Importancia cultural de la flora empleada por la comunidad nativa Asheninka Sheremashe, Ucayali, Perú / Cultural importance of the flora used by the Asheninka Sheremashe native community, Ucayali, Peru

The cultural significance of the flora used by the native Asheninka Sheremashe community in Ucayali, Peru was determined. To do this, a fieldwork of over 4 months was conducted, involving semi-structured interviews with 106 residents through non-probabilistic convenience sampling. The community utilizes 139 plant species in their daily lives, belonging to 120 genera and 52 families, with the most abundant being Fabaceae, Arecaceae, Malvaceae, Solanaceae, Poaceae, and Rutaceae. Furthermore, 25.9% of the species are of significant importance to theinhabitants according to the Cultural Index (CI), such as Manihot esculenta, Theobroma cacao, Bixa orellana, Musa paradisiaca, Ficus insipida, among others. It can be concluded that the flora plays a prominent role in the life of the community, with the categories reporting the highest number of species being: food (29.35%), medicine (28.36%), culture (9.95%), construction (9.45%), lumber (6.97%), commerce (3.48%), craftsmanship (2.49%), toxic (2.49%), and other uses (7.46%)

Se determinó la importancia cultural de la flora empleada por la comunidad nativa Asheninka Sheremashe, en Ucayali, Perú. Para ello, se realizó un trabajo de campo de más de 4 meses, donde se aplicaron entrevistas semiestructuradas a 106 habitantes mediante un muestreo no probabilístico por conveniencia. La comunidad emplea 139 especies vegetales en su día a día, pertenecientes a 120 géneros y 52 familias; siendo las más abundantes las Fabaceae, Arecaceae, Malvaceae, Solanaceae, Poaceae y Rutaceae. Además, el 25.9% de las especies tiene gran importancia para los pobladores según el Índice Cultural (IC): Manihot esculenta, Theobroma cacao, Bixa orellana, Musa paradisiaca, Ficus insipida, entre otras. Se concluye que la flora tiene un rol preponderante en la vida de la comunidad, siendo las categorías que presentaron mayor reporte de especies: alimentación (29.35%), medicina (28.36%), cultura (9.95%), construcción (9.45%), aserrío (6.97%), comercio (3.48%), artesanía (2.49%), tóxico (2.49%) y otros usos (7.46%)

Segmentation by motivations in religious tourism: A study of the Christ of Miracles Pilgrimage, Peru.

The present study, focused on pilgrimages as part of religious tourism, aimed to achieve the following objectives: Identify the motivations of the demand for religious tourism focused on pilgrimages; analyze the segmentation of the demand; identify the relationship between demand segments with satisfaction and loyalty; and establish the sociodemographic aspects that characterize demand segments. The study was conducted during the Pilgrimage of the Christ of Miracles in Lima, Peru. The sample was taken on-site from 384 tourists. The statistical techniques used were factor analysis and the k-means clustering method. The results reveal five motivational dimensions: Religious Experience, Belief Experience, Escape, Touristic Experience, and Shopping. Three attendee segments were also identified: Believers, related to belief experience; Religious, related to religious experience; and Passive, tourists with low motivations. The Religious segment had the highest satisfaction and loyalty levels among these groups. Sociodemographic differences were also found in the demand segments. The findings will contribute to management guidelines for destination administrators with religious events and provide insights into academic literature.

Identifying priority double-duty actions to tackle the double burden of malnutrition in infants and young children in Peru: Assessment and prioritisation of government actions by national experts.

Multiple forms of malnutrition coexist in infants and young children (IYC) in Peru. The World Health Organization has proposed double-duty actions (DDAs) to simultaneously address undernutrition and overweight/obesity. We assessed current implementation of- and priority for- government-level actions to tackle multiple forms of malnutrition in IYC in Peru. Mapping of current policy activity was undertaken against 47 indicators of good practice for five DDAs (exclusive breastfeeding, complementary feeding, food marketing, maternal nutrition, preschool nutrition; assessed by 27 indicators) and for the enabling policy environment, i.e., 'infrastructure support' (health in all policies, platforms for interactions, financing, monitoring, governance, leadership; assessed by 20 indicators). Interviews with 16 national experts explored views on the level of and barriers to implementation of DDAs and infrastructure support, as well as their prioritisation based on likely impact and feasibility. The level of implementation of actions was categorised into two groups (agenda setting/formulation vs. implementation/evaluation). Mean scores were generated for prioritisation of DDAs and infrastructure support. Deductive qualitative analysis was undertaken to identify barriers that influence policy implementation. Only 5/27 DDA indicators were reported as fully implemented by all national experts (international code that regulates the marketing of breastmilk substitutes, iron supplementation for IYC, micronutrient powders in IYC, iron/folic acid supplementation in pregnant women, paid maternity leave). Only 1/20 infrastructure support indicator (access to nutrition information) was rated as fully implemented by all experts. Barriers to implementing DDAs and infrastructure support included: legal feasibility or lack of regulations, inadequate monitoring/evaluation to ensure enforcement, commercial influences on policymakers, insufficient resources, shifting public health priorities with the COVID-19 pandemic and political instability. The experts prioritised 12 indicators across all five DDAs and eight infrastructure support indicators. Experts highlighted the need to improve implementation of all DDAs and identified ways to strengthen the enabling policy environment.

