bluuebunny/crossref_metadata_2025 huggingface dataset:
Logistic Regression Analysis Of Predictors Of Loan Defaults By Customers Of Non-Traditional Banks In Ghana
Authors: Agbemava Edinam , Nyarko Israel Kofi , Adade Thomas Clarkson , Bediako Albert K.
Published: February 2016

The objective of this research is to identify the risk factors that influence loan defaults by customers in the microfinance sector and to develop a model that links these factors to credit default by customers in the sector. Data from a microfinance institution based in Accra Ghana was used. A binomial logistic regression analysis was fitted to a data of 548 customers who were granted credit from January 2013 to December 2014. The results of the study revealed that six factors: X3 (Marital Status); X7 (Dependents); X11 (Type of Collateral or Security); X13(Assessment); X15 (Duration); and X16 (Loan Type) were statistically significant in the prediction of loan default payment with a predicted default rate of 86.67%. It is therefore suggested that microfinance institutions adopt among others, the default risk model to ascertain the level of risk since it’s relatively efficient and cost effective. There should also be up to date training for loan officers of microfinance institutions in order to improve on their assessment skills and methodology. The supervising body of microfinance institutions (Bank of Ghana) should also consider enacting laws that will ensure that all such institutions in Ghana are roped into centralized database to check multiple borrowing and also serve as an internal control measure for the sustainability of these institutions.
Expanding Infrastructure And Environmental Protection – Indissoluble Contradiction Or Reasonable Symbiosis?
Authors: Herber Franz-Rudolf
Published: February 2016

The expanding of infrastructure (roads/energy) is necessary as well in the developed countries as well as in the emerging countries: But the approach is different: In the developed countries the preservation of the given infrastructure is more important than new infrastructure. In the emerging countries necessary infrastructure is lacking and should be erected. Nevertheless, the management of such measures have to take the protection of environment into account. Those, who do not have any respect for nature, are behaving wrong. The belief, that such behaviour does not have any negative effects, is wrong. Nature does not endure any maltreatment and cannot endlessly recycle itself. But nature is a power that might be underestimated: If nature takes revenge on mankind, the consequences are drought, tornados and the drop of the sea level. Of course, if ones does have a religion, the answer has to be that the revenge of God will be severe, the Bible does call it apocalypsis or the end the world.
Étude Évaluative D’examen Normalisé De Sciences De La Vie Et De La Terre Au Cycle Secondaire Collegial
Authors: El Allaoui Abdellah , Rhazi Filali Fouzia , El Hadri El mokhtar , Fetteh Khalid , Bouhadi Malika
Published: February 2016

Generally an exam, a performance test or a test to be used for summative or evaluation purposes must be prepared according to a definite plan. The present paper aimed at analyzing and evaluating the certificate exam, the study also revealed the questions representation of Bloom's cognitive levels. This article presents also the statistical and psychometric indices that characterize each of the questions (26 items) that make up a certification exam of the Sciences of Life and Earth in a Moroccan high school in Meknes. Indeed, two hundred test copies have been analyzed using the SPSS and Anitem software. The average of goals achieved in activities of knowledge, analysis, understanding and evaluation is 61%, 52%, 37.5%, 58% respectively, but it is only 19% for "application" activity. The success rate in open questions items is only 38.5% against 61.5% for Multiple Choice Questions (MSQ) and closed questions. The internal homogeneity coefficient is greater than 0.8 (α = 0.84), which means that the homogeneity of the instrument has been considered satisfactory. According to the index of difficulty out of the 26 items, two are extremely inferior (P> 0.8), while two others are extremely superior (P <0.2). According to the index of discrimination eleven items meet the conditions of validity, three are not discriminating and twelve should be reviewed. The correlation between the success rate in these items and their difficulty index is high (R = 0.98). In light of the findings, we recommended the necessity of having measurement and evaluation experts in writing questions of exams and we highly recommend the necessity of continuous training of teachers in the field of assessment and evaluation.
Effets De La Regulation Et Du Developpement Institutionnel Sur Le Secteur Bancaire De La Cemac
Authors: Eleazar Jumbo Urie , Bertrand Ndzana Mekia Alain
Published: February 2016

The objective of this study is to assess the impact of the regulation (of requirements in equity capital) and of the institutional development on some performances of the ‘’CEMAC’’ banking sector. The secondary data used come from the publications of the World Bank (World Bank Development Indicators) and from the services of ‘’BEAC’’ and ‘’COBAC’’. The method of estimation is that of the Generalized Moment Method (GMM) in dynamic panel via the model of Arellano and Bond (1991). The study spans a period of 8 years (2005-2012) and takes into account the six countries of the CEMAC subregion. The results of the study are presented as follows: (1) the level of the prescribed equity capital does not affect neither the “banking development” nor the “capacity of mobilization of the domestic saving” and just as the “economies financing capacity”. (2) The level of legal and institutional development influences negatively and significantly the “banking development” and the “volume of domestic saving”. (3) Also, the level of legal and institutional development influences positively and significantly the “capacity of the banking sector to finance the economies”. These results lead therefore to some implications of economic policy such as: the public authorities should reinforce the financing capacity of the “CEMAC” economies in setting up a real financial market. They should also develop and in a significant way political and institutional infrastructures in order to stimulate the confidence of savers and investors.
An Examination Of Ethiopia’s Anti -Terrorism Proclamation On Fundamental Human Rights
Authors: Sekyere Peter , Asare Bossman
Published: February 2016

