En el Perú y el mundo hay tendencias importantes en crecimiento, por un lado tenemos los cambios sociales respecto al bienestar de la salud física y mental donde jóvenes y mayores buscan alimentarse saludablemente reduciendo el azúcar, harinas o grasas, bebiendo más agua o practicando actividades relacionadas al deporte. Negocios cómo los gimnasios, spa, sauna, etc. vienen creciendo anualmente, así mismo, la importancia de un buen descanso para las personas está ganando un lugar importante en esta tendencia y es que la llamada “calidad de sueño” es más que solo dormir, es el momento donde el cuerpo recupera y se prepara física y mentalmente para afrontar las actividades diarias de las personas. Por otro lado, la evolución de la tecnología es parte de nuestras vidas, desde muy pequeños convivimos con productos inteligentes y contar con uno no es solo estar actualizado sino ganar un status en la sociedad actual. Debido a esto, es una gran oportunidad para Smart Blanket lanzar un producto inteligente que cubra esta necesidad contribuyendo a la salud y a través de la tecnología. Existen aplicaciones exitosas dedicadas a mejorar la calidad de sueño a través de melodías relajantes, por lo que ya hay intención de cubrir esta necesidad y nuestro producto lo hace de la misma forma y mejor teniendo otras consideraciones importantes que se detallan a la largo del proyecto donde demostraremos también, que con una inversión inicial de S/. 81,145.00 podemos generar importantes ingresos, una rentabilidad que nos permita recuperar la inversión dentro del primer año y una escalabilidad a otros sectores del país o incluso con otros productos relacionados. / In Peru and the world there are important trends in growth, on the one hand we have social changes regarding the well-being of physical and mental health where young and old seek to eat healthy by reducing sugar, flour or fat, drinking more water or practicing related activities to sport. Business like gyms, spa, sauna, etc. They have been growing annually, likewise, the importance of a good rest for people is gaining an important place in this trend and is that the so-called "quality of sleep" is more than just sleeping, it is the time when the body recovers and prepares physically and mentally to deal with people's daily activities. On the other hand, the evolution of technology is part of our lives, from a very young age we coexisted with smart products and having one is not only up-to-date but also gaining a status in today's society. Because of this, it is a great opportunity for Smart blanked to launch a smart product that meets this need by contributing to health and through technology. There are successful applications dedicated to improving sleep quality through relaxing melodies, so there is already an intention to cover this need and our product does it in the same way and better having other important considerations that are detailed throughout the project where We will also demonstrate that with an initial investment of S /. 81,145.00 we can generate significant income, a return that allows us to recover the investment within the first year and scalability to other sectors of the country or even with other related products. / Trabajo de investigación

Objetivo: Evaluar la asociación entre la calidad del sueño y la depresión perinatal en gestantes que cursan entre la semana de gestación 12 y la semana de gestación 36 en un centro materno infantil de Lima . Materiales y Métodos: Estudio transversal analítico en gestantes atendidas en un centro de atención primaria entre agosto y diciembre del año 2019 . Los datos se recogieron mediante una encuesta auto aplicada. Se empleó el Índice de calidad del sueño de Pittsburgh (PSQI) para la evaluación de la calidad de sueño. La evaluación de la depresión perinatal fue con la escala de Depresión Postnatal de Edimburgo (EPDS). Para el análisis multivariado se utilizó la regresión de Poisson con varianzas robustas a fin de calcular las razones de prevalencia crudas y ajustadas y sus respectivos intervalos de confianza. Resultados: Se incluyeron 200 participantes. La mediana de la edad fue de 26 años (RIQ :22-32) y 111 (55.5%) gestaciones fueron no planificadas. El 52% presento una mala calidad de sueño y el riesgo de depresión perinatal fue del 31.5%. La mala calidad de sueño se asoció con una frecuencia significativamente mayor de depresión perinatal. ( RPa de 4.8 para aquellas con mala calidad de sueño que merece atención médica presentaron , RPa de 6.6 para aquellas con mala calidad de sueño que merece atención y tratamiento médico). Conclusiones : Existe una asociación entre la mala calidad del sueño y la depresión perinatal en gestantes entre las semanas 12 y 36 de gestación. Se debe promover investigaciones operativas a fin de evaluar si intervenciones para mejorar la calidad del sueño podrían tener un impacto positivo en la reducción de la depresión perinatal. / Objective: Evaluate the association between sleep quality and perinatal depression in pregnant women between the 12th week of gestation and the 36th week of gestation in a maternal and child center in Lima. Materials and Methods: Analytical cross-sectional study in pregnant women cared for in a primary care center between August and December 2019. The data were collected through a self-administered survey. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The evaluation of perinatal depression was with the Edinburgh Postnatal Depression Scale (EPDS). For the multivariate analysis, Poisson regression with robust variances was used to calculate the crude and adjusted prevalence ratios and their respective confidence intervals. Results: The sample was composed of 200 participants. The median age was 26 years (IQR: 22-32) and 111 (55.5%) pregnancies were unplanned. 52% presented a poor quality of sleep and the risk of perinatal depression was 31.5%. Poor quality of sleep was associated with a significantly higher frequency of perinatal depression. (RPa of 4.8 for those with poor quality of sleep that deserves medical attention and RPa of 6.6 for those with poor quality of sleep that deserves medical attention and treatment). Conclusion: There is an association between poor sleep quality and perinatal depression in pregnant women between weeks 12 and 36 of gestation. Operational research should be promoted to assess whether interventions to improve sleep quality could have a positive impact on reducing perinatal depression. / Tesis

Objetivo: Determinar si existe una relación entre el consumo de una dieta mediterránea y la calidad de sueño en adultos de Lima, Perú - 2020. Método: Estudio transversal analítico con una muestra de 313 adultos entre las edades de 18 a 64 años invitados a participar por medio de las plataformas virtuales Facebook e Instagram. Se evaluó la prevalencia de consumo de una dieta mediterránea por medio de la encuesta “Cálculo del Índice Chileno de la Dieta Mediterránea” y la calidad de sueño por la encuesta “Índice de Calidad de Sueño de Pittsburgh”, la cual fue validada en una población peruana. Se calcularon razones de prevalencia crudas (RPc) y ajustadas (RPa) mediante regresión de Poisson. Resultados: No se encontró una asociación significativa entre la calidad de sueño y la adherencia regular (RPa = 0.99; IC 95%: 0.96 – 1.02) o buena (RPa = 0.93; IC 95%: 0.86-1.01) a una dieta mediterránea. Además, se determinó que las personas de sexo masculino tienden a tener una mejor calidad de sueño a comparación del sexo femenino (RPa = 0.94; IC 95%: 0.90 -0.97). De igual manera, se pudo apreciar que las personas que cursaban entre las edades de 51 a 64 años tenían una mejor calidad de sueño a comparación de las personas que cursaban entre las edades de 18 a 20 años (RPa = 0.92; IC 95%: 0.87-0.98). Asimismo, se pudo estimar una asociación significativa entre el sobrepeso/obesidad con una mejor calidad de sueño; sin embargo, al realizar el análisis crudo y ajustado este pierde su significancia. Conclusiones: No se logró determinar una asociación entre el consumo de una dieta mediterránea y la calidad de sueño en adultos de Lima – Perú - 2020, esto se pudo deber a que no se midió las variables de confinamiento social, el cual aumenta los niveles de ansiedad y depresión que son un factor determinante en la calidad de sueño. / Objective: To determine if there is a relationship between the consumption of a mediterranean diet and the quality of sleep in adults from Lima, Peru - 2020. Method: Analytical cross-sectional study with a sample of 313 adults between the ages of 18 to 64 years, who were invited to participate through the virtual platforms Facebook and Instagram. The prevalence of consumption of a mediterranean diet was evaluated through the survey "Calculation of the Chilean Mediterranean Diet Index”; and the quality of sleep, by the survey “Pittsburgh Sleep Quality Index”, which was validated in peruvian population. To perform statistical analysis, crude prevalence ratios (cRP) and adjusted prevalence ratios (aRP) were calculated using Poisson regression. Results: No significant association was found between quality of sleep and regular (aPR = 0.99; 95% CI:0.96 - 1.02) or good (aPR = 0.93; 