Boosting self-efficacy and improving practices for smoking prevention and cessation among South American cancer care providers with a web-based algorithm.

BACKGROUND: Digital technologies have positively impacted the availability and usability of clinical algorithms through the advancement in mobile health. Therefore, this study aimed to determine if a web-based algorithm designed to support the decision-making process of cancer care providers (CCPs) differentially impacted their self-reported self-efficacy and practices for providing smoking prevention and cessation services in Peru and Colombia. METHODS: A simple decision-making tree algorithm was built in REDCap using information from an extensive review of the currently available smoking prevention and cessation resources. We employed a pre-post study design with a mixed-methods approach among 53 CCPs in Peru and Colombia for pilot-testing the web-based algorithm during a 3-month period. Wilcoxon signed-rank test was used to compare the CCPs' self-efficacy and practices before and after using the web-based algorithm. The usability of the web-based algorithm was quantitatively measured with the system usability scale (SUS), as well as qualitatively through the analysis of four focus groups conducted among the participating CCPs. RESULTS: The pre-post assessments indicated that the CCPs significantly improved their self-efficacy and practices toward smoking prevention and cessation services after using the web-based algorithm. The overall average SUS score obtained among study participants was 82.9 (± 9.33) [Peru 81.5; Colombia 84.1]. After completing the qualitative analysis of the focus groups transcripts, four themes emerged: limited resources currently available for smoking prevention and cessation in oncology settings, merits of the web-based algorithm, challenges with the web-based algorithm, and suggestions for improving this web-based decision-making tool. CONCLUSION: The web-based algorithm showed high usability and was well-received by the CCPs in Colombia and Peru, promoting a preliminary improvement in their smoking prevention and cessation self-efficacy and practices.

Mood and Sleep Quality in Peruvian Medical Students During COVID-19 Pandemic.

INTRODUCTION: The prolongation and consequences of the COVID-19 pandemic have led to an uncertain and devastating panorama in many populations, and the evidence shows a high prevalence of mental health problems in medical students. The objective was to evaluate the association between mood disorders and sleep quality (SQ) in Peruvian medical students during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted on 310 medical students from a private university in Peru. The SQ was measured using the Pittsburgh Sleep Quality Index (PSQI), while mood disorders were evaluated using the Depression Anxiety and Stress Scale-21 (DASS-21). All information was collected by online surveys and then analysed in the R programming language. RESULTS: The SQ results measured by PSQI were poor in 83.9% of the medical students. In the Poison regression analysis, the results of the bivariate analysis in men show that all mood disorders found the prevalence of poor SQ. However, in the multivariate analysis only stress (PRa=1.30; 95% CI, 1.08-1.57; P<0.01) and anxiety (PRa=1.34; 95% CI, 1.09-1.56; P <0.01) increased the prevalence of poor SQ. Women had a similar pattern in bivariate analysis, whereas in multivariate analysis, only severe stress (PRa=1.15; 95% CI, 1.01-1.29; P <0.05) increased the prevalence of poor SQ. CONCLUSIONS: This study allows us to observe the consequences that the COVID-19 pandemic is having on medical students in Peru. It also revealed a population group vulnerable to poor quality of sleep and bad mood, which in the future will impact on health. It is suggested to educate medical students about the importance of proper sleep hygiene and the consequences of poor sleep hygiene practices.

Longitudinal patterns of natural hazard exposures and anxiety and depression symptoms among young adults in four low- and middle-income countries.

We estimated the effect of community-level natural hazard exposure during prior developmental stages on later anxiety and depression symptoms among young adults and potential differences stratified by gender. We analyzed longitudinal data (2002-2020) on 5585 young adults between 19 and 26 years in Ethiopia, India, Peru, and Vietnam. A binary question identified community-level exposure, and psychometrically validated scales measured recent anxiety and depression symptoms. Young adults with three exposure histories ("time point 1," "time point 2," and "both time points") were contrasted with their unexposed peers. We applied a longitudinal targeted minimum loss-based estimator with an ensemble of machine learning algorithms for estimation. Young adults living in exposed communities did not exhibit substantially different anxiety or depression symptoms from their unexposed peers, except for young women in Ethiopia who exhibited less anxiety symptoms (average causal effect [ACE] estimate = - 8.86 [95% CI: - 17.04, - 0.68] anxiety score). In this study, singular and repeated natural hazard exposures generally were not associated with later anxiety and depression symptoms. Further examination is needed to understand how distal natural hazard exposures affect lifelong mental health, which aspects of natural hazards are most salient, how disaster relief may modify symptoms, and gendered, age-specific, and contextual differences.

Development and Pilot-Testing of an Optimized Conversational Agent or "Chatbot" for Peruvian Adolescents Living With HIV to Facilitate Mental Health Screening, Education, Self-Help, and Linkage to Care: Protocol for a Mixed Methods, Community-Engaged Study.