Since the enactment of Ethiopia’s Proclamation on Anti-Terrorism in August 2009, at least11 journalists have been convicted, each sentenced to at least 10 years imprisonment. There are concerns that the proclamation limits the right to freedom of thought, opinion and expression, provided for in Ethiopia’s Constitution. Through the lens of the right to freedom of thought, opinion and expression, the paper argues that Ethiopia’s Anti-Terrorism Proclamation violates the human rights of people within its jurisdiction. It finds that there is a real potential for the state to crack down on political dissent in governance and curtail the growth of democracy in Ethiopia.
Estudio De Los Centros Privados Concertados Religiosos, Desde La Perspectiva De Sus Directores Titulares, En El Contexto Multicultural De La Ciudad Autónoma De Ceuta
Authors: Cabrera Arturo Fuentes , Viñas Arturo Manuel Fuentes
Published: February 2016

World population is constantly changing. That fact offers contexts where the multiculturalism is more important. Ceuta, a Spanish city located in the North of Africa, is one of the best examples of this multiculturalism. In this context, it is interesting to study the development of the education and its staging. In this research, some schools which form the educational offer in the city of Ceuta were taken as models. We were attracted by the idea of carrying out a detailed research about the private and the receiving state subsidy schools which a religious nature, in order to know their features, the connections inside and outside of the centre and the maintenance of them, among other factors. To get that, a quantitative research with surveys has been carried out. At the same time, the semi-structured interviews have provided some qualitative data. In this research, the results show how “difficult” is the survival of these institutions and the preservation of the thinking of all of them in the multicultural context aforementioned. In spite of the complex reality, we conclude by affirming that these institutions are highly regarded in the city of Ceuta.
Development And Validation Of A Technology Ability Test (TAT) For Admission Of Students Into Technology Teacher Education Programmes In Nigerian Universities
Authors: E. Inyiagu Emmanuel
Published: February 2016

This study was an instrumentation research. The purpose of the study was to develop and validate a Technology Ability Test (TAT) for admission of students into Technology Teacher Education Programmes in Nigerian Universities. A sample of 120 students drawn from four universities in the southeast geopolitical zone of Nigeria that offers the programme was used for the study. Six research questions were answered and two hypotheses tested in the study. The 50 – items TAT that emerged after the preliminary testing was used for data collection. Results of TAT’s psychometric qualities indicated that 80 percent of the items possessed moderate difficulty and high (suitable) discrimination indices. The reliability coefficient obtained from the test is 0.96, which indicates that TAT is very reliable. Results further revealed that gender has slight influence on the Technology Ability Test, students of the federal universities performed marginaly better than their state counterparts and that TAT scores has very low concurrent validity with JAMB scores. The educational implications of the findings when the developed Technology Ability Test (TAT) is adopted included helping admission officers and counselors to objectively identify students with the capability to succeed in technology teacher education programmes in Nigerian Universities and data obtained after the administration will provide efficient indices for future performances of students in technology teacher education, since a valid ability test is also predictive. Based on the findings of this study, the researcher recommended that the developed test be used in admiting candidates into technology teacher education programmes and admission officers be trained on how to use the newly developed test.
Factorial Invariance of Self-efficacy in Physical Health Care Scale for Men and Women University Students
Authors: Rodriguez-Villalobos Judith M. , Vega Luis H. Blanco , Gonzalez Martin A. , Ledezma Yunuen Rangel
Published: February 2016

The present study analyses the psychometric properties of the Selfefficacy in Physical Health Care Scale. The overall sample consisted of 2006 subjects: 902 women and 1104 men, with a mean age of 18.53 years (SD= 1.52) and 18.84 years (SD= 1.55) respectively. The Factorial Psychometric analysis showed that a three-factorial structure (nutrition, physical health and hydration) was viable and adequate for both populations (men and woman) according to the established psychometric requirements when the informers are the students themselves. The results showed that factor structure, factor loadings and intercepts of the instrument could be considered invariant across groups; however, there are differences between groups in favor of men for the means of the nutrition and physical health factors.
Investigating Factors Influencing Adoption of Land Record Management Information System (LRMIS): A Case of Pakistan
Authors: Malik Babur Hayat , Shuqin Cai , Talukder Mohammad Shamim , Mattiullah Butt
Published: February 2016

Objective of this article is to investigate the factors affecting adoption of Land Record Management Information System (LRMIS) in Pakistan context. Under financial assistance of World Bank, this Pakistan egovernment initiative is based on government’s long term digital strategic policy that aims to reform and modernize Land Record administration and resources. The model formulated here is based on Unified Theory of Acceptance and Use of Technology (UTAUT) and incorporates constructs such as performance expectancy, effort expectancy, and social influence, facilitating conditions, self-efficacy, trust and behavioral intention. The verifiable results exhibited the positive and significant relations for all 14 hypotheses affirmed using seven constructs. The empirical demonstrations and arguments mentioned in this article can assist Pakistan government to enhance upon and to fully avail the potentiality of LRMIS as an effective and serviceable substance for lucid, not bribable governance and towards modernized digital Land Records not only for one province but throughout the country.
Stereotypical Views of Private Sector Employees about Public Sector Employees' Performance in Kingdom of Bahrain
Authors: Eldin Amira Karam
Published: February 2016