95% CI:0.86-1.01) adherence to a mediterranean diet. In addition, it was determined that male persons tend to have a better quality of sleep compared to female with a (aPR = 0.94; 95% CI 0.90 -0.97). Likewise, it could be seen that people who were between the ages from 51 to 64 years had a better quality of sleep compared to people who were between the ages of 18 to 20 years (aPR = 0.92; 95% CI 0.87-0.98). As well, it was possible to estimate a significant association between being overweight/obese with a better quality of sleep; however, when performing the crude and adjusted analysis, it loses its significance. Conclusions: It was not possible to determine an association between the consumption of a Mediterranean diet and the quality of sleep in adults from Lima – Peru - 2020, this could be due to the fact that the variables of social confinement were not measured, which increases the levels of anxiety and depression that are a determining factor in the quality of sleep. / Tesis

Critics generally read the matter of diagetic subjectivity as existential in Carlos Solórzano's works Las manos de Dios and El sueño del ángel. This study, however, seeks to explore the possibility of non-existential modes of subjectivity in these dramas. It posits an Althusserian mode of subjectivity due to the central conflict of the plays revolving around the oppressive rituals of a controlling church institution. Although the author expresses existential ideals, a reading that takes into account the issue of the church as an ideology producing mechanism, as well as its modes of operation, shows that on the diagetic level the experience of the characters is one in which they find themselves in a world where individuals operate as non-autonomous subjects.

El estrés académico en estudiantes universitarios ha sido investigado desde la psicología de la salud. En esta línea, se ha identificado que, en el contexto de pandemia, existían diversos factores que contribuyen como estresores en la población universitaria. Para afrontar aquellos estresores, también, se han estudiado las estrategias que ocupan un rol relevante. En el Perú, no se han encontrado investigaciones sobre la regulación emocional y la calidad del sueño relacionados al estrés académico. Por ello, el objetivo de la presente investigación es analizar el rol de la regulación emocional y la calidad del sueño sobre el estrés académico en universitarios de Lima durante la pandemia. Los participantes fueron 184 estudiantes (hombres y mujeres). Para recoger la información acerca de las variables se utilizó una metodología cuantitativa utilizando la técnica del análisis para obtener una data cuantitativa de las respuestas. Se tuvo como resultado que la regulación emocional y calidad de sueño son predictores del estrés académico. En este sentido, un primer modelo muestra que las variables de supresión expresiva y la de navegar por internet explican la varianza de los estresores. Asimismo, un segundo modelo visibiliza que el sexo biológico, la supresión expresiva y la calidad de sueño explica la varianza de síntomas del estrés académico. Ello estaría reflejando que la salud de los estudiantes durante el contexto de pandemia se ha visto afectada a nivel psicológico. / The academic stress in university students has been investigated from health psychology. In this line, it has been identified that, in the context of the pandemic, there were various factors that contribute as stressors in the university population. Strategies have also been studied to deal with those stressors who play a relevant role. In Peru, no research has been found on emotional regulation and sleep quality related to academic stress. Therefore, the objective of this research is to analyze the role of emotional regulation and sleep quality on academic stress in university students in Lima during the pandemic. The participants were 184 students (men and women). To collect information about the variables, a quantitative methodology was obtained using the analysis technique to obtain quantitative data on the responses. The results concluded that the variables of emotional regulation and sleep quality were identified to explain those of academic stress. In this sense, a first model shows that the expressive suppression variables and surfing the internet explain the variance of the stressors. Also, a second model shows that biological sex, expressive suppression and sleep quality explain the variance of academic stress symptoms. This would be reflecting that the health of students during the context of the pandemic has been psychologically affected.

