This thesis contains the work from two inter-related studies focusing on the self-perceptions of pupils with Down Syndrome. After a brief account of my value position in relation to the research in Chapter 1, Chapter 2 discusses the literature on self-perceptions. This discussion provides the rationale for study 1. In Chapter 3 the developmental profile of children with Down Syndrome is discussed. This provides the rationale for the choice of research instruments. In study 1 the self-perceptions of 96 pupils with Down Syndrome between the ages of 8 and 16 years were assessed in three school related domains: academic competence, physical competence and social acceptance Results from the Pictorial Scale of Perceived Competence and Acceptance (Harter & Pike, 1981/1984) and a Situations Grid suggested that pupils with Down Syndrome hold very positive self-perceptions in each school related domain, that self-perceptions become more positive with age, are more positive for female than for male pupils and remain positive regardless of school placement type (mainstream or special school). The findings from study 1 left unanswered a number of questions concerning the self- perceptions of pupils with Down Syndrome. Furthermore, examination of individual scores revealed considerable differences in the self-perceptions of individual pupils. Therefore, the aim of study 2 was to investigate factors associated with high and low self-perceptions. Study 2 also allowed pupils, teachers and parents more freedom to participate in the research. Fourteen qualitative case studies were completed. The interview and observation data arising from study 2 revealed the heterogeneity in factors associated with the self-perceptions of pupils with Down Syndrome. In the closing chapters: possible explanations for the study findings and suggestions for further research are raised, the utility of quantitative and qualitative approaches for studying pupils with Down Syndrome is discussed, and the implications of the findings for existing theories are covered.

Background: Aminoglycoside antibiotics are commonly used in paediatric clinical practice, especially for the treatment of neonatal sepsis and pulmonary exacerbations in cystic fibrosis (CF). However, megalin-mediated endocytosis of the aminoglycosides by renal proximal tubule epithelial cells leads to toxicity, and may result in acute kidney injury and chronic kidney disease. Current approaches to identify and prevent toxicity are limited. Several novel biomarkers have shown utility in preclinical studies for the identification of aminoglycoside-induced nephrotoxicity, but clinical data and an understanding of their clinical utility is lacking. The potential of statins to prevent aminoglycoside-induced nephrotoxicity by inhibition of megalin-mediated endocytosis has been previously demonstrated in vitro and in a rat model, but its potential in man is unclear. Aims: Firstly, to investigate the utility of novel urinary biomarkers for the early identification of aminoglycoside-induced nephrotoxicity in children. Secondly, to develop a novel intervention using statins to prevent aminoglycoside-induced nephrotoxicity in children with CF. Methods and Results: Urine samples were collected from 41 premature neonates at least once per week, and daily during courses of gentamicin. Three urinary biomarkers were measured using Luminex-based (Kidney Injury Molecule-1 (KIM-1) and Neutrophil Gelatinase-associated Lipocalin (NGAL)) and colorimetric assays (N-acetyl-β-D-glucosaminidase (NAG)). All three biomarkers were elevated during treatment with gentamicin, but when adjusted for potential confounders, only the elevation in KIM-1 remained significant (mean difference from not treated, 1.35ng/mg urinary creatinine; 95% CI 0.05-2.65). Electrochemiluminescent assays for both KIM-1 and NGAL were validated, and were compared to Luminex-based assays by analysing samples from healthy children in the UK (n=120) and the US (n=171). 95% reference intervals for both biomarkers were derived using quantile regression. Urine samples were collected from a cohort of children with cystic fibrosis (n=158) at outpatient clinic appointments and during exposure to tobramycin. Biomarkers were measured using the validated electrochemiluminescent assays. Elevations in both KIM-1 and NGAL (median peak fold-change was 2.28 (IQR 2.69) and 4.02 (IQR 7.29) respectively) were observed during exposure to tobramycin. In a multiple regression model, baseline KIM-1 was associated with the number of previous courses of IV aminoglycoside (p < 0.0001; R2=0.11). An in vitro model of aminoglycoside-induced nephrotoxicity was developed using a conditionally immortalized proximal tubule epithelial cell line (ciPTECs). Dose and time-dependent toxicity was demonstrated with neomycin, gentamicin, and tobramycin (from most to least potent). In rats, the addition of rosuvastatin significantly reduced nephrotoxicity compared to gentamicin alone (p < 0.01). In guinea pigs, dose-dependent inhibition of gentamicin-induced nephrotoxicity was seen with rosuvastatin (at a minimum concentration of 0.94mg/kg/day, p < 0.0001), but not with simvastatin. In vitro models demonstrated that neither rosuvastatin nor atorvastatin had any effect on the minimum inhibitory concentration of tobramycin for Pseudomonas aeruginosa. Conclusion: Urinary KIM-1 has shown potential as a biomarker of both acute and chronic proximal tubular injury associated with exposure to aminoglycosides in children. Inhibition of aminoglycoside-induced nephrotoxicity by statins was demonstrated in further animal models, allowing the selection of a statin and dose (rosuvastatin 10mg) which have been taken forward into a clinical trial which will test this hypothesis in children with CF, utilising urinary KIM-1 as the primary outcome measure.

