El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Purpose We sought to evaluate the extent to which childhood physical and/or sexual abuse history is associated with post-traumatic stress disorder (PTSD) during early pregnancy and to explore the extent to which the childhood abuse-PTSD association is mediated through, or modified by, adult experiences of intimate partner violence (IPV). Methods In-person interviews collected information regarding history of childhood abuse and IPV from 2,928 women aged 18-49 years old prior to 16 weeks of gestation. PTSD was assessed using the PTSD Checklist-Civilian Version. Multivariate logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Compared to women with no childhood abuse, the odds of PTSD were increased 4.31-fold for those who reported physical abuse only (95% CI, 2.18–8.49), 5.33-fold for sexual abuse only (95% CI, 2.38–11.98), and 8.03-fold for those who reported physical and sexual abuse (95% CI, 4.10–15.74). Mediation analysis showed 13% of the childhood abuse-PTSD association was mediated by IPV. Furthermore, high odds of PTSD were noted among women with histories of childhood abuse and IPV compared with women who were not exposed to either (OR = 20.20; 95% CI, 8.18–49.85). Conclusions Childhood abuse is associated with increased odds of PTSD during early pregnancy. The odds of PTSD were particularly elevated among women with a history of childhood abuse and IPV. Efforts should be made to prevent childhood abuse and mitigate its effects on women's mental health. / Revisión por pares

Aim: To assess if there is an association between sitting time and obesity among adult Peruvian population, using three different anthropometric measurements. Methods: A secondary analysis using data from a population-based study, the National Household Survey (ENAHO, in Spanish), was conducted enrolling adults aged ≥18 years from the 25 regions of Peru using a multistage random sampling technique. The outcome of interest was obesity, determined by body mass index (BMI > 30 kg/m2), waist circumference (WC > 80 and >90 cm in women and men, respectively) and waist to height ratio (WHR > 0.5); while the exposure was sitting time, measured using the last domain of the International Physical Activity Questionnaire and then categorised in <4 hours/day, 4 to <8 hours/day and 8+ hours/day. Associations were estimated using Poisson regression models, reporting prevalence ratios (PRs) and their respective 95% CI. Results: Data from 8587 subjects were analysed; mean age was 38.4 (SD: 13.5) and 53.6% were females. The prevalence of obesity was 16.3% (95% CI: 15.2–17.5%) by BMI, 58.5% (95% CI: 56.9–60.0%) by WC, and 78.0% (95% CI: 76.5–79.3%) by WHR. In the multivariable model, subjects reporting a sitting time of 8+ hours/day were more likely to be obese than those reporting <4 hours/day according to BMI (PR: 1.38; 95% CI: 1.15–1.65), WC (PR: 1.20; 95% CI: 1.12–1.28) and WHR (PR: 1.05; 95% CI: 1.01–1.10). Conclusions: Subjects with greater sitting time were more likely to be obese, and this association was evident with three different anthropometric indicators. Findings suggest the need of generating public health actions to reduce sedentary behaviour. / Revisión por pares / Revisión por pares

Background: Recent analyses have described metabolomic markers for depression and suicidal ideation in non-pregnant adults. We examined the metabolomic profile of antepartum depression and suicidal ideation during mid-pregnancy, a time of high susceptibility to mood disorders. Methods: We collected fasting blood from 100 pregnant Peruvian women and profiled 307 plasma metabolites using liquid chromatography-mass spectrometry. We used the Patient Health Questionnaire 9 to define antepartum depression (score ≥ 10) and suicidal ideation (having thoughts that you would be better off dead, or of hurting yourself). Logistic regression was used to calculate odds ratios (ORs). Results: Three triacylglycerol metabolites (C48:5 triacylglycerol [OR = =1.89; 95% confidence interval (CI): 1.14–3.14], C50:6 triacylglycerol [OR = =1.88; 95%CI: 1.13–3.14], C46:4 triacylglycerol [OR = =1.89; 95%CI: 1.11–3.21]) were associated with higher odds of antepartum depression and 4 metabolites (betaine [OR = =0.56; 95%CI:0.33–0.95], citrulline [OR = =0.58; 95%CI: 0.34–0.98], C5 carnitine [OR = =0.59; 95%CI: 0.36–0.99], C5:1 carnitine [OR = =0.59; 95%CI: 0.35–1.00]) with lower odds of antepartum depression. Twenty-six metabolites, including 5-hydroxytryptophan (OR = =0.52; 95%CI: 0.30–0.92), phenylalanine (OR = =0.41; 95%CI: 0.19–0.91), and betaine (OR = =0.53; 95%CI: 0.28–0.99) were associated with lower odds of suicidal ideation. Limitations: Our cross-sectional study could not determine whether metabolites prospectively predict outcomes. No metabolites remained significant after multiple testing correction; these novel findings should be replicated in a larger sample. Conclusions: Antepartum suicidal ideation metabolomic markers are similar to markers of depression among non-pregnant adults, and distinct from markers of antepartum depression. Findings suggest that mood disorder in pregnancy shares metabolomic similarities to mood disorder at other times and may further understanding of these conditions’ pathophysiology. / Revisión por pares