The researcher observed a widely-held stereotype about the performance of the public-sector employees in general society discourse, and especially with private-sector employees. Public-sector employees are taken as individuals who settle at mediocre performance. This research aims to test these observations using hypothesis analysis. One questionnaire was distributed on a sample of private sector employees to survey their perceptions about public sector employees' performance. Another questionnaire was distributed on a sample of public sector employees to find whether they are aware of these stereotypical views, and whether this awareness causes frustration emotions. H1: private-sector employees have negative stereotypical views about public-sector employees’ performance H2: public sector employees know about the negative stereotypes held by private-sector employees about their performance H3: public sector employees experience emotions of frustration by the negative stereotypes held by private-sector employees about their performance Two self-administered questionnaires were designed, one for the private sector employees to survey their perceptions about the public sector employees' performance, and the other one for public sector employees to survey whether they are aware about these stereotypes, and whether this awareness produces emotions of frustration. The questionnaires included demographic questions, close-ended questions and one open question for remarks. The Likert scale was used for close-ended questions to seek the respondents' opinions on a list of statements. The results validated all hypotheses. Nonetheless, we found that the stereotypes are not deeply embedded. In essence, we argue that they represent a manifestation of customer dissatisfaction gained from private sector employees' experiences with public sector front offices. These findings highlight the importance of maintaining high level front-office services at the public sector as the disappointments are generalized to the organizations in whole and all their employees.
Aux Origines De La Question De L’emploi Salarie Et Du Chomage En Cote D’ivoire
Authors: Loba Robert G.
Published: February 2016

How did the notion of paid employment, so far unknown in the economic and social landscape of Côte d’Ivoire, impose itself upon the consciousness of the Ivorian populations? As a series of investigations made through documentary observations, following an approach both historical and dialectical, it appeared with the economic, social and cultural transformations introduced by the French colonisation. It is so well imbedded in the minds of the populations that it has become the main focus of most of the strategies of social promotion. Moreover, while before it everyone integrated himself harmoniously in economic fabric without trying to be employed by the other, its adoption as cardinal value has generated, with stupefying figures, unemployment which has become like an inescapable trap for the Ivorian youth.
L’identite Canadienne Française : Une Analyse De Les Anciens Canadiens De Philippe Aubert De Gaspé
Authors: Kalplata Kalplata
Published: February 2016

Philippe Aubert de Gaspé establishes French Canadian identity through his book Les Anciens Canadiens written in 1863. This work announces already the start of nationalism in this part of the world, Canada, which is cold and isolated by its climate but where warmth and humanity are present in every heart. Les Anciens Canadiens is a book which is primarily Canadian. Through this novel, the author unveils Canadian characteristics, its local colour, its land and its language. In this article we discuss mainly the style used by the author which makes this book a Canadian book. This style comes from the environment, from the cold weather and the silence of Canada. We analyse also the character of José who represents the Canadian innocence. Like José, Canada is fresh, welcoming, kind, endowed with ancient tradition. He is witness to Canadian pride and love.
Crisis of the Modern Age and the Way Out: An Examination of T. S. Eliot’s Four Quartets
Authors: Al-Badrani Fatima Falih Ahmed , Al-Badarneh Abdullah Fawaz
Published: February 2016

The twentieth century was one of change and unrest. What characterises the age is that society, up to a high degree, was hostile to spiritual life. The spiritual values seemed to be neglected or totally abandoned for the material, more matter-of-fact values. This left society in a state of increasing confusion that was substantially realised in the outbreak of World War I. The impact of the war revealed the degeneration of the modern world with the breakdown of religion and moral and spiritual traditions. T. S. Eliot was fully aware of the ills of modern civilisation that surrounded people with a number of faiths established haphazardly to fight against the troubles of modern life. These faiths refer to political and social ideologies, parties, and allegiances. Eliot finds that all modern ideologies are poor and futile substitutions for religious faith. He finds that society should be built not upon power and its corruption, but upon a higher system of values which are mainly spiritual and moral. This research paper demonstrates how Eliot's Four Quartets affirms the possibility of spiritual regeneration and gives a positive projection of hope. The central theme of the poem is that if the heart of the individual is ever to be at rest, if his/her tormented apprehension about the transience of human life is ever to be calmed, it will be so when he/she accepts the conviction that humans’ peace is in God's will.
The Effective Utilization of Knowledge Management in E-Government: A Case Study of E-Government in Jordan
Authors: Amyan Mozfi Mohammad , Al-saudi Musa , Al-Onizat Hamdan Hasan
Published: February 2016

The study is aimed at investigating the effective utilization of knowledge management in the Jordanian e-government system. The study proposes the knowledge management model for the implementation of egovernment in Jordan. The sample consisted of 132 employees derived from a population that had a sufficient knowledge of knowledge management in the Jordanian e-government team. The data collection tool used was a selfadministrated questionnaire. The study revealed the existence of a strong correlation between knowledge management and the utilization of knowledge. Furthermore, the study sample agreed that knowledge management is a widespread organizational practice. The study concluded that the utilization of knowledge is related to proper planning and follow-up of the applications for the knowledge management in Jordan e-government entities. In addition, the study recommended the spread of the culture of knowledge management which was supported by the senior management at the Jordanian entities.
A Qué Te Enfrentas Cuando Emprendes
Authors: Gutiérrez Sagrario M. Quijano , Ramírez Humberto Olan , Aguilar Fredy Manuel Dzib , López José Alberto Sánchez
Published: February 2016

"Puerta de Sol" is an ecotourism project. This tourist unit will be located in the community of Miguel Colorado in the municipality of Champotón Campeche. The project was developed by applying the methodology for Environmentally Planned Tourism (EPT). The author of this methodology is named Jorge Chavez de la Peña. Chavez is a writer recognized for his contributions in the project of the monarch butterfly in the community El Capulín. The author took as a specific methodological basis the Gulf of California Ecotourism Cyber Atlas, elaborated for the SEMARNAT. The project "Puerta de Sol" is to build ecological cabins. In order to develop this project, renewable materials were used. These materials are used to the everyday activities of the community and as a fundamental part of their economic development.
A Cognitive-Pragmatic Study of Irony Response
Authors: Ying Zhang
Published: February 2016