Numerous studies have shown the benefits of breastfeeding, however, the incidence and duration of breastfeeding in the UK is low and static, and breastfeeding rates in Liverpool in the North West of the UK are even lower. Breastfeeding is frequently promoted as being free yet little research has been carried out to substantiate this claim. Further, little is known about breastfeeding practices in Liverpool. Four inter-related studies were conducted to investigate the cost of infant feeding and associated practices. Initially a database was compiled of infant feeding products, this revealed a vast number of products marketed to both breast and formula feeding mothers. Semi-structured interviews were then conducted to identify all the items purchased for feeding infants up to the age of four months. The results of these interviews revealed that breastfeeding was more expensive than formula feeding but high and low cost models suggest that substantial savings could be made. Many mothers purchased items and subsequently did not use or need them. The suggestion that infant feeding and particularly breastfeeding has become unnecessarily commercialised was supported by content analysis of a wide range of UK pregnancy and baby magazines. These were consistent with parenthood being a consumer experience to be 'perfected', in addition to emphasising the need for 'expert' advice. Breastfeeding messages were undermined by formula company advertisements and breastfeeding was frequently presented as being painful and problematic. With these conflicting messages, it may not be surprising that many women initiated breastfeeding but ceased within three months. Those who did initiate breastfeeding frequently gave 'baby-centred' reasons such as breast is best whilst those who initiated formula feeding gave 'mother-centred' reasons such as others could help with feeding. Many women who ceased breastfeeding would have liked to have continued, and cited reasons that could have been overcome with increased support and encouragement. The importance of being supported was further highlighted by the women who attended the infant feeding clinic. This study has demonstrated that the materials needed for breastfeeding are clearly identified and health professionals are trained to support parents. In addition, the media needs to be persuaded to help create and support a breastfeeding culture, with the risks of formula feeding clearly communicated.

Orientadores: Ricardo Mendes Pereira, Gabriel Hassel / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-20T14:45:04Z (GMT). No. of bitstreams: 1 Braga_GiselledeMelo_D.pdf: 2252934 bytes, checksum: 401162ce812285a389b7e0d8f827d5e3 (MD5) Previous issue date: 2012 / Resumo: A paracoccidioidomicose e uma micose sistêmica, endêmica em alguns países da America Latina. O objetivo do estudo foi descrever a frequência e as características clinicas, laboratoriais e histológicas do acometimento hepático em crianças. Foram incluídos 102 pacientes menores de 16 anos, admitidos entre 1980 e 2010, com diagnostico confirmado pela demonstração do fungo em exame anatomopatológico. Os dados clínicos e laboratoriais foram obtidos a partir do prontuário desses pacientes. O tecido hepático foi obtido a partir de uma necropsia e 12 biopsias. Ate setembro de 2007, as biopsias foram realizadas em pacientes com icterícia persistente, dilatação da arvore biliar intra-hepática ou hipertensão portal. De outubro de 2007 a abril de 2010, a indicação de biopsia hepática foi a elevação de aminotransferases e hipoalbuminemia. Foram utilizadas as colorações com hematoxilina-eosina e tricrômico de Masson, alem de imunomarcação com CK 7 e CK 19. Essa e a maior casuística pediátrica em paracoccidioidomicose de que encontramos relato. Do total de 102 pacientes, quarenta e um pacientes apresentaram acometimento hepático. As principais alterações clinicas foram linfonodomegalia generalizada (n=39), emagrecimento (n=34) e febre (n=32). Aproximadamente um terço dos pacientes teve icterícia. Houve maior proporção de meninos, menor media de idade e maior proporção de desnutridos nos pacientes com acometimento hepático. A apresentação clinica nesses pacientes foi mais exuberante, com maior frequência de queixas como emagrecimento, adinamia, anorexia e palidez. Ocorreu aumento predominante das enzimas canaliculares. Os pacientes com acometimento hepático apresentaram valores estatisticamente mais baixos de albumina (p<0,001) e hemoglobina (p=0,002). Pode-se utilizar ponto de corte de albumina (<3,05g/dL) e hemoglobina (<9,2g/dL) para inferir acometimento hepático. A hipoalbuminemia e mais intensa em pacientes com acometimento hepático (mediana de 2,4g/dl), podendo indicar pior função hepática ou complicação da doença (linfangiectasia intestinal). Houve óbitos (6) apenas entre os pacientes com acometimento hepático. No estudo histológico hepático, observamos intensa fibrose em pacientes com historia clinica de aproximadamente um mês e meio e com tratamento iniciado poucos dias antes