Esta investigación tuvo como objetivo conocer la relación entre el burnout académico y la somnolencia diurna en estudiantes de medicina. Para ello, se contó con la participación de 83 estudiantes de medicina de distintas universidades privadas, entre el 1er y 6to año de la carrera. Para la medición del burnout se usó la adaptación colombiana del Maslach Burnout Inventory - Student Survey (MBI-SS) y para la medición de la somnolencia diurna se utilizó la adaptación peruana del Epworth Sleepiness Scale. Los hallazgos indican que existe una relación directa entre la somnolencia diurna y las dimensiones de agotamiento emocional y cinismo y, una relación inversa entre la somnolencia diurna y la dimensión de eficacia académica. Los resultados demuestran que hay una problemática latente en los estudiantes de medicina que es necesario detectar y atender para un mayor bienestar en esta población y que asegure que su formación no se vea afectada. / The aim of this research is to determine the relationship between academic burnout and daytime sleepiness in medical students. To do this, 83 medical students from different private universities participated, between the 1st and 6th year of the degree. The Colombian adaptation of the Maslach Burnout Inventory - Student Survey (MBI-SS) was used to measure burnout, and the Peruvian adaptation of the Epworth Sleepiness Scale was used to measure daytime sleepiness. The findings indicate that there is a direct relationship between daytime sleepiness and the dimensions of emotional exhaustion and cynicism, and an inverse relationship between daytime sleepiness and the academic efficacy dimension. The results show that there is a latent problem in medical students that needs to be detected and attended for a greater well-being in this population and ensures that their formation is not going to be affected.

Made available in DSpace on 2016-01-26T12:51:26Z (GMT). No. of bitstreams: 1 carolinegabrielemarques_tese.pdf: 1078800 bytes, checksum: 0c7b0504e85857d877828a3f432fe74e (MD5) Previous issue date: 2006-09-25 / This study aims to identify associated characteristics of craniofacial skeletal and pharyngeal soft tissues, in lateral cephalometric teleradiography and their possible association with clinical and polyssonographic findings, observing anatomical areas which most influenced the upper airway obstruction. To evaluate a predicting cephalometric pattern for Sleep Apnea Hipopnea Obstructive Syndrome (SAHOS), a sample of 40 subjects was divided into two experimental groups: patients with mild to moderate and severe SAHOS, previously submitted to polyssonographic study, according to their Apnea or Hipopnea Índex (AHI), comparing them with a control group, 10 subjects, with no sleep disorder. The first experimental group had an AHI=15 <30 (moderate sleep apnea). The second group, an AHI> or = 30 (severe sleep apnea). After the results and the statistical methods used to compare the different studied groups, the conclusion was that the SAHOS patients when compared with the control group presented: some positional alterations in their skeletal anatomical structures, mainly a lowering of the hyoide bone in relation to the cervical vertebrae; mandilbular retrusion, increased dimensions of the pharyngeal soft tissues, increased length and width of the soft palate with a decrease of the posterior and superior airway space. / O propósito deste estudo é identificar associação entre as características craniofaciais esqueletais e de tecidos moles em telerradiografias cefalométricas laterais com os dados clínicos e polissonográficos, verificando as áreas anatômicas que mais contribuem para a obstrução das vias aéreas superiores nos pacientes com Síndrome da Apnéia Hipopnéia Obstrutiva do Sono (SAHOS). Para avaliar se existe um padrão cefalométrico previsível para a Síndrome da Apnéia Hipopnéia Obstrutiva do Sono, foram comparadas as diferenças das médias das dimensões esqueléticas craniofaciais e dos tecidos moles da faringe, em norma lateral, de uma amostra de 40 indivíduos, divididos em 2 grupos-teste, com da Síndrome da Apnéia Hipopnéia Obstrutiva do Sono Moderada e Síndrome da Apnéia Hipopnéia Obstrutiva do Sono Grave, previamente submetidos ao estudo polissonográfico e um grupo controle de 10 indivíduos sem a doença. Pertenciam ao primeiro grupo teste os pacientes com Índice de Apnéia e Hipopnéia (IAH) > 15 < 30 (apnéia do sono moderada) e ao segundo grupo teste os pacientes com Índice de Apnéia e Hipopnéia (IAH) &#8805; 30 (apnéia do sono grave). Diante dos resultados obtidos e após a aplicação dos métodos estatísticos usados para comparação dos diferentes grupos estudados, concluiu-se que os pacientes apnéicos quando comparados com o grupo controle apresentaram: alterações no posicionamento das estruturas anatômicas esqueletais, principalmente um posicionamento inferior do osso hióide em relação às vértebras cervicais, retrusão mandibular, dimensões aumentadas dos tecidos moles faringeanos, aumento no comprimento e largura do palato mole com diminuição do espaço aéreo póstero-superior.

