El marketing de valores

El present treball pretén aportar una definició del “màrqueting de valors” distingint-lo d'altres tipus de màrqueting que es podrien prestar a confusió: el màrqueting comercial, el màrqueting social, el màrqueting amb causa, i el màrqueting no lucratiu. Posteriorment ens endinsem en la filosofia postmoderna amb els corrents relativistas i nihilistas sobre la pèrdua dels valors tradicionals per a demostrar que, encara remanent en la nostra societat les visió del relativisme moral, no significa que hagi un relativisme ètic, legitimant així la nomenclatura de “màrqueting de valors”. En un segon capítol, s'analitzen vuit casos de projectes reals en països en vies de desenvolupament com exemples de màrqueting de valors. Acarem la viabilitat de la nostra proposta de definició de màrqueting de valors amb cadascun dels exemples, arribant a la conclusió que la definició és viable i defineix un tipus de màrqueting particular.

Normal glucagon signaling and β-cell function after near-total α-cell ablation in adult mice.

OBJECTIVEEvaluate whether healthy or diabetic adult mice can tolerate an extreme loss of pancreatic α-cells and how this sudden massive depletion affects β-cell function and blood glucose homeostasis.RESEARCH DESIGN AND METHODSWe generated a new transgenic model allowing near-total α-cell removal specifically in adult mice. Massive α-cell ablation was triggered in normally grown and healthy adult animals upon diphtheria toxin (DT) administration. The metabolic status of these mice was assessed in 1) physiologic conditions, 2) a situation requiring glucagon action, and 3) after β-cell loss.RESULTSAdult transgenic mice enduring extreme (98%) α-cell removal remained healthy and did not display major defects in insulin counter-regulatory response. We observed that 2% of the normal α-cell mass produced enough glucagon to ensure near-normal glucagonemia. β-Cell function and blood glucose homeostasis remained unaltered after α-cell loss, indicating that direct local intraislet signaling between α- and β-cells is dispensable. Escaping α-cells increased their glucagon content during subsequent months, but there was no significant α-cell regeneration. Near-total α-cell ablation did not prevent hyperglycemia in mice having also undergone massive β-cell loss, indicating that a minimal amount of α-cells can still guarantee normal glucagon signaling in diabetic conditions.CONCLUSIONSAn extremely low amount of α-cells is sufficient to prevent a major counter-regulatory deregulation, both under physiologic and diabetic conditions. We previously reported that α-cells reprogram to insulin production after extreme β-cell loss and now conjecture that the low α-cell requirement could be exploited in future diabetic therapies aimed at regenerating β-cells by reprogramming adult α-cells.

Influence of inflammation on total energy expenditure in hemodialysis patients.

Background and Objectives: Studies show that inflammation can contribute to an increase in resting energy expenditure in patients with chronic kidney disease; however, findings about total energy expenditure (TEE) have not been reported. The aim of this study was to evaluate the effects of inflammation on TEE and physical activity energy expenditure in hemodialysis (HD) patients.Design: This was a cross-sectional study.Setting: This study was conducted from Hopital Edouard Herriot, Lyon, France.Patients: This study included 24 HD patients and 18 healthy subjects.Main Outcome Measure: TEE and step counts were measured over a 7-day period by the SenseWear Pro2 Armband in 24 HD patients (15 patients with C-reactive protein,5 mg/L, aged 67.0 +/- 6 14.7 years, and 9 with C-reactive protein >5 mg/L, aged 69.0 +/- 6 18.0 years) and compared with 18 healthy subjects (62.3 +/- 6 15.3 years).Results: Mean estimated TEE measured with SenseWear Pro2 Armband was significantly lower (25.5 +/- 4.1 kcal/kg/day) in patients with inflammation when compared with those without inflammation (32.0 +/- 6.7 kcal/kg/day) and with healthy subjects (31.8 +/- 6 7.0 kcal/kg/day) (P = .012). There was a difference in the physical activity (step counts) between patient groups (P < .05). Healthy subjects and patients without inflammation walked more (8,107 +/- 5,419 and 6,016 +/- 3,752 steps/day, respectively) as compared with patients with inflammation (2,801 +/- 2,754 steps/day, P = .001).Conclusion: Our findings suggest that patients with inflammation have a lower TEE when compared with healthy subjects and patients without inflammation. TEE is influenced by physical activity because patients with inflammation appear to be less active. (C) 2011 by the National Kidney Foundation, Inc. All rights reserved.