da biopsia. Foi observada associação entre quantidade de fungo e intensidade da fibrose. A pesquisa de reação ductular mostrou que a imunohistoquímica e mais sensível para detectar alteração, podendo demonstrá-la mais precocemente que a coloração com hematoxilina-eosina. Foi encontrada agressão inflamatória a células ductais biliares, o que contribui na patogênese do acometimento hepático pela doença. A paracoccidioidomicose hepática em pacientes pediátricos tem características clinicas e laboratoriais especificas. Pacientes com intensa hipoalbuminemia e menor idade estão mais sujeitos a apresentarem acometimento hepático pelo Paracoccidioides brasiliensis. O acometimento hepático esta associado a maior numero de óbitos. A lesão do epitélio biliar por células inflamatórias pode explicar o aumento predominante de enzimas canaliculares / Abstract: Paracoccidiodomycosis is a systemic mycosis, endemic in some countries of Latin America. The study aimed to describe the frequency, the clinical, laboratory and histological characteristics of liver involvement in children. The study has included 102 patients less than 16 years, treated between 1980 and 2010, with diagnosis confirmed by demonstration of the fungus in a pathologic examination. The clinical and laboratory data were obtained from patient charts. The liver tissue was obtained from one necropsy and 12 biopsies. Until September 2007, the biopsies were taken from patients with persistent jaundice or portal hypertension. Between October 2007 and April 2010, the indication of biopsy was elevation of aminotransferases and low level of albumin. The hematoxylin-eosin, Masson's trichrome and immunohistochemical (CK7 and CK 19) staining were used. This is the largest pediatric series that we have read about. Among 102 patients, forty one had liver involvement. The clinical findings were generalized lymphadenopathy (n=39), weight loss (n=34) and fever (n=32). Approximately one third of patients had jaundice. There was a higher proportion of boys, of undernourished and lower mean age in patients with liver involvement. The clinical presentation in these patients was more exuberant, with higher frequency of weight loss, adynamia, anorexia and pallor. There was a predominant increase of canalicular enzymes. There were differences in albumin (p<0,001) and hemoglobin levels (p=0,002) between patients with and without liver involvement, and the lowest values were found in the liver involvement group. A cutoff of albumin (<3,05g/dL) and hemoglobin (<9,2g/dL) can be used to infer liver involvement. Hypoalbuminemia is more intense in patients with liver involvement (median=2,4g/dL), witch may indicate worsening of liver function or disease complication (such as intestinal lymphangiectasia). Deaths (6) occurred only among patients with liver involvement. In liver histology, we found intense fibrosis in patients that were sick for about a month and a half and whose treatment was started few days before the biopsy. There was association between amount of fungus and severity of fibrosis. The study of ductal proliferation showed that immunochemistry is more sensitive to detect such reaction and it could be demonstrated earlier than the hematoxylin-eosin staining. There was bile duct cells lesion by inflammatory cells, which contributes in the pathogenesis of liver involvement. Liver paracoccidioidomycosis in pediatric patients has specific clinical and laboratorial presentation. Younger patients and those with severe hypoalbuminemia are more likely to present liver involvement by Paracoccidioides brasiliensis. Liver involvement is associated with more deaths. The bile duct cells lesion by inflammatory cells may explain the predominant increase of canalicular enzymes / Doutorado / Pediatria / Mestre em Ciências

The differentiation of human endometrial stromal cells (HESCs) into specialised decidual cells prepares the endometrium for embryonic implantation. The biochemical and morphological transformation of these cells is highly temporally regulated in order to define a transient period of endometrial receptivity. Currently, the involvement of circadian machinery, and clock dependent pathways in this process are not fully understood. Firstly, analysis of circadian rhythms in HESCs revealed a consistent loss of oscillations in clock components upon decidualization. Down-regulation of Period 2 (PER2) expression, apparent in the early stages of differentiation, was shown to be sufficient to cause this aperiodicity. In turn, temporal suppression of PER2 expression was achieved via reduced CLOCK binding to a non-canonical Ebox enhancer in the PER2 promoter. RNA sequencing analysis upon premature PER2 knockdown revealed a disorganised decidual phenotype in which cell cycle and mitotic regulators were perturbed. As such, PER2 acts to uncouple the endometrium from circadian oscillations during decidualization. Secondly, the gene PRIP-1 was shown to be PER2 dependent in undifferentiated HESCs. Endometrial expression of PRIP-1 was induced