As the second part of an irony-irony response (I-IR) adjacency pair, an IR is based on the perception of irony. It affects the ironist and plays a significant role in shaping the communicative effect of irony as well as the nature of the ongoing conversation. Therefore, IRs reflect people’s employment of communicative strategies and deserve pragmatic attention. Within the framework of Sperber and Wilson’s relevance theory (RT), the author views IRs as illocutions with different relevance degrees chosen by reactors to perform certain perlocutionary acts and probes into the variety of IR strategies and motivations from a cognitive-pragmatic aspect. As is found, IRs can be simple and complex illocutions with various relevance degrees: maximally relevant, very relevant, weakly relevant and irrelevant. In responding to irony, people are inclined to perform simple relevant acts rather than supplying irrelevant reactions. Moreover, the familiarity degree between the interlocutors overweighs the content of irony in affecting reactors’ motivations and hence their response choices.
Importance And Implementation Of Nursing Documentation: Review Study
Authors: Alkouri Osama A , AlKhatib Ahed J , Kawafhah Mariam
Published: February 2016

This study was conducted to review the literature about nursing documentation. We presented the importance and implementation of nursing documentation. The importance of this topic has been realized here, in Jordan, and the Ministry of Health has recently started application of electronic documentation systems. Nursing documentation can be either paper based or electronic based documentation. Paper based documentation has been described not meet the required standards. We argued the standards of nursing documentation that should be met including completeness, clearing, and concision.
Valoración De La Composición Química De Fermentación Y Degradabilidad Ruminal In Vitro De Dietas Con Diferentes Inclusiones De Harina De Banano Y Urea
Authors: Espinoza Víctor Godoy , Cevallos Juan Avellaneda
Published: February 2016

The purpose of this study was to evaluate the chemical of in vitro ruminal fermentation of diets with different inclusions of banana flour and urea. The assessment and in vitro fermentation were performed in the laboratory of nutrition and metabolism Rumiologia Faculty of Animal Science. In the first phase the chemical composition is performed in the second stage fermentation in vitro degradability It was a desing completely random was applied, with four diets and four replications; repetition consisted of a bottle or container or in vitro digestibility. Each bottle will be an experimental unit represent a repetition. Data were analyzed using the statistical package procedure Eva DE-A-Dva and mean differences were compared using the Tukey test (p <0.05). The degradability of dry matter (DM) of the diet obtained in this study confirm the disappearance of nutrients as time passes (2, 6, 14, 24, 36, 48, 72 hours) reaching values above 70% digestibility which guarantees the quality of the diet. The pH in the rumen fermentation in vitro obtained in this research on diet with inclusions of banana flour and urea from 0 to 6 and 6 to 72 hours is not dropped to dangerous levels of critical thresholds for celulolisis.
Etude Ethnobotanique, Evaluation De L’activite Antifongique Sur Candida Albicans Et De La Toxicite Sur Des Cellules Hff De Bersama Abyssinica (Fresen.), Une Plante De La Pharmacopee Ivoirienne
Authors: Camara Djeneb , Bene Kouadio , Gnahoue Goueh , Fofie N’guessan Bra Yvette , Zirihi Guédé Noël
Published: February 2016

To make a contribution to the fight against opportunistic mycoses in sharp increase in AIDS patients, we conducted an ethnobotanical investigation in the Department of Transua (Côte d’Ivoire). This investigation has shown that the plant Bersama abyssinca is the most used in the treatment of skin infection. Our team tested different extracts of leaves of B. abyssinica (aqueous extract total (ETA), 70% ethanol extract (EE70%) and aqueous extract residual (ERA)) on the in vitro growth of Candida albicans, to determine some inhibitions parameters. These three extracts were active in C. albicans, with respective IC50: 160 μg/ml for ETA, 100 μg/ml for EE70% and 55 μg/ml for ERA. We found that B. abyssinica is not toxic for human cells HFF, on the contrary, it increases the proliferation of dividing cells thereby improving defense mechanisms.
Profil Epidemiologique De La Leishmaniose Cutanee Dans La Region Du Gharb- Maroc De 2006 À 2014
Authors: El Aasri Aziz , Zakaria Alaoui , El Kharrim Khadija , Belghyti Driss , Aqachmar Yassine , Hadji Mohamed
Published: February 2016

Between 2006 and 2014, 439 cases of cutaneous leishmaniasis were recorded in the region of Gharb Chrarda Beni Hssen in the north-west of Morocco. With an annual incidence of 49.1 cases per year and a sex-ratio (M / F) of 0.71. The disease has affected all age groups. The most stricken population is children and young people between the ages of 6 months and 30 years with more than 60.26 % of cases. Therefore, Cutaneous leishmaniasis almost hits the rural and urban areas but with an uneven impact. It is higher in rural areas where they are registered with a percentage of 56.7% of cases in contrast to a percentage of 43.3% in urban areas.
Caractérisation Sédimentologique Et Minéralogique Des Formations Du Tertiaire-Quaternaire De La Région D’anyama Au Sud De La Côte d’Ivoire
Authors: Clarisse Kra Akoua , Yao Paul Assale Fori , Jean-Paul Yao N’Goran , Sylvain Monde , Kouamé Aka
Published: February 2016