Does previous hip arthroscopy negatively influence the short term clinical result of total hip replacement?

INTRODUCTION: The risk that hip preserving surgery may negatively influence the performance and outcome of subsequent total hip replacement (THR) remains a concern. The aim of this study was to identify any negative impact of previous hip arthroscopy on THR. METHODS: Out of 1271 consecutive patients who underwent primary THR between 2005 and 2009, 18 had previously undergone ipsilateral hip arthroscopy. This study group (STG) was compared with two control groups (CG, same approach, identical implants; MCG, paired group matched for age, BMI and Charnley categories). Operative time, blood loss, evidence of heterotopic bone and implant loosening at follow-up were compared between the STG and the MCG. Follow-up WOMAC were compared between the three groups. RESULTS: Blood loss was not found to be significantly different between the STG and MCG. The operative time was significantly less (p < 0.001) in the STG. There was no significant difference in follow-up WOMAC between the groups. No implant related complications were noted in follow-up radiographs. Two minor complications were documented for the STG and three for the MCG. CONCLUSION: We have found no evidence that previous hip arthroscopy negatively influences the performance or short-term clinical outcome of THR.

Influencia del diseño de alta flexión, con conservación del LCP, en el rango de movimiento tras la implantación de una prótesis total de rodilla

Els nous implants de genoll pretenen millorar la flexió màxima aconseguida amb els implants convencionals. El nostre estudi pretén demostrar que els pacients intervinguts quirúrgicament, per a la implantació d’una artroplàstia total de genoll d’alta flexió, són capaços d’aconseguir un balanç articular i una flexió màxima superior a l’aconseguida pels pacients tractats amb el model convencional. La flexió màxima post-operatòria, a l’any de la intervenció, va ser 13º major en el grup de pacients portadors d’un implant d’alta flexió, respecte al grup de pacients portadors d’un implant convencional. (P & 0,05).

Paratirina intacta a las 24 horas de la tiroidectomía total.Valor predictivo de hipoparatiroidismo definitivo

Estudio clínico prospectivo de 70 pacientes sometidos a tiroidectomía total (TT) El objetivo del estudio es analizar el valor de la determinación de paratirina (PTHi) a las 24 horas de la TT como indicador de riesgo de hipoparatiroidismo definitivo. Cuarenta y cuatro pacientes (62,9%) presentaron hipocalcemia y 27 (38,6%) una deficiencia de PTHi a las 24 h de la TT. Una concentración de PTHi a las 24 h postTT 5,8 pg/mL predice con una sensibilidad del 100% y una especificidad del 81,5% la evolución a hipoparatiroidismo definitivo, con un valor predictivo negativo del 100%. Estudi clínic prospectiu de 70 pacients sotmesos a tiroïdectomia total (TT). L’objectiu de l’estudi és analitzar el valor de la determinació de paratirina (PTHi) a les 24 hores de la TT com a indicador de risc d’hipoparatiroïdisme definitiu. Quaranta-quatre pacients (62,9%) presentaren hipocalcèmia i 27 (38,6%) una deficiència de PTHi a les 24 hores de la TT. Una concentración de PTHi a les 24 h postTT 5,8 pg/mL prediu amb una sensibilitat del 100% i una especificitat del 81,5% l’evolució a hipoparatiroïdisme definitiu, amb un valor predictiu negatiu del 100%.