Esta tesis, siguiendo la reciente edición de Alberto Pérez-Amador Adam, aborda al Primero sueño (PS) de Sor Juana Inés de la Cruz desde diversas tradiciones literarias con novedosas fuentes hispánicas y latinas. Aquí se propone que el poema, mediante una estrategia textual original, sienta las bases para su interpretación, al menos en un sentido coherente con la teoría de los sentidos de la escritura de la exégesis bíblica. Se sostiene, asimismo, que el PS de Sor Juana Inés de la Cruz refleja un singular modo de composición e intelección que convierte al poema en enunciado y, asimismo, en su propia hermenéutica. En principio, esta idea parte de una comprensión del poema como discurso anagógico, es decir, como texto que supone una progresión ascendente a través de las vías del conocimiento (Pérez-Amador Adam 434). Este proceso se expresa por medio de símbolos y mitos que, como en el discurso alegórico, están encadenados para aunarse en un símbolo mayor. Una aproximación semejante ha sido emprendida ya en los estudios de Rocío Olivares (1998) y Alberto Pérez-Amador Adam (2015). Esta hipótesis se sostiene en el hecho de que PS tiene como modelo y fuente para sus repertorios simbólico y mitológico a las tradiciones mitográfica y emblemática (Rocío Olivares, 2011, 70-71). Al tratarse de una obra de madurez, refleja el procedimiento creativo de la poética de Sor Juana Inés de la Cruz; por lo tanto, se estima necesaria una valoración filosófica del poema a partir de la sugerente línea de investigación iniciada por Ruth Hill a inicios del siglo XXI que vincula al PS con la filosofía moderna, concretamente con pensadores anglosajones como Francis Bacon. / Tesis

Made available in DSpace on 2016-01-26T12:51:37Z (GMT). No. of bitstreams: 1 nelsoncolombini_tese.pdf: 1052278 bytes, checksum: 65caf5c2304f80f9167fa51d736325f5 (MD5) Previous issue date: 2010-03-22 / To describe the results obtained by the Maxillo Mandibular Advancement (MMA), associated to a glossectomy of Medium Line (GML) to CO2 Laser in the surgical treatment of Obstructive Sleep Apnea-Hypoapnea Syndrome (ASOSH), from moderate to severe, with adequate analysis of macroscstruture e microstructure of the sleep. Casuistics and Method: In the period from February 2005 to December 2008, 22 sequencial patients with ASOSH, from moderate to severe, with or without maxillary mandibular bone alterations, were selected. These patients were submitted to MMP plus GML using a CO2 laser. All patients underwent clinical, polissonographic and cephalometric evaluations. The polissonographic parameters used were: IAH, MD, Minimum SAT O2% < measured in minutes, sleep stages N1, N2, N3 and REM, preoperative and postoperative. The cephalometric parameters used were: SNA, SNB, PAS, PP2 PP2, preoperative and postoperative. Results: Evaluation of eventual differences in the preoperative and postoperative moments were investigated with the appropriate statistical tools. The surgical treatment proved to be effective in 8, out of 22 of the cases (36.36%), according to international criteria of normality. On the other hand, in these patients the IAH was not the best parameter to evaluate the therapeutic success. The MD (68.18% of improvement), stage N3 (59.09% of improvement) and Minimum SAT O2% < 90 measured in minutes (81.81% of improvement) demonstrated that they were the best instruments for characterizing the laboratorial control of the disease. Discussion: The MMA has expanded the dimensions of the pharynx and the hypopharynx. The GLM was associated in order to maximize the VAS, improve the stability of the dental occlusion, as well as the function of the temporomandibular joint, reducing the morbidity of the procedure. A postoperative evaluation with polysomnography showed improvements of the parameters in both macro and microarchitecture of the sleep (in relation to preoperative findings), besides proving that the IAH is not the best parameter for a postoperative evaluation (this applies to the patients of this series). Conclusions: The surgical treatment performed with MMA, associated to the GLM with CO2 laser was effective to treat patients with from ASOSH : - The improvement using the most accepted parameter by the international community (IAH < 5/ hour) was 8 out of the 22 (36.36%); - The