BACKGROUND: Adolescents living with HIV are disproportionally affected by depression, which worsens antiretroviral therapy adherence, increases viral load, and doubles the risk of mortality. Because most adolescents living with HIV live in low- and middle-income countries, few receive depression treatment due to a lack of mental health services and specialists in low-resource settings. Chatbot technology, used increasingly in health service delivery, is a promising approach for delivering low-intensity depression care to adolescents living with HIV in resource-constrained settings. OBJECTIVE: The goal of this study is to develop and pilot-test for the feasibility and acceptability of a prototype, optimized conversational agent (chatbot) to provide mental health education, self-help skills, and care linkage for adolescents living with HIV. METHODS: Chatbot development comprises 3 phases conducted over 2 years. In the first phase (year 1), formative research will be conducted to understand the views, opinions, and preferences of up to 48 youths aged 10-19 years (6 focus groups of up to 8 adolescents living with HIV per group), their caregivers (5 in-depth interviews), and HIV program personnel (5 in-depth interviews) regarding depression among adolescents living with HIV. We will also investigate the perceived acceptability of a mental health chatbot, including barriers and facilitators to accessing and using a chatbot for depression care by adolescents living with HIV. In the second phase (year 1), we will iteratively program a chatbot using the SmartBot360 software with successive versions (0.1, 0.2, and 0.3), meeting regularly with a Youth Advisory Board comprised of adolescents living with HIV who will guide and inform the chatbot development and content to arrive at a prototype version (version 1.0) for pilot-testing. In the third phase (year 2), we will pilot-test the prototype chatbot among 50 adolescents living with HIV naïve to its development. Participants will interact with the chatbot for up to 2 weeks, and data will be collected on the acceptability of the chatbot-delivered depression education and self-help strategies, depression knowledge changes, and intention to seek care linkage. RESULTS: The study was awarded in April 2022, received institutional review board approval in November 2022, received funding in December 2022, and commenced recruitment in March 2023. By the completion of study phases 1 and 2, we expect our chatbot to incorporate key needs and preferences gathered from focus groups and interviews to develop the chatbot. By the completion of study phase 3, we will have assessed the feasibility and acceptability of the prototype chatbot. Study phase 3 began in April 2024. Final results are expected by January 2025 and published thereafter. CONCLUSIONS: The study will produce a prototype mental health chatbot developed with and for adolescents living with HIV that will be ready for efficacy testing in a subsequent, larger study. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55559.

Prevalence of hypertension and diabetes mellitus in Peruvian patients with chronic kidney disease: a systematic review and meta-analysis.

BACKGROUND: Chronic Kidney Disease (CKD) represents a major challenge for public health, with hypertension and diabetes being the main causes of its occurrence. Therefore, this study aims to determine the prevalence of hypertension (HTN) and diabetes mellitus (DM) in Peruvian patients with CKD. METHODS: A systematic search for studies about CKD in Peru was carried out in PubMed, Scopus, Embase, Web of Science, ScienceDirect, Google Scholar, Virtual Health Library (VHL), and Scielo from 2011 to December 2023. The protocol of this research was registered in the international registry of systematic reviews, the Prospective International Registry of Systematic Reviews (PROSPERO), with registration number CRD42023425118. Study selection, quality assessment, and data extraction were performed independently by two authors. Study quality was assessed using the Joanna Briggs Institute Statistical Meta-Analysis Assessment and Review Instrument. A random-effects model with inverse variance weighting was used to estimate the combined prevalence of HTN and DM in Peruvian patients with CKD. To analyze data heterogeneity, the I2 statistical test was used. Statistical analysis was performed with R version 4.2.3. RESULTS: A total of 1425 studies were retrieved, of which 23 were included in the final meta-analysis. A total of 43,321 patients with CKD were evaluated, of whom 52.22% were male and 47.78% were female. The combined prevalence of HTN in Peruvian patients with CKD was 38% (95% CI: 30-46%; 41,131 participants; 21 studies, I2 = 99%, p = 0), while the combined prevalence of DM in Peruvian patients with CKD was 33% (95% CI: 26-40%; 43,321 participants; 23 studies, I2 = 99%, p = 0). CONCLUSION: Approximately one-third of Peruvian patients with CKD have HTN and DM. These findings highlight the importance of implementing prevention and control measures for these chronic noncommunicable diseases in the Peruvian population, such as promoting healthy lifestyles, encouraging early detection and proper management of hypertension and diabetes, and improving access to medical care and health services.

Quality of life and its associated factors in chronic kidney disease patients undergoing hemodialysis from a Peruvian city: A cross-sectional study.

OBJECTIVE: To assess quality of life and explore its associated factors in a group of patients with chronic kidney disease (CKD) undergoing hemodialysis in Peru. METHODOLOGY: We conducted a cross-sectional analysis of patients with CKD treated at two medical centers in Tacna, Peru; between July and September 2023. We conducted a survey via telephone interviews with eligible patients using the Short Form 36 (SF 36) to assess their quality of life. RESULTS: Of 257 patients with CKD undergoing hemodialysis, we successfully interviewed 207 (59.9% males, median age: 62 years, median time on hemodialysis: 3.5 years). In the context of the SF-36 assessment, the dimensions with the lowest scores were physical role (mean: 13.9), emotional role (32.2), and physical function (32.4). Regarding the SF-36 summary scores, the average scores were 42.2 in the mental health domain and 32.0 in the physical health domain. In the adjusted model, the physical health domain score was higher in males (ß = 2.7) and those with economic self-sufficiency (ß = 3.0) and lower in older adults (ß = -2.5). The score in the mental health domain was higher in those with a higher level of education (ß = 4.1), in those with economic self-sufficiency (ß = 3.8), and in those receiving care at one of the centers included (ß: 4.2). CONCLUSION: Quality of life was affected, particularly in the realms of physical and emotional well-being. Furthermore, both the physical and mental health domains tend to show lower scores among women, older individuals, those lacking economic self-sufficiency, individuals with lower educational levels, and those with comorbidities.