Relació de l’aspecte de la ferida quirúrgica en el postoperatori immediat d’una artroplàstia total de genoll amb l’evolució funcional posterior

Mitjançant un estudi observacional prospectiu, hem descrit i classificat la ferida quirúrgica en el postoperatori immediat de 159 pacients que se’ls hi va implantar una artroplàstia total de genoll, mitjançant una escala descriptiva fiable i reproduïble creada pels autors (estudi de validesa). Es va observar que l’aspecte de la ferida quirúrgica en el postoperatori immediat no tenia relació amb la funcionalitat de la pròtesis als 6 mesos de seguiment ni amb el dolor que patia el pacient en l’estància hospitalària. Si que vam observar correlació estadísticament significativa entre el pitjor aspecte de la ferida i l’aparició d’infeccions protèsiques profundes.

Cuantificación de las partículas de polietileno en líquido sinovial tras artroplastia total de rodilla, utilizando un polietileno convencional o uno altamente entrecruzado: estudio preliminar y protocolo de estudio

La formació de partícules de polietilè és la principal causa de osteòlisi i per tant de fracàs a l’artroplàstia total de genoll. El nostre objectiu és comparar, in vivo, el nombre de partícules que es formen amb un polietilè convencional amb un altament entrecreuat, esperant que el segon cas el nombre sigui més petit. Utilitzem una tècnica de aïllament de partícules en líquid sinovial ja descrita, que reproduïm a l’estudi preliminar. Presentem un protocol d’estudi prospectiu a doble cec, on s’estudiaran pacients amb artroplàstia de genoll d’un any d’evolució.

Traitement de la coxarthrose par des prothèses totales de hanche sur mesure [Treatment of coxarthrosis with fitted total hip prostheses replacement]

The treatment of hip osteoarthritis with total hip arthroplasty has continuously evolved since it was first introduced in the sixties. The problem of aseptic loosening of the cemented prostheses, mainly in young active patients, has stimulated two different types of research: on one side the improvement of cementing techniques and on the other side the development of cementless osteoinegrable implants. We discuss the problems of these cementless hip prostheses. Recently published anatomic and biomechanic studies have led to the development of personalized custom femoral stems for each patient. The conception technique and first clinical results are described.

Multi-segment foot kinematics after total ankle replacement and ankle arthrodesis during relatively long-distance gait.

This study aimed to investigate the influence of ankle osteoarthritis (AOA) treatments, i.e., ankle arthrodesis (AA) and total ankle replacement (TAR), on the kinematics of multi-segment foot and ankle complex during relatively long-distance gait. Forty-five subjects in four groups (AOA, AA, TAR, and control) were equipped with a wearable system consisting of inertial sensors installed on the tibia, calcaneus, and medial metatarsals. The subjects walked 50-m twice while the system measured the kinematic parameters of their multi-segment foot: the range of motion of joints between tibia, calcaneus, and medial metatarsals in three anatomical planes, and the peaks of angular velocity of these segments in the sagittal plane. These parameters were then compared among the four groups. It was observed that the range of motion and peak of angular velocities generally improved after TAR and were similar to the control subjects. However, unlike AOA and TAR, AA imposed impairments in the range of motion in the coronal plane for both the tibia-calcaneus and tibia-metatarsals joints. In general, the kinematic parameters showed significant correlation with established clinical scales (FFI and AOFAS), which shows their convergent validity. Based on the kinematic parameters of multi-segment foot during 50-m gait, this study showed significant improvements in foot mobility after TAR, but several significant impairments remained after AA.

El Videojuego : el paso de un producto de entretenimiento social a un nuevo producto de marketing social

Aquest treball final de carrera analitza el món dels videojocs des d’una perspectiva comercial i de màrqueting. Els videojocs s’han convertit en la forma d’oci audiovisual més important, per davant del cinema i de la música, fins arribar a estar presents en la majoria de les plataformes actuals: consoles, ordinadors, dispositius mòbils, xarxes socials… Aquest creixement exponencial del mercat dels videojocs no ha passat desapercebut per les grans marques, les quals ja han començat a invertir importants sumes de diners en el desenvolupament de noves campanyes amb els videojocs com a protagonistes. El que ens fa també adonar-nos del potencial que té aquest mitjà publicitari de cara al futur, són les constants millores que van sortint al mercat de forma progressiva. Algunes millores que ja han començat a situar la videoconsola com el centre d'oci multimèdia dins de les nostres llars.