and maintained upon decidualization by the post-ovulatory rise in progesterone. Analysis of Ca2+ fluxes demonstrated the ability of PRIP-1 to act as a chelator of IP3 signalling. Additionally, PRIP-1, via its regulation of the AKT pathway, is shown to be an anti-apoptotic regulator in decidual HESCs. Together, these results indicate PRIP-1 functions as a molecular switch in response to progesterone signalling. High PRIP-1 levels during differentiation enable AKT and IP3 mediated cell survival, whilst declining levels upon P4 withdrawal leads to decidual apoptosis. In summary, I provide a novel paradigm whereby both PER2 and PRIP-1 act to uncouple the endometrium from various signalling inputs, enabling an autonomous decidual response. Asynchrony in these pathways can lead to a cascade of events resulting in an array of adverse pregnancy complications.

The purpose of this research study was to describe managerial guidelines to support parents with the hospitalisation of their child in a private paediatric unit. The study explored and described: · the nursing care experiences of parents regarding the hospitalisation of their child in a paediatric unit; · managerial guidelines to support parents with their lived experiences of their child’s hospitalisation in a private paediatric unit. To achieve the purpose and the objectives of the research, an interpretivephenomenological qualitative approach was used in the research design and method. Various questioning methods were employed during this study. Parents were invited to take part in unstructured individual interviews to ascertain parents’ experiences of their child’s hospitalisation. A narrative diary was used as the second method of questioning and parents were asked to narrate their lived experiences of their child’s hospitalisation in a private paediatric unit. During the study the researcher kept field notes as she participated in the fieldwork. The data obtained was then incorporated into existing literature during the conceptualisation phase. The population and sampling for this study consisted of seven parents who took part in the interviews and 15 parents who completed the narrative diaries. Purposive sampling was used to achieve saturation of data. The model of Guba and Lincoln (1985) was used to ensure trustworthiness. Ethical considerations were maintained throughout the study and consent was obtained from the respondents. The recommendations of the research were that attention should be given to: · empowering parents to participate in certain aspects of their child’s care to the extent and intensity that they feel comfortable with, recognising parents’ strengths and intrinsic characteristics and minimising feelings of parental guilt created by social roles; · guiding nursing personnel to plan the discharge process effectively; · including parents in the unit routine and managing resources whilst promoting cost containment; II · interpersonal relationships in the paediatric unit, with special emphasis on fostering a trusting and caring relationship between parents and nursing care professionals · promoting the communication of information by using a communication style that ensures parents receive adequate information; and · creating a safe, therapeutic environment for parents, where parents can be comfortable with adequate facilities and minimal external stimuli. / Prof. K. Jooste

Paediatric specific medicines have become increasingly researched since the introduction of paediatric investigation plan requirements in 2007. Various dosage forms continue to be investigated for their appropriateness for children, including multiparticulates. Multiparticulates are currently available as tablets, capsules, sachets and medicated spoons/straws/syringes. These presentations offer limited dose flexibility with some only providing a single fixed dose. A device capable of repeated flexible multiparticulate dosing is therefore required to exploit the inherent flexibility of the dosage form and allow for patient-specific personalised dosing. This thesis takes a user-centered approach to conceptualise multiparticulate dosing devices through qualitative participatory design studies with user groups including children, caregivers and patients. Having explored User and Formulation requirements in terms of device design, a device specification has been generated with subsequent concept generation and mechanism prototyping. The research with users provided further understanding of the different contributors to ease of use, and highlighted the importance of device simplicity, accuracy and speed of use. Exploration of the concepts of self-administration and context of use with potential paediatric MP device users discovered that self-administration was more than a single step process. Caregivers also found it difficult to provide an age at which they would be happy for their child to self-administer and highlighted various influences upon their decision including child maturity, adult supervision and child familiarity