes en carcelarios y clínicos) como aquellas sin TDAH.This work was supported by the Regional Government of Asturias under Grant [FC-15-GRUPIN14-053]

Pembrolizumab Plus Gemcitabine in the Subset of Triple-Negative Advanced Breast Cancer Patients in the GEICAM/2015-04 (PANGEA-Breast) Study

Bomarkers; Breast cancer; PembrolizumabBiomarcadores; Cáncer de mama; PembrolizumabBiomarcadors; Càncer de mama; PembrolizumabThe PANGEA-Breast trial evaluated a new chemo-immunotherapeutic combination that would synergistically induce long-term clinical benefit in HER2-negative advanced breast cancer patients. Treatment consisted of 21-day cycles of 200 mg of pembrolizumab (day 1) plus gemcitabine (days 1 and 8). The primary objective was the objective response rate (ORR). The tumor infiltrating lymphocytes (TILs) density and PD-L1 expression in tumor, and the myeloid-derived suppressor cells (MDSCs) level in peripheral blood, were analyzed to explore associations with treatment efficacy. Considering a two-stage Simon’s design, the study recruitment was stopped after its first stage as statistical assumptions were not met. A subset of 21 triple-negative breast cancer (TNBC) patients was enrolled. Their median age was 49 years; 15 patients had visceral involvement, and 16 had ≤3 metastatic locations. Treatment discontinuation due to progressive disease (PD) was reported in 16 patients. ORR was 15% (95% CI 3.2–37.9). Four patients were on treatment >6 months before PD. Grade ≥3 treatment-related adverse events were observed in 8 patients, where neutropenia was the most common. No association was found between TILs density, PD-L1 expression or MDSCs levels and treatment efficacy. ORR in TNBC patients also did not meet the assumptions, but 20% were on treatment >6 months.The study was partially supported by a research grant from Merck’s (MSD in Europe) Investigator Initiated Studies Program, which also supplied the pembrolizumab

Pembrolizumab in combination with gemcitabine for patients with HER2-negative advanced breast cancer: GEICAM/2015–04 (PANGEA-Breast) study

Advanced breast cancer; Chemotherapy; PembrolizumabCáncer de mama avanzado; Quimioterapia; PembrolizumabCàncer de mama avançat; Quimioteràpia; PembrolizumabBackground We evaluated a new chemoimmunotherapy combination based on the anti-PD1 monoclonal antibody pembrolizumab and the pyrimidine antimetabolite gemcitabine in HER2- advanced breast cancer (ABC) patients previously treated in the advanced setting, in order to explore a potential synergism that could eventually obtain long term benefit in these patients. Methods HER2-negative ABC patients received 21-day cycles of pembrolizumab 200 mg (day 1) and gemcitabine (days 1 and 8). A run-in-phase (6 + 6 design) was planned with two dose levels (DL) of gemcitabine (1,250 mg/m2 [DL0]; 1,000 mg/m2 [DL1]) to determine the recommended phase II dose (RP2D). The primary objective was objective response rate (ORR). Tumor infiltrating lymphocytes (TILs) density and PD-L1 expression in tumors and myeloid-derived suppressor cells (MDSCs) levels in peripheral blood were analyzed. Results Fourteen patients were treated with DL0, resulting in RP2D. Thirty-six patients were evaluated during the first stage of Simon’s design. Recruitment was stopped as statistical assumptions were not met. The median age was 52; 21 (58%) patients had triple-negative disease, 28 (78%) visceral involvement, and 27 (75%) ≥ 2 metastatic locations. Progression disease was observed in 29 patients. ORR was 15% (95% CI, 5–32). Eight patients were treated ≥ 6 months before progression. Fourteen patients reported grade ≥ 3 treatment-related adverse events. Due to the small sample size, we did not find any clear association between immune tumor biomarkers and treatment efficacy that could identify a subgroup with higher probability of response or better survival. However, patients that experienced a clinical benefit showed decreased MDSCs levels in peripheral blood along the treatment. Conclusion Pembrolizumab 200 mg and gemcitabine 1,250 mg/m2 were considered as RP2D. The objective of ORR was not met; however, 22% patients were on treatment for ≥ 6 months. ABC patients that could benefit of chemoimmunotherapy strategies must be carefully selected by robust and validated biomarkers. In our heavily pretreated population, TILs, PD-L1 expression and MDSCs levels could not identify a subgroup of patients for whom the combination of gemcitabine and pembrolizumab would induce long term benefit.The study was partially supported by a research grant from Merck (MSD in Europe) Investigator Initiated Studies Program, which also supplied pembrolizumab

Hormonoterapia primaria en mujeres añosas con cáncer de mama localizado hormonosensible

Se analizó de forma retrospectiva una serie de pacientes con una edad mediana de 79 años con cáncer de mama localizado, con receptor de estrógeno positivo tratadas con hormonoterapia primaria. Tras recibir el tratamiento primario las pacientes candidatas se sometían a cirugía. La respuesta clínica fue de un 63.6%. La mediana de tiempo a progresión fue de 94 meses y la mediana de la supervivencia global no se alcanzó, siendo la media de 123 meses. Se evaluó el impacto del tratamiento quirúrgico en estos resultados, no objetivándose diferencias estadísticamente significativas. La hormonoterapia exclusiva en casos seleccionados es efectiva y seguraEs va analitzar de forma retrospectiva una sèrie de pacients amb una edat mitjana de 79 anys amb càncer de mama localitzat, amb receptor d'estrogen positiu tractades amb hormonoteràpia primària. Després de rebre el tractament primari les pacients candidates es van sotmetre a cirurgia. La resposta clínica va ser del 63.6%. La mitjana de temps a progressió va ser de 94 mesos i la mitjana de la supervivència global no es va assolir, essent la mitja de 123 mesos. Es va avaluar l'impacte de la cirurgia en aquests resultats, sense trobar-se diferències estadísticament significatives. La hormonoteràpia exclusiva en casos seleccionats és efectiva i segura