Anyama is located on the onshore of the sedimentary basin of Côte d’Ivoire. It is to the east of the basin and the formations, particularly those dating back to the Quaternary may have been studied. Based on samples, collected from two drill holes (An1 and An2), each 114 m deep, a sedimentology and mineralogy characterization of Plio-Quaternary formations was carried out. The sedimentological study was assessed by taking account the lithology, the grain size, the transport model and the environment deposit of the sediments, the morphoscopy and the exoscopy of the quartz grain. The mineralogy study was made on clays through X-Ray Diffraction (XRD). Lithological characterization, revealed the presence of clay facies (kaolinite), sandy facies and mixed sediments, all covered with the earth bar. As for the size, it indicates coarse to medium sands with a positive asymmetry to almost positive, sands moderately classified to fairly classify. The relative mineralogy reveals the presence of silicon, aluminum and iron oxides. XRD indicates that quartz and kaolinite prevail and gypsum, rutile or anatase, illite and calcium sulfate hydrate are associated minerals.
Pression d’inoculum de la maladie des raies noires (MRN) causée par Mycosphaerella fijiensis Morelet, dans les plantations industrielles de bananiers, en Côte d’ivoire
Authors: Essis B. , Kobenan K. , Traoré S. , Yatty J. , Koné D. , Aby N. , Thiémélé D.E.F.
Published: February 2016

The Black Leaf Streak Disease (BLSD) is one of main parasitic constraints of the agro-industrial plantations of banana in the world. Caused by a fungus ascomycete (Mycosphaerella fijiensis Morelet), the losses of yield are up to 50 %, without of resistant cultivars and effective management. This study relative to the level of the disease has been conducted in 12 industrial plantation in 6 production area: Aboisso, Grand- Bassam, Dabou, Agboville, Azaguié and Tiassalé; for a total surface of 2576 ha. The observations concerned the ranks of Youngest Leaf Spotted (YLS), of the Youngest Leaf Necrosed (YLN), the Number of Standing Leaves (NSL) and the gap between the Youngest Leaf Spotted and the Number of Standing Leaves. The results showed that chronic re-infestation of industrial plantation during the last five years, except CDBCI Tiassalé-Songon in 2011 and 2012. An acceptable level of re-infestation was observed in 2012 on other plantations, with the rank of YLS greater than or equal to 3, except BATIA Tiassalé and CDBCI Azaguié. The internal inoculum pressure (YLS) varied a lot from one plantation to another and from one year to another. Except plantation SBMK Aboisso and BATIA Tiassalé, other plantations had at least one value of the rank of the top YLS or equal to 8, during the study indicating a relatively low severity of the BLSD. From 2009 to 2012, all plantations have shown over 8 standing leaves, the minimum required for proper filling of the bunch of banana regime at the time of flowering.
Studying The Prevalence Of Achieving Therapeutic Goals Of Diabetes Treatment Among Diabetic Patients In Royal Medical Services
Authors: Almala Abdulelah Meqbel , Bisharat Toleen Issam , Ababneh Rawan Abid Alkareem , Alkaradsheh Ola Issa , Husban Kholoud , Hayajneh Maisan Mahmoud , Abeeleh Jaafar Abu
Published: February 2016

Diabetic complications are considered a public concern on global level and have their negative impacts on patients. The main objectives of the present study were to determine the prevalence of diabetic complications among a sample of diabetics in Royal Medical Services and to conclude the appropriate recommendations to reduce the effects of diabetic complications. The method of choice involved a retrospective design and 392 files of diabetic patients were reviewed. Study findings showed that the prevalence of diabetic neuropathy was 43%, hypertension 42%, diabetic foot ulcer 9%, glaucoma 48%, and heart disease 25%. Predictors for diabetic neuropathy were the level of HbA1C (p=0.015), and gender (p=0.018), while the predictors for hypertension were duration of DM (p=0.000) and age (p=0.000). The predictors of foot ulcer included the level of HbA1C (p=0.013), and the use of metformin (p=0.026). Glaucoma was predicted by duration of DM (p=0.002), and gender (p=0.017). Heart disease was predicted by duration of DM (p=0.003), gender (p=0.041), and age (p=0.000). Taken together, diabetic complications are prevalent on global level and in our settings which implies that the therapeutic options of DM are still far from their ultimate goals. we recommend adopting of more effective monitoring systems for screening diabetics, particularly those who are expected to develop diabetes. We also recommend to activate the roles of clinical pharmacist to raise the awareness level about diabetic complications among the public.
Comparación entre estimulación cardiaca en tracto de salida y Ápex del ventrículo derecho
Authors: Anchante-Hernández Henry , Medina-Palomino Félix , Salazar-Cáceres Martin , Talledo-Paredes Luisa , Vega-Aponte, Gabriel , Villanueva-Pérez Fernando
Published: February 2016