with administration. A knowledge gap surrounding the use of mass-based mechanisms to determine multiparticulate dose has also been addressed. With new knowledge surrounding MP measurement and the mechanical specifications required for a personalised dosing device presented. A case study is presented, highlighting a possible application of multiparticulates and their dosing device in Cystic Fibrosis patients. This population was selected given their familiarity with a multiparticulate like dosage form as part of their pancreatic enzyme replacement therapy. This study demonstrates how the global device requirements (presented in this work) can be refined on a case-specific basis allowing for a refined, user-centered device specification. This work provides an industry road map for user engagement, acting as a platform for future multiparticulate dosing device design and development, guiding multiparticulate formulation design and ultimately advancing the field of personalised medicines and improving health outcomes (particularly of paediatric patients).

Hereditary peripheral neuropathy, known asCharcot Marie Tooth disease (CMT) and with an incidence of 1:2500 -1:10 000, is the most common hereditary neuromuscular disorder. Type CMT 1A is the most common form of CMT refering to the group of primary demyelinitateing motor and sensory peripheral neuropathies. CMT phenotype is clinically characterized by chronic slowly progressive distal muscle weakness and atrophy with hypo or areflexia and mild to moderate acral sensory loss. The lower limbs are predominantly affected. The aims of this study were to describe the first and most common signs of CMT1A during the first decade of life, to characterize their progression, and evaluate the sensitivity of CMTNS (Charcot-Marie- Tooth neuropath scale) for CMT1A young children. Sixteen children aged 3 to 10 years with genetically proven CMT 1A were examined. All patients were clinically examined, underwent electrophysiological examination, and were scored by CMTNS. Eight were followed for up to two years. Our data shows that CMT 1A in children under the age of 10 years causes only a mild disability. Initial signs of CMT 1A were difficulty in heel walking (15/16, 93%) and lower limb hypo or areflexia ( 13/16, 81%). The test of heel walking can be easily used as a screening test for hereditary neuropathies in pediatrics....

There is an increased number of childhood cancer survivors living into adulthood. As more survivors live into adulthood, researchers have been able to study and better understand the late effects of cancer treatment. A well-known late effect of cancer treatment is the risk of infertility. Cancer-related infertility is a source of distress to cancer survivors. There have been many advances to fertility preservation over the last few years and there are now multiple options available for both men and women. Despite the improved understanding of the risk of cancer-related infertility and advances to fertility preservation treatment, these services remain underutilized by cancer patients. It is known that discussing fertility preservation options with newly diagnosed cancer patients improves survivors’ long-term quality of life and reduces decisional regret, regardless of if they pursue fertility preservation treatment. Survivors often report that the risk of treatment-related infertility and/or available fertility preservation options was often inadequately or not discussed with them at the time of diagnosis. The use of fertility preservation decision aids for adult patients newly diagnosed with cancer have been proven to be effective at improving participants’ knowledge surrounding fertility preservation, reducing decisional conflict, and reducing long term decisional regret. A fertility preservation decision aid has not yet been developed for use by adolescents newly diagnosed with childhood cancer. This study aims to engage survivors and providers to develop a fertility preservation decision aid to improve the decision quality of adolescents newly diagnosed with childhood cancer who are determining their preferences on accepting a referral to a fertility specialist. This study then proposes to field test the decision aid with newly diagnosed patients. The use of a decision aid will lead adolescents with childhood cancer to have increased knowledge on the risk of infertility and the fertility preservation options available. This study also aims to lower participants’ levels of decisional conflict about their fertility preferences. There is a need to incorporate the use of a fertility preservation decision aid into childhood cancer treatment. If this decision aid proves effective, referral to the fertility preservation decision aid may become common practice at the time of initial diagnosis. If the decision aid is effect at improving decision quality and reducing decisional conflict, survivors may experience long-term benefits including improved quality of life and reduced levels of decisional regret.