Association between gamma glutamyl transpeptidase to HDL-Cholesterol (GGT/HDL-C) ratio and metabolic syndrome resolution after sleeve gastrectomy.

OBJECTIVE: To evaluate the association between GGT/HDL-C ratio and resolution of MetS in adults after sleeve gastrectomy (SG). METHODS: We conducted a retrospective cohort study using secondary data from a Peruvian bariatric center. The study population consisted of adults aged 18 and above who underwent laparoscopic SG and were diagnosed with MetS prior to the surgery. The main outcome measured was MetS resolution 6 months post-surgery and the exposure variable was the GGT/HDL-C ratio. RESULTS: We analyzed 137 patients with a mean age of 38.9 ± 10.9 years; 64.2% were females. The median GGT/HDL-C ratio was 1.1 [0.7 - 1.5], and 83.9% of patients experienced resolution of MetS. Furthermore, both the middle tertile of GGT/HDL-C (aRR: 1.28; 95% CI: 1.04 - 1.58; p = .019) and the lowest tertile (aRR: 1.27; 95% CI: 1.01 - 1.60; p = .038) showed a significant association with the resolution of MetS. CONCLUSION: Eight out of 10 patients undergoing SG experience resolution of MetS within 6 months after surgery. Patients in the middle and lower tertiles of the GGT/HDL-C were more likely to achieve this outcome. Therefore, the GGT/HDL-C ratio should be considered a valuable and efficient biomarker for preoperative assessment of bariatric surgery candidates.

The role of cattle in the transmission of cystic echinococcosis in a highly endemic area of the Peruvian Andes.

Cystic echinococcosis (CE) causes significant losses in Andean livestock production and affects Andean food security. However, more studies are needed to understand the epidemiology of the disease. In addition, the potential contribution of Andean cattle to the transmission of Echinococcus granulosus sensu lato needs to be known. This study aimed to determine the CE-prevalence and its association with risk factors, such as age and sex of the animals, the parasite load (number of cysts/organ) of condemned organs, and the viability and fertility of Echinococcus cysts from cattle in the Andes. The prevalence was examined in 348 cattle from an authorized slaughterhouse of Huancayo at 3300 m altitude. Cyst burden was determined by extracting all cysts from the total of the CE-infected organs. Cyst fertility and protoscolices viability were analysed from 90 randomly selected CE-infected organs. The CE prevalence was 35.6% (124/348; 95% CI: 30.6%-40.6%). There was no significant effect of age and sex on CE prevalence. CE was significantly more prevalent (p < 0.05) in lungs than livers, 34.8% (121/348; 95% CI: 29.8%-39.8%) vs 8.9% (31/348; 95% CI: 5.9%-11.9%). Most (75%) infected organs had one to five cysts. The mean cyst burden was significantly (p = 0.018) higher in the lungs than livers, 6.4 ± 4.9 vs 3.7 ± 2.9. Cyst fertility was 1.6% (10/608; 95% CI: 0.6%-2.6%). Despite the high CE prevalence, infected organs from Andean cattle play a minor role in CE transmission to dogs in the central Peruvian Andes.

Immunohistochemistry and real-time Polymerase Chain Reaction: importance in the diagnosis of intestinal tuberculosis in a Peruvian population.

INTRODUCTION: The diagnosis of intestinal tuberculosis is challenging even nowadays. This study aims to report the positivity rates of new diagnostic methods such as immunohistochemistry and Real-Time Polymerase Chain Reaction in patients with intestinal tuberculosis, as well as describe the pathological and endoscopic features of intestinal tuberculosis in our population. METHODS: This was a retrospective observational study conducted in patients diagnosed with intestinal tuberculosis, between 2010 to 2023 from the Hospital Nacional Daniel Alcides Carrion and a Private Pathology Center, both located in Peru. Clinical data was obtained, histologic features were independently re-evaluated by three pathologists; and immunohistochemistry and real-time Polymerase Chain Reaction evaluation were performed. The 33 patients with intestinal tuberculosis who fulfilled the inclusion criteria were recruited. RESULTS: Immunohistochemistry was positive in 90.9% of cases, while real-time Polymerase Chain Reaction was positive in 38.7%. The ileocecal region was the most affected area (33.3%), and the most frequent endoscopic appearance was an ulcer (63.6%). Most of the granulomas were composed solely of epithelioid histiocytes (75.8%). Crypt architectural disarray was the second most frequent histologic finding (78.8%) after granulomas, but most of them were mild. CONCLUSION: Since immunohistochemistry does not require an intact cell wall, it demonstrates higher sensitivity compared to Ziehl-Neelsen staining. Therefore, it could be helpful for the diagnosis of paucibacillary tuberculosis.

Associations between social network addiction, anxiety symptoms, and risk of metabolic syndrome in Peruvian adolescents-a cross-sectional study.