Skeletal Anomalies in Senegalese Sole (Solea senegalensis, Kaup) Fed with Different Commercial Enriched Artemia: A Study in Postlarvae and Juveniles

The high incidence of skeletal anomalies in Senegalese sole (Solea senegalensis) still constitutes a bottleneck constraining its production. There are diverse commercially available products for the enrichment of live preys, but few reports of their influence on skeletogenesis in Senegalese sole. This study evaluated the presence of vertebral anomalies in postlarvae and juvenile Senegalese sole fed with Artemia spp. metanauplii enriched with four commercial products (EA, EB, EC, and ED) in a fish farm. The most frequent alterations consisted of deformations of the neural/haemal arches and spines and fusions and deformations of hypurals, epural, or parhypural. The correspondence analysis ordered fish from each age in separated semiaxis, indicating the presence of different anomaly patterns for the two sampled stages. The results showed only very light changes in the frequency of vertebral abnormalities among tested enrichment products, i.e., individuals from EC and EA lots displayed less vertebral body anomalies and/or vertebral column deviations at 31 and 105 days after hatching, respectively. The existence of a large shared malformation pattern in all the experimental groups leads to impute to the rearing conditions as the main driving factor of the onset of such group of anomalies, probably masking some dietary effectThis research was funded by “Consellería de Economía e Industria” of Xunta de Galicia (10MMA020E) and Stolt Sea Farm and by “Programa de Consolidación e Estructuración de Unidades de Investigación Competitivas GPC2015/034”, SpainS

Expression of IL-33 Receptor Is Significantly Up-Regulated in B Cells During Pregnancy and in the Acute Phase of Preterm Birth in Mice

Interleukin-33 (IL-33) is a mucosal alarmin belonging to the IL-1 cytokine family and is now recognized to have a key role in innate and adaptive immunity, contributing to tissue homeostasis and response to environmental stresses. In addition, IL-33 has also been shown to work as a positive regulator that initiates and maintains a Th2 immune response. In the context of pregnancy, it has been recently demonstrated that upon certain stress conditions, such as an infection induced inflammation, IL-33 is released from the uterine mucosa and triggers decidual B cells to produce anti-inflammatory molecules, which in turn restore immune homeostasis and prevents the development of preterm birth. In this study we therefore performed a detailed characterization of IL-33 receptor (Il1rl1 or ST2) expression in B cells during normal pregnancy, as well as in a mouse model of preterm birth. We observed that splenic B cells significantly up-regulate the expression of Il1rl1 during pregnancy and identified the B1 B cell population as the main ST2-expressing B cell subset. A further kinetic analysis showed that percentages of ST2-expressing B1 B cells are significantly augmented on days 12 and 14 of pregnancy, both in the spleen and peritoneal cavity of pregnant mice, and then drop toward the end of pregnancy to the levels observed in non-pregnant animals. Furthermore, using a mouse model of LPS-induced preterm birth, we demonstrated that not only are the percentages of ST2-expressing B1 B cells significantly enlarged in the spleen during the acute phase of preterm birth, but decidual B cells also significantly up-regulate ST2 expression as compared to term-pregnant mice. Overall, our results suggest a functional role of ST2 expression in B cells during pregnancy and reinforce the importance of the IL-33/ST2 axis in B cells as a critical mechanism to control inflammation-induced preterm birth.Fil: Valeff, Natalin Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Juriol, Lorena Vanesa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Quadrana, Florencia. Laboratory For Immunology Of Pregnancy; ArgentinaFil: Muzzio, Damián Oscar. Universität Greifswald; AlemaniaFil: Zygmunt, Marek. Universität Greifswald; AlemaniaFil: Quiroga, María Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; ArgentinaFil: Ventimiglia, María Silvia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Jensen, Cristian Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; Argentina. Universidad Nacional Arturo Jauretche; Argentin

ADGRL3 (LPHN3) variants predict substance use disorder

Factors genètics; Desordre d'ús de substànciesFactores genéticos; Desorden de uso de sustanciasGenetic factors; Substance use disorder; ADGRL3 (LPHN3)Genetic factors are strongly implicated in the susceptibility to develop externalizing syndromes such as attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, conduct disorder, and substance use disorder (SUD). Variants in the ADGRL3 (LPHN3) gene predispose to ADHD and predict ADHD severity, disruptive behaviors comorbidity, long-term outcome, and response to treatment. In this study, we investigated whether variants within ADGRL3 are associated with SUD, a disorder that is frequently co-morbid with ADHD. Using family-based, case-control, and longitudinal samples from disparate regions of the world (n = 2698), recruited either for clinical, genetic epidemiological or pharmacogenomic studies of ADHD, we assembled recursive-partitioning frameworks (classification tree analyses) with clinical, demographic, and ADGRL3 genetic information to predict SUD susceptibility. Our results indicate that SUD can be efficiently and robustly predicted in ADHD participants. The genetic models used remained highly efficient in predicting SUD in a large sample of individuals with severe SUD from a psychiatric institution that were not ascertained on the basis of ADHD diagnosis, thus identifying ADGRL3 as a risk gene for SUD. Recursive-partitioning analyses revealed that rs4860437 was the predominant predictive variant. This new methodological approach offers novel insights into higher order predictive interactions and offers a unique opportunity for translational application in the clinical assessment of patients at high risk for SUDR01 DA039881/DA/NIDA NIH HHS/United States. DA039881/U.S. Department of Health & Human Services NIH, National Institute on Drug Abuse (NIDA)