El ápex de ventrículo derecho (AVD) es el sitio convencional de estimulación cardiaca; sin embargo, no ha conseguido un patrón de activación y sincronía fisiológico. La evidencia de su efecto deletéreo ha hecho que se cuestione su práctica tradicional, por lo que nace el interés de búsqueda de sitios alternativos. El tracto de salida de ventrículo derecho (TSVD) ha demostrado ser un lugar adecuado para estimulación, sin diferencias entre umbrales de estimulación entre ambos sitios. Objetivo: Comparar los resultados del implante a nivel del ápex con los del implante en tracto de salida de ventrículo derecho. Material y métodos: Estudio descriptivo, comparativo de serie de casos retrospectivo. Se incluyeron 54 pacientes con implante de marcapaso entre 2010 y 2011. Se tomaron en cuenta datos clínicos, datos del implante propiamente dicho y sus complicaciones. Resultados: La edad promedio fue 73,7 años. La indicación más frecuente de implante fue bloqueo auriculoventricular (55,6%). La vía de acceso del electrodo ventricular fue disección de vena cefálica izquierda (76,7%). En 66,7% se consiguió estimulación en AVD y en 33,3% en TSVD. La complicación más frecuente fue hematoma de bolsillo (7,4%). No se evidenció diferencias en parámetros y umbrales de estimulación al momento del implante en ambos grupos. Conclusiones: El TSVD ha demostrado ser un lugar adecuado para estimulación; no existiendo diferencias en los umbrales estimulación o impedancia con el AVD.
Características familiares asociadas a la percepción de la calidad de vida en pobladores de un área urbano-marginal en el Distrito de Los Olivo, Lima
Authors: Cuba María , Jurado Arturo , Romero Zoila , Cuba Mary
Published: February 2016

Es necesario identificar estrategias que nos ayuden a trasladar la atención individual basada en riesgos físicos a la atención del conjunto de personas que conforman la familia y las diferentes dimensiones de la salud familiar. Objetivos: Describir las características familiares y la percepción de la calidad de vida en una zona urbano-marginal de Lima y determinar la asociación entre la funcionalidad familiar y la calidad de vida en las familias. Material y métodos: Estudio transversal, descriptivo y de base poblacional, en una muestra de 120 familias, empleando instrumentos para medir la calidad de vida, las características familiares y funcionalidad familiar. Resultados: El 75% de las familias tuvo una percepción de mejor calidad de vida. El tipo más frecuente de familia fue la nuclear, el 33% de las familias se encontraban en ciclo evolutivo plataforma de despegue, seguido de familias con hijos adolescentes con 31%. El 35% de familias tenía funcionalidad inadecuada mediante el APGAR Familiar y el 3% de familias eran extremas, mediante el test de FACES III; no se encontró asociación significativa entre la calidad de vida y la funcionalidad familiar. Conclusión: La funcionalidad familiar no se relaciona a la calidad de vida percibida en este estudio.
Diarrea y micronutrientes
Authors: Zea Alonso , Ochoa Theresa J
Published: February 2016

La diarrea continúa siendo una causa importante de morbi-mortalidad en niños pequeños. Si bien el uso de las sales de rehidratación oral ha sido de gran ayuda para disminuir la mortalidad asociada a deshidratación, aún se requieren de estrategias efectivas para disminuir la morbilidad asociada a esta enfermedad. El zinc y la vitamina A son dos micronutrientes que han demostrado ser útiles en la prevención y tratamiento de la diarrea en niños. La suplementación de zinc actualmente es recomendada por la OMS para el manejo de diarrea en niños en países en vías de desarrollo, ya que se ha demostrado que disminuye la duración y severidad de los episodios de diarrea, el riesgo de diarrea persistente, y la recurrencia de episodios en los siguientes 2 a 3 meses. La vitamina A se usa de forma profiláctica hace mucho tiempo y es una de las intervenciones más importantes para la reducción en la mortalidad infantil. Se ha demostrado que la vitamina A disminuye la mortalidad y la incidencia de la diarrea. Sin embargo, el uso terapéutico de esta vitamina no ha sido muy estudiado ya que el éxito de su uso profiláctico limita su evaluación.
Infecciones por Enterobacterias productoras de β-lactamasas de espectro extendido
Authors: García Coralith
Published: February 2016

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Elevada frecuencia de neuropatía periférica en pacientes con Diabetes mellitus tipo 2 de un hospital general de Lima-Perú
Authors: Ticse Ray , Pimentel Renán , Mazzeti Pilar , Villena Jaime
Published: February 2016

Objetivos: Determinar la frecuencia de neuropatía periférica en pacientes con diabetes mellitus tipo 2 y la correlación entre la evaluación clínica con el estudio de la velocidad de conducción nerviosa (VCN). Material y métodos: Estudio descriptivo, transversal. Se evaluaron 62 pacientes con diagnóstico de diabetes mellitus tipo 2. Se utilizó el Michigan Neuropathy Screening Instrument (MNSI), el Michigan Diabetic Neuropatic Score (MDNS) y el estudio de VCN. Además se describieron las variables demográficas, antropométricas y de laboratorio. Resultados: La frecuencia de neuropatía periférica fue 96,8% según la VCN y 45% según el MNSI. La correlación entre el número de nervios afectados según VCN y el score MDNS fue moderada (Spearman r=0,59; p<0,001). Conclusiones: Existe una elevada frecuencia de neuropatía periférica en los pacientes diabéticos evaluados y no hubo buena correlación entre VCN y el score MDNS.
Pregrado en Medicina Humana: ¿Es posible graduarse publicando?
Authors: León Jiménez Franco
Published: February 2016

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Resistencia antibiótica en infecciones urinarias en niños atendidos en una institución privada, periodo 2007 – 2011
Authors: Polanco Fernando , Loza Reyner
Published: February 2016