Background: The link between physical and mental health and screen time in adolescents has been the subject of scientific scrutiny in recent years. However, there are few studies that have evaluated the association between social network addiction (SNA) and metabolic risk in this population. Objective: This study determined the association between SNA and anxiety symptoms with the risk of metabolic syndrome (MetS) in adolescents. Methods: A cross-sectional study was conducted in Peruvian adolescents aged 12 to 18 years, who completed a Social Network Addiction Questionnaire and the Generalized Anxiety Disorder 2-item scale (GAD-2), between September and November 2022. A total of 903 participants were included in the study using a non-probability convenience sample. Sociodemographic and anthropometric data were also collected. Binary logistic regression was used to explore the association between SNA and anxiety symptoms with MetS in a cross-sectional analysis. Results: Males were more likely to have MetS than females (OR = 1.133, p = 0.028). Participants who were 16 years of age or older and those with excess body weight were 2.166, p = 0.013 and 19.414, p < 0.001 times more likely to have MetS, respectively. Additionally, SNA (OR = 1.517, p = 0.016) and the presence of anxiety symptoms (OR = 2.596, p < 0.001) were associated with MetS. Conclusion: Our findings suggest associations between SNA, anxiety symptoms, and MetS among youth. However, more studies are needed to better understand this association and to deepen the possible clinical and public health implications.

La dinámica del comercio ilegal de armas de fuego en Lima, Perú / The dynamics of the illegal firearms trade in Lima, Peru / A dinâmica do comércio ilegal de armas de fogo em Lima, Peru

El comercio ilegal de armas de fuego representa un problema significativo para mantener el orden y la seguridad del país, pues conlleva la adquisición de armas y municiones sin cumplir la normatividad y las regulaciones proporcionadas por el Estado, desviando la utilización de dichos equipos hacia la delincuencia. La investigación tiene como propósito analizar la dinámica del comercio ilegal de armas de fuego en Lima, Perú, mediante una metodología cualitativa y de diseño fenomenológico hermenéutico. La muestra incluye veinte funcionarios de la Policía Nacional del Perú (PNP) y la Superintendencia Nacional de Control de Servicios de Seguridad, Armas, Municiones y Explosivos de Uso Civil (Sucamec). La información se recolectó por medio de entrevistas semiestructuradas. El estudio concluye que el comercio ilegal de armas de fuego se estructura en tres fases clave: la primera fase determinada por la filtración o desvío de armas del mercado legal al ilegal, debido a la falta de control y fiscalización por las autoridades pertinentes. La segunda fase implica la creación de un mercado ilegal en espacios itinerantes, donde participan diversos actores, como intermediarios y compradores. La tercera y última fase comprende la consumación del delito, incluye la entrega del arma y el pago bajo estrictas medidas de seguridad para asegurar la impunidad de los involucrados.

The illegal trade in firearms represents a significant problem for the maintenance of order and security in the country, as it leads to the acquisition of arms and ammunition without complying with the norms and regulations provided by the State, diverting the use of such equipment towards crime. The purpose of this research is to analyse the dynamics of the illegal firearms trade in Lima, Peru, using a qualitative methodology and a hermeneutic phenomenological design. The sample includes twenty officers from the Peruvian National Police (PNP) and the National Superintendence for the Control of Security Services, firearms, Ammunition and Explosives for Civilian Use (Sucamec). The information was collected through semi-structured interviews. The study concludes that the illegal firearms trade is structured in three key phases: the first phase determined by the leakage or diversion of arms from the legal to the illegal market, due to the lack of control and oversight by the relevant authorities. The second phase involves the creation of an illegal market in itinerant spaces, where various actors, such as intermediaries and buyers, participate. The third and final phase involves the consummation of the crime, including the delivery of the weapon and payment under strict security measures to ensure the impunity of those involved.

O comércio ilegal de armas de fogo representa um problema significativo para a manutenção da ordem e da segurança no país, pois leva à aquisição de armas e munições sem o cumprimento das normas e regulamentos fornecidos pelo Estado, desviando o uso desses equipamentos para o crime. O objetivo desta pesquisa é analisar a dinâmica do comércio ilegal de armas de fogo em Lima, Peru, usando uma metodologia qualitativa e um desenho fenomenológico hermenêutico. A amostra inclui vinte policiais da Polícia Nacional do Peru (PNP) e da Superintendência Nacional de Controle de Serviços de Segurança, Armas, Munições e Explosivos para Uso Civil (Sucamec). As informações foram coletadas por meio de entrevistas semiestruturadas. O estudo conclui que o comércio ilegal de armas de fogo está estruturado em três fases principais: a primeira fase é determinada pelo vazamento ou desvio de armas do mercado legal para o ilegal, devido à falta de controle e fiscalização por parte das autoridades competentes. A segunda fase envolve a criação de um mercado ilegal em espaços itinerantes, onde vários atores, como intermediários e compradores, participam. A terceira e última fase envolve a consumação do crime, incluindo a entrega da arma e o pagamento sob rigorosas medidas de segurança para garantir a impunidade dos envolvidos.