Objective: To describe the prevalence of dengue virus serotypes, as well as other viral and bacterial pathogens that cause acute febrile illness during an outbreak in Cajamarca in 2016. Results: Dengue virus (DENV) was the most frequent etiologic agent detected in 25.8% of samples (32/124), followed by Rickettsia spp. in 8.1% (10/124), Zika virus in 4.8% (6/124), Chikungunya virus 2.4% (3/124) and Bartonella bacilliformis 1.6% (2/124) cases. No positive cases were detected of Oropouche virus and Leptospira spp. DENV serotypes identification was only achieved in 23% of the total positive for DENV, two samples for DENV-2 and four samples for DENV-4. During the 2016 outbreak in Cajamarca-Peru, it was observed that in a large percentage of positive samples for DENV, the infecting serotype could not be determined by conventional detection assays. This represents a problem for the national surveillance system and for public health due to its epidemiological and clinical implications. Other viral and bacterial pathogens responsible for acute febrile syndrome were less frequently identified. / Revisión por pares

Introduction: Bariatric surgery is considered the most effective treatment for severe obesity. However, it is not clear if patients with diabetes mellitus or insulin resistance have the same response than patients without those conditions. Our objective was to evaluate association between pre-surgical HOMA-IR index and percentage of excess weight loss (EWL%) one year after bariatric surgery using sleeve gastrectomy. Methods: Retrospective cohort including patients ≥ 18 years old with BMI ≥ 35 kg/m2, who underwent primary sleeve gastrectomy between 2014-2017 at the Avendaño Medical Center, Peru. Only patients with Type 2 Diabetes, Hypertension, or Dyslipidemia were included. EWL% ≥ 60% one year after surgery was considered satisfactory. Crude and adjusted Lineal and Poisson regression with robustness was used to assess statistical associations with EWL%. Results: Ninety-one patients were included with a median of 34 years, and 57.1% were women. 85.7% had insulin resistance as per HOMA-IR. One year after surgery, 76.9% had a satisfactory EWL%. The lineal model showed. 29% less EWL% per each extra year of life (P = .019), and. 93% more EWL% per each extra HOMA-IR point (P = .004). The adjusted Poisson model showed 2% lower risk of having a satisfactory EWL% per each additional year of life (P = .050), and 2% more chance of success per each additional HOMA-IR point (P = .038). Conclusions: There was association between a higher pre-surgical HOMA-IR index and increased EWL% one year after surgery. It is possible that insulin resistance does not affect negatively sleeve gastrectomy outcomes. / Revisión por pares

Growing concern about the ongoing environmental crisis has prompted an increased awareness of pollution and climate change. These grave environmental problems are often framed as pressing global issues, but they take unique forms in different locations. This thesis endeavours to contextualize these global issues and explore how they are apprehended at a local level. Through a focus on embodied experiential knowledge and social, political, and historical context, I have examined the specificity and local character of what it means to live with pollution and climate change in Lima, Peru. Based on ethnographic fieldwork in Lima’s Cono Sur, including participant observation and interviews, I argue that environmental understandings and practices must be seen as embodied, historical, and situated in time and space.

This diploma thesis examines the influence of sport activity on human drug addiction, as well as the influence of coaching on the quality and benefits of sport exercises in the group and community. Sport is currently not being used as a part of the drug addiction treatment, although it has been a topic in many researches and studies. For a purpose of application of the acquired findings the case study is used to examine options of inclusion of guided sport activities in a drug addiction treatment program. In order of the application, a development project is created to enhance efficiency of drug addiction treatment in Takiwasi centre, Peru, which uses traditional Amazonian medicine to treat drug addiction. In view of the faint use of sport activities in Takiwasi centre, this thesis presents development project proposal to increase the effectiveness of drug treatment in the community of the centre, located in San Martín region.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / In this document it was proposed to apply Lean Agriculture, using the five Lean principles focused on the production of organic apples, which would allow to achieve a differentiated product, through the reduction of waste, improvements in the quality of activities and the commitment of the farmers. For this, a review of the literature that corroborated the impact of the methodology was carried out. In addition, surveys were conducted, taking a sample of farmers, which evidenced the gap. Finally it was obtained as a conclusion that after the implementation of the Lean Agriculture methodology in the processes, an increase in production suitable for sale in traditional and organic markets is achieved. In addition, the increase in quality achieved a percent of production suitable for exporting.

Objective: To describe frequency and clinical characteristics of MAYV infection in Piura, as well as the association of this pathogen with DENV. Results: A total of 86/496 (17.3%) cases of MAYV were detected, of which 54 were MAYV mono-infection and 32 were co-infection with DENV, accounting for 10.9% and 6.4%, respectively. When evaluating monoinfection by MAYV the main groups were 18–39 and 40–59 years old, with 25.9% and 20.4% respectively. Co-infections were more common in the age group 18–39 and those > 60 years old, with 34.4% and 21.9%, respectively. The most frequent clinical presentation were headaches (94.4%, 51/54) followed by arthralgias (77.8%, 42/54). During the 8-month study period the most cases were identified in the months of May (29.1%) and June (50.0%). / National Research Foundation of Korea / Revisión por pares

This study focuses on the clitic pronoun usage by Spanish-Quechua bilingual speakers in Cuzco, Peru when faced with a question that includes a definite article preceding the direct object. Answers are analyzed to determine whether or not the definite article has an effect on the presence or absence of the clitic pronoun. Direct objects tested were both [+human] and [-human] objects to determine if these variables affect clitic pronoun use as well. Speakers who have identified themselves as bilingual in both Spanish and Quechua were given a survey to complete in order to see what factors may contribute to the use or omission of the clitic pronouns.