La resistencia antibiótica es un serio problema de salud, sobre todo en pacientes con recurrencia de episodios y anomalías del sistema urinario. Objetivo: Describir el patrón de resistencia antibiótica de las bacterias causantes de la infección del tracto urinario (ITU) como primer episodio, recurrente o complicada en niños menores de 5 años. Material y métodos: Estudio tipo serie de casos observacional, retrospectivo y descriptivo. Se revisaron las historias clínicas de los pacientes con diagnóstico de ITU con cultivo de orina positivo, durante un periodo de 5 años en una institución de salud privada. Resultados: Se incluyeron 111 niños de 1 mes a 5 años; 97 (87,4%) fueron mujeres; 68 (61,3%) fueron lactantes; hubieron 77 pacientes con ITU, 34 con ITU recurrente o complicada. Escherichia coli (63,1%) fue el microorganismo más frecuente en todos los grupos. La resistencia antibiótica fue: ampicilina 80,6%, cefalotina 59%, amoxicilina/clavulánico 55,4%, trimetoprima-sulfametoxazol 51,6%, ácido nalidixico 51%, cefalexina 40%, cefotaxima 31%, cefuroxima 29,8%, ceftriaxona 28,6%, ceftazidima 27,3%, norfloxacino 21,2%, ciprofloxacino 21,1%; y con menos resistencia fueron nitrofurantoína 17%, gentamicina 13,2%, amikacina 1%. Conclusiones: La resistencia antimicrobiana para los antibióticos usados para el tratamiento de ITU es alta para las aminopenicilinas, sulfas, cefalosporinas de primera, segunda y tercera generación así como quinolonas; los aminoglucósidos aún presentan muy baja resistencia porque lo que serían útiles para la terapia de primera elección.
Sobre la fiabilidad del test-retest: Comentario de los autores
Authors: Loza César A.
Published: February 2016

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Regulación del transporte y accidentes de tránsito por vehículos motorizados en el Perú
Authors: Bambarén Celso , Chú Meilind
Published: February 2016

Entre 1998 y 2012, en el Perú se han producido más de un millón doscientos mil accidentes terrestres por vehículos automotores con 49 mil fallecidos. A pesar de la aprobación de diversas regulaciones sobre tránsito y seguridad vial, no se observa una tendencia hacia la disminución de las lesiones fatales en los usuarios del tránsito. Las regulaciones parecen no tener un efecto de protección sobre los ocupantes de los vehículos y peatones, debido a que el número de lesiones fatales se ha incrementado en ambos grupos. Las estadísticas podrían tener variaciones del tipo de usuarios afectados por los accidentes y el número de lesiones fatales para los eventos en vías urbanas, peri urbana y carretera.
Los 25 años de la Revista Médica Herediana con el desarrollo de la comunicación científica
Authors: Miyahira Arakaki Juan
Published: February 2016

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Características demográficas y epidemiológicas de pacientes con diabetes mellitus tipo 2 hospitalizados por cetoacidosis diabética en un hospital general de Lima-Perú
Authors: Ticse Ray , Alán-Peinado Alexis , Baiocchi-Castro Luis
Published: February 2016

Objetivo: Describir las características demográficas y epidemiológicas de pacientes con diabetes mellitus tipo 2 hospitalizados por cetoacidosis diabética en un hospital general de Lima-Perú. Material y Métodos: Estudio observacional descriptivo, realizado en la totalidad de pacientes con cetoacidosis diabética hospitalizados entre enero de 2001 y diciembre de 2009 en el Hospital Nacional Cayetano Heredia (HNCH). Se seleccionaron pacientes mayores de 18 años con cetoacidosis diabética o diabetes mellitus, registrados en la base de datos de la Oficina de Epidemiologia del HNCH. Se exploraron las características demográficas y relacionadas a su internamiento. Los pacientes con diabetes tipo 1 fueron excluidos del estudio. Resultados: Se incluyeron 3 683 pacientes, 3 470 con diabetes tipo 2. Se identificaron 206 casos de cetoacidosis, 60,8% fueron diabéticos tipo 2; la edad promedio fue 50,6 años y la estancia hospitalaria fue 9,9 días. De las condiciones asociadas, 42,23% fueron infecciones, 13,59% enfermedad cardiovascular y en 30,58% ninguna. La tasa anual de cetoacidosis en pacientes con diabetes tipo 2 se incrementó de 3,58 a 5,80 por 100 diabéticos tipo 2 hospitalizados al año, con una mortalidad total de 8,25%. Conclusiones: En este hospital general de Lima la frecuencia de cetoacidosis diabética en pacientes con diabetes tipo 2 se ha incrementado y presenta una elevada tasa de mortalidad, especialmente en adultos mayores.
Implementación de un microscopio virtual para el curso de Patología General del pregrado en una Facultad de Medicina
Authors: Orellano Carlos
Published: February 2016

Objetivo: Describir la implementación de un microscopio virtual (MV) para la visualización de las láminas virtuales (LV) correspondientes a las prácticas de microscopia del curso de Patología General. Material y métodos: Se eligió como visor para el MV a la aplicación de Google Maps por su fácil manejo y amplia difusión. Para generar las LV, se evaluó cada grupo de fotografías (tomadas con un cabezal de cámara de microscopía y un lente ocular de 10X), según el objetivo usado, para determinar cuál tenía una mejor área de visualización y menor difusión de imagen a mayor acercamiento. Luego, fueron segmentadas a través de un script para producir un mosaico de imágenes por cada nivel de visualización (NV) y se almacenaron en uno de los servidores de la Facultad. Resultados: Se eligieron y procesaron las fotografías obtenidas con el objetivo de 10X para producir 6 NV (del 0 al 5) para el MV, siendo el segundo, tercer y cuarto nivel equivalentes a 100X, 200X y 400X respectivamente. Se produjeron 68 250 archivos de imagen con un tamaño total de 1110,29 MB. Finalmente, se publicaron en el Espacio Virtual para la Docencia del curso. Conclusiones: La disposición de microfotografías con un MV fue viable de acuerdo a los lineamientos planteados. Su uso no debe reemplazar a las prácticas habituales de microscopía, sino es una herramienta complementaria. Debido a su elevada similitud con la microscopía tradicional, se puede aplicar en cualquier disciplina donde las imágenes sirven para el diagnóstico a través de la telemedicina.
Gran Ronda de Medicina Interna y Especialidades del Hospital Nacional Cayetano Heredia / Caso clínico 01-2014. Varón de 48 años con ascitis progresiva y baja de peso
Authors: Zelaya Elena , Vera Rosialzira , Rotta Aida , Castañeda Enrique
Published: February 2016