La labor del Protomedicato en la salud pública en el virreinato del Perú / O trabalho do Protomedicato na saúde pública no vice-reinado do Peru / The work of the Protomedicato in public health in the viceroyalty of Peru

El objetivo de la presente investigación es conocer el papelque cumplió el Protomedicato en la salud publica en elvirreinato del Perú. La metodología utilizada fue la narraciónhistórica siguiendo el método heurístico y hermenéutico,utilizando fuentes primarias documentales de archivoshistóricos peruanos y españoles. El resultado obtenido fueconfirmar que el Protomedicato veló por la salud de losvecinos y que tenía carácter administrativo judicial y susfunciones principales fueron regularizar la labor de los queejercieran cualquier tipo de atención sanitaria, otorgandolicencias, fijando aranceles y vigilando el trabajo realizadoen las boticas y la calidad de los medicamentos, a través devisitas periódicas. La conclusión determina que hubo mejorassanitarias como consecuencia de la gestión del Protomedicatoen el virreinato del Perú, proponiendo medidas salubrese, incluso, disponía la movilización de personal médico através del virreinato y participaba ante cualquier consultade otras entidades coloniales, como el cabildo, referentes asalud pública, como eliminación de acequias, declaraciónde pestes, y otros.(AU)

The objective of this research is to know the role that theProtomedicato played in public health in the viceroyaltyof Peru. The methodology used was historical narrationfollowing the heuristic and hermeneutic method, usingprimary documentary sources from Peruvian and Spanishhistorical archives. The result obtained was to confirm thatthe Protomedicato looked after the health of the neighborsand that it had a judicial administrative nature and its main functions were to regularize the work of those whocarried out any type of health care, granting licenses, settingtariffs and monitoring the work carried out in pharmaciesand the quality of medicines, through periodic visits. Theconclusion determines that there were health improvementsas a consequence of the management of the Protomedicato inthe viceroyalty of Peru, proposing health measures and evenordered the mobilization of medical personnel throughoutthe viceroyalty and participated in any consultation fromother colonial entities, such as the council, referring to publichealth, such as elimination of ditches, declaration of pests,and others.(AU)

O objetivo desta pesquisa é conhecer o papel que o Protomedicatodesempenhou na saúde pública no vice-reinado do Peru. Ametodologia utilizada foi a narração histórica seguindo o métodoheurístico e hermenêutico, utilizando fontes documentaisprimárias de arquivos históricos peruanos e espanhóis. Oresultado obtido foi confirmar que o Protomedicato zelava pelasaúde dos vizinhos e que tinha caráter administrativo judiciale suas principais funções eram regularizar o trabalho de quemrealizava qualquer tipo de assistência à saúde, concedendolicenças, fixando tarifas e acompanhamento do trabalhorealizado nas farmácias e da qualidade dos medicamentos,através de visitas periódicas. A conclusão determina quehouve melhorias na saúde como consequência da gestão doProtomedicato no vice-reinado do Peru, propondo medidassanitárias e ainda ordenou a mobilização de pessoal médicoem todo o vice-reinado e participou de qualquer consultade outras entidades coloniais, como o conselho. , referentesà saúde pública, como eliminação de valas, declaração depragas, entre outros.(AU)

Crecimiento físico y aptitud física de nadadores y no nadadores de una región del Perú / Physical growth and fitness of swimmers and non-swimmers in a Peruvian region

Introducción: La evaluación del crecimiento físico y la aptitud física es considerada una tarea beneficiosa para la salud y del rendimiento deportivo. Objetivo: Comparar el crecimiento físico y la aptitud física de jóvenes nadadores y no-nadadores de una región del Perú. Metodología: Se efectuó un estudio descriptivo (comparativo) en niños y adolescentes de 6 a 13 años. Se conformó dos grupos de estudio. Grupo 1: Practicantes de natación (nadadores) y Grupo 2: No-practicantes de natación (no-nadadores). Se evaluó las medidas antropométricas de peso, estatura, circunferencia de la cintura (CC) y las pruebas físicas de salto horizontal (SH) y agilidad. Se calculó el Índice de Masa Corporal (IMC) y el estado de madurez. Resultados: No hubo diferencias en el peso y estatura entre ambos grupos en todos los rangos de edad (p>0,05). En la CC, los nadadores de ambos sexos mostraron valores inferiores en relación a los no-nadadores al menos desde los 6-7 años, 8-9 años y 10-11 años (p<0,05). En las pruebas físicas, no hubo diferencias en la agilidad entre ambos grupos (p>0,05), sin embargo, en el SH, los nadadores mostraron mejor despeño que sus similares no-nadadores (P<0,05), en los hombres a los 10-11 años y 12-13 años (p<0,05) y en las mujeres en todos los rangos de edad (p<0,05). Conclusión: Los jóvenes nadadores y no-nadadores presentaron un similar patrón de crecimiento físico en peso y estatura, excepto en la CC, donde los no-nadadores mostraron valores superiores. En las pruebas físicas, ambos grupos evidenciaron similares valores de agilidad en todos los rangos de edad y los nadadores mostraron mejores resultados en el SH que sus similares no nadadores. Estos resultados sugieren la práctica de la natación de tres veces por semana, lo que podría ayudar a mantener un adecuado perfil antropométrico y mejorar la fuerza de los miembros inferiores.(AU)