El presente proyecto busca implementar un Centro Pediátrico Nutricional, en el distrito de Villa el Salvador, perteneciente a la zona sur de la capital de Lima, caracterizada por un desarrollo económico emergente y con necesidades crecientes de salud no cubiertas en cantidad y calidad. Mercado objetivo son los niños de 0-17 años de este distrito y de distritos aledaños. Actualmente la población se ve obligada a trasladarse a centros de atención fuera del distrito, perciben maltrato por los sistemas de salud públicos o privados de la zona, con filas enormes desde muy temprano para acceder a una consulta, las atenciones apresuradas o de corto tiempo que puede omitir condiciones riesgosas como masas abdominales (Hepatomas), renales (Tumor de Wilms), alteraciones visuales (estrabismo, ambliopía), trastornos de integración sensorial (TDAH) de abordaje oportuno. Además, en los establecimientos de salud no existe un lugar donde recibir orientación complementaria para la prevención, el cuidado y la instrucción nutricional del infante, que asegure una vida saludable futura. El presente proyecto tiene por objetivo ofrecer una alternativa de atención pediátrica integral y nutricional, donde no solo se brinde atención curativa o recuperativa, sino enfocadas en la mejora de hábitos y estilos de vida saludable así como en la prevención de enfermedades crónicas de la adultez, tales como obesidad, diabetes, hipertensión, síndrome metabólico (Pediatría Funcional). El futuro ciudadano presentara menos problemas de salud, un mejor desarrollo de sus potencialidades, debido a las intervenciones oportunas realizadas durante su niñez con un abordaje holístico, además de la asistencia emocional y física. Otra bondad de este proyecto es la innovación tecnológica en la atención al incluir las plataformas de asistencia digital, que favorecerán el acceso inmediato con el profesional médico, disminuyendo las automedicaciones y el tiempo que demanda una atención tradicional.. La proyección económica ha sido realizada en un horizonte de 10 años, el proyecto contará con un financiamiento por parte de los socios del 56.49% del total y el 43.51% a través de un crédito financiero por un periodo de 6 años. El periodo de recuperación de la inversión se ha calculado en 2.09 años. Los ratios financieros que indican que el proyecto es viable son un VAN positivo, un TIR del 48.69% y un WACC del 13.33%, siendo muy atractivo para los futuros inversionistas. / This project seeks to implement a Pediatric Nutrition Center, in the district of Villa el Salvador, belonging to the southern part of the capital of Lima, characterized by an emerging economic development and with growing health needs not covered in quantity and quality. The target audience is children from 0-17 years of age from this district and surrounding districts. Currently the population is forced to move to other care centers outside the district, they perceive the abuse by public or private health systems in the area, with huge lines from very early to access a medical consultation, hasty care or short time it can omit risky conditions such as abdominal masses (Hepatomas), renal (Wilms tumor), visual disturbances (strabismus, amblyopia) and sensory integration disorders (ADHD) of timely approach. In addition, in health centers, there is no place to receive complementary guidance for the prevention, the care and the nutritional instruction of the infant which ensures a healthy future life. The purpose of this project is to offer an alternative of comprehensive and nutritional pediatric care, where not only curative or recovery care is provided, but focused on improving healthy habits and lifestyles as well as on the prevention of chronic diseases of adulthood, such as obesity, diabetes, hypertension, metabolic syndrome (functional Pediatrics). The future citizen will present fewer health problems, a better development of their potential, due to the opportune interventions carried out during their childhood with a holistic approach, in addition to emotional and physical assistance. Another goodness of this project is technological innovation in care by including digital assistance platforms, which will favor direct access with the medical professional, reducing self-medication and the time required for traditional care. The economic projection has been carried out over a 10-year horizon, and the project will be financed by the partners of 56.49% of the total and 43.51% through a financial loan for a period of 6 years. The period of recovery of the investment has been calculated in 2.09 years. The financial ratios that indicate that the project is viable are a positive NPV, an IRR of 48.69% and a WACC of 13.33%, being very attractive for future investors. / Tesis