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Tipo de familia y ansiedad y depresiÃ³n
Authors: Vargas Murga Horacio
Published: February 2016

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Cáncer esofágico: ¿Cuál es la situación en el Perú?
Authors: Bendezú-Quispe Guido , Cárdenas-Quispe Elleen , Flores-Ferreyra Juan Carlos
Published: February 2016

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Síndrome de Patau
Authors: Diaz-Kuan Alicia
Published: February 2016

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Características clínicas y anatomo-patológicas de las pacientes que ingresaron al Programa de Control de Tuberculosis con diagnóstico de tuberculosis de mama
Authors: Tafur Karla , Cáceres Jaime , Accinelli Roberto
Published: February 2016

Objetivo: Describir las características clínicas y anatomo-patológicas de pacientes que ingresaron con diagnóstico de TB de mama al Programa de control de Tuberculosis (PCT) de un hospital general. Material y métodos: Se incluyeron los casos registrados en el PCT como TB de mama en cuyo informe anatomo-patológico figuraba inflamación crónica granulomatosa. Se revisaron las historias clínicas y revaluaron las biopsias de mama. Resultados: Se incluyeron 69 mujeres con edad promedio 35,79 ± 7,94 años. Las manifestaciones más frecuentes fueron presencia de nódulo (89,86%), dolor (89,86%) y signos inflamatorios (40,58%). La revaluación de la biopsia mostró granulomas de tipo supurado, con células gigantes multinucleadas tipo Langhans y cuerpo extraño, sin necrosis caseosa, localizados a nivel de la unidad ducto lobular (UDL) y extra-UDL en 85,51 % de los casos. Solo en 3 casos se observó bacilos ácido alcohol resistente en la secreción o tejido de mama. Todos los casos recibieron tratamiento antituberculoso. Treinta y ocho casos tuvieron seguimiento, de ellos 73,68% presentó persistencia o recurrencia al menos un mes después del inicio de tratamiento antituberculoso. Conclusiones: Todos los casos del estudio fueron mujeres, la mayoría presentaron nódulo, dolor o signos de inflamación en mama, sin síntomas o signos sistémicos y con presencia de granulomas supurados, sin necrosis caseosa. A pesar de recibir tratamiento antituberculoso en todos los casos, cerca del 75% con seguimiento de al menos un mes presentaron persistencia o recurrencia clínica.
Gran Ronda de Medicina Interna y Especialidades del Hospital Nacional Cayetano Heredia / Caso clínico 05-2014. Mujer de 83 años con rigidez muscular, diarrea e insuficiencia cardiaca
Authors: Vásquez Sergio , De la Cruz Jesús
Published: February 2016

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Películas y series televisivas en la enseñanza de la ética médica
Authors: García-Berrocal Jorge , Zambrano-Huailla Alexander , Zambrano-Huailla Rommel , Zavala-Flores Ernesto , Montes-Alvis José
Published: February 2016

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De la práctica clínica a la publicación científica: errores del lenguaje en la redacción médica
Authors: Leonardo Olivera Wilder , Villalobos Aguinaga María , Fernández Mogollón Jorge
Published: February 2016

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Síndrome Urémico-hemolítico. Problemas aún no resueltos.
Authors: Loza Munarriz Reyner
Published: February 2016

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Gran Ronda de Medicina Interna y Especialidades del Hospital Nacional Cayetano Heredia / Caso clínico 01-2015. Varón de 32 años con ulcera crónica en pie, compromiso visual y masa cervical
Authors: Sosa Héctor , Torres Haline , Dueñas Roy , Calvo Armando
Published: February 2016

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Presencia de casos autóctonos de infección por virus Chikungunya en Perú
Authors: Maguiña-Vargas Ciro , Custodio-Pitsfil Matias
Published: February 2016

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Fibromialgia
Authors: Calvo Quiroz Armando
Published: February 2016

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Nivel de conocimiento y frecuencia de autoexamen de mama en alumnos de los primeros años de la carrera de Medicina
Authors: Carrillo-Larco Rodrigo M. , Espinoza-Salguer Manuel E. , Avilez José , Osada Jorge
Published: February 2016

Objetivos: Determinar la frecuencia y el conocimiento de la práctica del autoexamen de mama en alumnos de los tres primeros años de la carrera de Medicina en una universidad privada de Lima, Perú. Material y métodos: Estudio transversal descriptivo en 281 estudiantes que consistió en una encuesta de once preguntas diseñadas para evaluar lafrecuencia de la práctica y el conocimiento del autoexamen de mama. Resultados: El 89,7% de los participantes había oído del autoexamen de mama; el 21,0% lo practicaba y el 41,0% de ellos lo hacía mensualmente. En términos de conocimiento, la media fue 6,8 ± 1,8 puntos; solo el 1,0% alcanzó el puntaje máximo de once puntos. Conclusiones: La práctica del autoexamen es baja; pero parece haber un conocimiento aceptable. Es importante enfocar el esfuerzo de las intervenciones en promover la práctica de este método de tamizaje temprano.