Introduction: The evaluation of physical growth and fit-ness is considered a beneficial task for health and sports per-formance.Objective: To compare the physical growth and fitness ofyoung swimmers and non-swimmers in a region of Peru Methodology: A descriptive (comparative) study was car-ried out in children and adolescents aged 6 to 13 years. Twostudy groups were formed. Group 1: Swimming practitioners(swimmers) and Group 2: Non-swimming practitioners (non-swimmers). Anthropometric measurements of weight, height,sitting height, waist circumference (WC) and the physicaltests of horizontal jump (HH) and agility were evaluated.Body Mass Index (BMI) and maturity status were calculated.Significant differences were determined by means of the “t”test for independent samples.Results: There were no differences in weight, sittingheight and height between both groups in all age ranges(p>0.05). In CC, swimmers of both sexes showed lower val-ues in relation to non-swimmers at least from 6-7 years, 8-9years and 10-11 years (p<0.05). In the physical tests, therewere no differences in agility between both groups (p>0.05),however, in the SH, swimmers showed better performancethan their similar non-swimmers (P<0.05), in males at 10-11years and 12-13 years (p<0.05) and in females in all ageranges (p<0.05).Conclusion: Young swimmers and non-swimmers pre-sented a similar pattern of physical growth in weight andheight, except in CC, where non-swimmers showed highervalues. In the physical tests, both groups evidenced similaragility values in all age ranges and swimmers showed betterresults in SH than their similar non-swimmers. These resultssuggest that the practice of swimming three times a week hasa positive role on the anthropometric profile, adipose andlower limb strength performance.(AU)

Talla baja asociado a errores de refracción ocular en escolaresde Muquiyauyo, Perú / Short stature associated with ocular refractive errors in schoolchildren in Muquiyauyo, Peru

Objetivo: Determinar la asociación entre talla baja y erro-res de refracción ocular en escolares de Muquiyauyo. Metodología: El tamaño de la población estuvo constituidapor 250 escolares y el tamaño muestral (n) para el nivel deconfianza 99.99% fue de 215 escolares, el estudio fue analí-tico observacional transversal, y la técnica utilizada para la re-colección de datos fue de observación y encuesta medianteuna ficha con datos de medición antropométrica y refracciónocular (medida de vista con autokeratorefractometro). Resultados: De los 215 niños evaluados 158 presentanerrores de refracción ocular, a quienes se les realizó la medidade vista con autokeratorefractometro; presentando 17 niñosmiopía, 9 hipermetropía, 21 astigmatismo, 32 miopía y astig-matismo y 79 hipermetropía y astigmatismo. Con respecto al análisis bivariado de talla baja y miopía, astigmatismo, hiperme tropía se encontraron que los niños que tienen tallabaja se asociaron significativamente con el astigmatismo p = <0.0000965, la razón de prevalencia =2.33 IC (1.44,3.78); es decir, que los que presentan talla baja tienen dosveces más el riesgo de presentar astigmatismo. Los niños que presentaron talla baja se asocian significati-vamente con refracción ocular P=<0.01 razón de prevalencia6.81 IC (2.57,18.1). Conclusión: Los escolares de Muquiyauyo con talla bajatienen 6 veces más riesgo de presentar alteraciones en la re-fracción ocular.(AU)

Objective: To determine the association between shortstature and ocular refractive errors in schoolchildren inMuquiyauyo. Methodology: The population size consisted of 250 scho-olchildren and the sample size(n) for the 99.99% confidencelevel was 215 schoolchildren. The study was a cross-sectionalobservational analytical study, and the technique used fordata collection was observation and survey using an anthro-pometric measurement and ocular refraction data sheet (eyemeasurement with autokeratorefractometer). Results: Of the 215 children evaluated, 158 had ocular re-fractive errors, and their eyesight was measured with an au-tokeratorefractometer; 17 children had myopia, 9 had hypero-pia, 21 had astigmatism, 32 had myopia and astigmatism and79 had hyperopia and astigmatism. With respect to the biva-riate analysis of short stature and myopia, astigmatism andhyperopia, it was found that children with short stature weresignificantly associated with astigmatism p = <0.0000965,prevalence ratio =2.33 CI (1.44, 3.78); that is, those withshort stature have twice the risk of presenting astigmatism. Children with short stature are significantly associated withocular refraction P=<0.01 prevalence ratio 6.81 CI (2.57,18.1). Conclusion: Muquiyauyo school children with short statureare 6 times more likely to have ocular refractive disorders.(AU)

Estado nutricional de los escolares y conocimientos sobre lonchera saludable de las madres, Lima-Perú / Nutritional status of schoolchildren and mothers’ knowledge of healthy lunchboxes, Lima-Perú

Introducción: Durante la etapa escolar la familia cumple un rol importante en el estilo de alimentación del niño, sin embargo, las decisiones que toman los padres sobre la práctica de alimentación son influenciados por factores sociales, culturales y/o económicos.Objetivo: Identificar la relación entre el estado nutricional del escolar y conocimientos sobre loncheras de las madres de una institución educativa.Material y métodos: La investigación fue de enfoque cuantitativo, diseño no experimental, transversal y correlacional. Contó con una muestra no probabilística por conveniencia formada por 133 escolares de ambos sexos de las edades de 6 a 12 años y también participaron sus respectivas madres (n= 133) y edad promedio de 23 años (DE=2.3). Se utilizó una ficha de registros de evaluación nutricional y el cuestionario de conocimientos el cual fue validado a través del juicio de expertos, con una excelente confiabilidad y validez. Para el análisis estadístico se utilizó el SPSS, se empleó la prueba Chi-cuadrado.Resultados: El estado nutricional de los escolares según IMC/ Edad fue 73.6% normal y 2.3% delgadez; el 91% presentaron talla normal, 7.5% talla baja y 1.5% talla alta. El nivel de conocimiento sobre lonchera saludable de las madres fue bajo con 2.3%, regular con 50.4% y alto con 47.4%. Existe relación entre el IMC/edad del escolar y los conocimientos sobre loncheras en las madres (p= 0.024), pero no existe relación entre la talla/edad del escolar (p= 0.527).Conclusiones: Existe relación entre el IMC/Edad del escolar y los conocimientos sobre loncheras en las madres de una institución educativa.

Introduction: During the school stage, the family plays animportant role in the child’s feeding style; however, the deci-sions made by parents about feeding practices are influencedby social, cultural and/or economic factors.Objective: To identify the relationship between the nutri-tional status of schoolchildren and knowledge about lunchboxes among mothers in an educational institution.Material and methods: The research had a quantitativeapproach, non-experimental, cross-sectional and correlationaldesign. It had a non-probabilistic sample by convenienceformed by 133 schoolchildren of both sexes from 6 to 12 yearsof age and their respective mothers also participated and av-erage age of 23 years (SD=2.3). A nutritional evaluationrecord card and the knowledge questionnaire were used, which was validated through expert judgment, with excellentreliability and validity. For the statistical analysis, SPSS wasused, the Chi-square test was used to relate the nutritionalstatus variables of the schoolchildren and the mothers’knowledge of healthy lunch boxes.Results: The nutritional status of the schoolchildren ac-cording to BMI/age was 73.6% normal and 2.3% thin; 91%were normal height, 7.5% short height and 1.5% tall height.The mothers’ level of knowledge of healthy lunchboxes waslow at 2.3%, regular at 50.4% and high at 47.4%. There isa relationship between BMI/age of the schoolchild andknowledge about lunch boxes in mothers (p= 0.024), butthere is no relationship between height/age of the school-child (p= 0.527).Conclusions:Obesity and overweight are associated withknowledge about a healthy lunch box; a high-calorie lunchbox increases the student’s energy needs; however, there wasno relationship in height due to factors such as cost andcultural and social preferences.(AU)

Consumo de alimentos ultraprocesados y somatotipo en estudiantes de una institución educativa pública de la Amazonía Peruana / Consumption of ultra-processed foods and somatotype in students of a publiceducational institution in the Peruvian Amazon

Introducción: El consumo de alimentos ultraprocesados condiciona el biotipo de una persona. Objetivo: determinar la asociación entre el consumo de alimentos ultraprocesados y el somatotipo en escolares de una institución educativa pública de la región Loreto. Materiales y Métodos: se trata de una investigación de enfoque cualitativo, con un diseño no experimental, transversal y correlacional. La muestra final del estudio estuvo conformada por 171 escolares del tercero, cuarto y quinto grado de nivel secundario durante el período académico correspondiente al año 2022 en la institución educativa pública 60050, República de Venezuela, Loreto (Perú). Se incluyó a estudiantes que entregaron el consentimiento y asentimiento informado, menores de 18 años y con matrícula vigente. La valoración antropométrica se realizó mediante el método de Health-Carter; la medición del nivel de consumo de alimentos ultraprocesados se realizó mediante una la aplicación de una encuesta de consumo de alimentos ultraprocesados. Para evaluar la asociación de las variables se utilizó la prueba estadística Chi cuadrado. Resultados: se logró determinar que el 47,4% de la población presenta como biotipo predominante el endomorfismo, con una mayor presencia de población femenina, que el 36,3% de la población presenta un biotipo mesomórfico y que el 16,4% presenta un biotipo ectomórfico. Al evaluar el consumo de alimentos ultraprocesados, se determinó que el 58,5% de la población muestra tener un alto consumo de alimentos ultraprocesados, con una mayor presencia de la población masculina, que el 32,2% presenta un consumo en riesgo y que el 9,4% presenta un bajo consumo de estos. Al analizar la asociación entre el consumo de alimentos ultraprocesados y el somatotipo en escolares se obtuvo un valor p>0,05. Conclusión: el consumo de alimentos ultraprocesados no tiene asociación con el somatotipo en escolares de una institución educativa pública en la Amazonía peruana.(AU)

Introduction: The consumption of ultra-processed food sconditions a person’s biotype. A parameter for its evaluationis the anthropometric assessment of the somatotype and asurvey of consumption of ultra-processed foods to assesstheir consumption levels. Objective: determine the association between the con-sumption of ultra-processed foods and somatotype in school-children from a public educational institution in the Peruvian Amazon. Materials and Methods: qualitative research approach,with a non-experimental, transversal and correlational design.The final sample of the study was made up of 171 studentsfrom the third, fourth and fifth grades of secondary schoolduring the academic period corresponding to the year 2022.It included students who provided informed consent and as-sent, under 18 years of age and with current registration. Theanthropometric assessment was performed using the Heath-Carter method; The measurement of the level of consumptionof ultra-processed foods was carried out through a food con-sumption frequency survey. Results: 47.4% of the population presents endomorphismas the predominant biotype, with a greater presence of thefemale population, 36.3% of the population presents a meso-morphic biotype and 16.4% presents an ectomorphic biotype.When evaluating the consumption of ultra-processed foods, itwas determined that 57.8% of the population shows a highconsumption of ultra-processed foods, with a greater pres-ence of the male population; that 32.2% have irrigation con-sumption and that 9.4% have low irrigation consumption. Theresults indicate that there is no statistically significant rela-tionship between the consumption of ultra-processed foodsand the type of somatotype present in the study population. Conclusion: Despite the high consumption of ultra-processed foods, no association was found with somatotype,because there are several factors that determine somatotypein this age group...(AU)