IAH was not the best instrument to evaluate the control of the disease; - Were MD, stage N3 and Minimum SAT O2% < 90 measured in minutes showed that they are good indicators of the control of the disease (postoperative moment); - The Minimum SAT O2% < 90 measured in minutes was the best parameter in the evaluation of the surgical treatment (18/22 or 81.81%). / Descrever os resultados obtidos pelo Avanço Maxilo- Mandibular (AMM) associados à Glossectomia de Linha Média (GLM) a Laser CO2 no tratamento cirúrgico da Síndrome da Apnéia/Hipopnéia Obstrutiva do Sono (SAHOS) moderada e severa, usando instrumentos estatísticos que avaliem a arquiquetura do sono quanto à macro e micro estrutura para adequada e real avaliação dos resultados obtidos pelo tratamento proposto. Casuística e Método: No período de fevereiro de 2005 a dezembro de 2008 foram selecionados 22 pacientes seqüenciais portadores de SAHOS moderada e severa, com ou sem alterações esqueléticas maxilo-mandibulares. Estes pacientes foram submetidos à AMM, mais GLM com laser de CO2. Todos pacientes tiveram avaliação clínica, polissonográfica e cefalométrica. Os parâmetros polissonográficos utilizados foram: IAH, MD, SAT O2 % Mínima < 90 medida em minutos, estágios do sono N1, N2, N3 e REM, pré e pósoperatório. Os parâmetros cefalométricos utilizados foram: SNA, SNB, PAS, PP2 PP2 pré e pós-operatório. Resultados: Avaliação de eventuais diferenças nos momentos pré e pós-operatório foram investigadas com ferramenta estatística apropriada. O tratamento cirúrgico mostrou-se eficaz em 8/22 (36,36%) dos casos, segundo critérios internacionais de normalidade. Por outro lado nestes pacientes o IAH não foi o melhor parâmetro para avaliar sucesso terapêutico. MD (68,18% melhora), estágio N3 (59,09% de melhora) e SAT O2% Mínima < 90 medida em minutos (81,81% de melhora) mostraram-se melhores instrumentos para caracterizar controle laboratorial da enfermidade.Discussão: O AMM ampliou as dimensões da faringe e hipofaringe. A GLM foi associada para maximizar a VAS, aumentar a estabilidade da oclusão dentária e função da articulação têmporo-mandibular, reduzindo a morbidade do procedimento. Avaliação pós-operatória com polissonografia demonstrou melhora de parâmetros de macro e micro-arquitetura do sono (em relação aos achados pré-operatórios), além de comprovar não ser o IAH o melhor parâmetro para avaliação pós-operatória (isto para os pacientes desta série). Conclusões: O tratamento cirúrgico com AMM associado à GLM com laser de CO2 foi eficaz para tratar pacientes com SAHOS: A melhora utilizando o parâmetro mais aceito pela comunidade internacional (IAH < 5/hora) foi de 8/22 (36,36%); IAH não foi o melhor instrumento para avaliação do controle da enfermidade; MD, estágio N3 e SAT O2% Mínima < 90 medida em minutos mostraram-se bons indicadores de controle da enfermidade (momento pósoperatório); SAT O2% Mínima < 90 medida em minutos foi o melhor parâmetro na avaliação do tratamento cirúrgico (18/22 ou 81,81%).

This dissertation asserts that the tortuous relationship Spanish American literature had with cosmopolitanism since the Wars of Independence reached a turning point towards the end of the second half of the twentieth century. While the literary production of the nineteenth and most of the twentieth century was centred on the Spanish American nation and the continent, contemporary literature has become increasingly deterritorialized, and has begun to present narrative worlds and discuss issues that transcend this circumscribed universe. The discerning of this articulation of global issues in contemporary literature – which I contend is predicated on the concept of cosmopolitanism – is the primary objective of this investigation. The five novels examined here are Elena Poniatowska’s La “Flor de Lis” (1988), Mario Vargas Llosa’s El Paraíso en la otra esquina (2003) and El sueño del celta (2010), and Jorge Volpi’s El fin de la locura (2003) and No será la Tierra (2006). This study aims to describe and assess an evolving perspective on the treatment of cosmopolitanism in Spanish America. I trace the shift from the previous generations’ main preoccupation with aesthetic cosmopolitanism, which sought to engage Latin American literary discourse with the Western canon, to what I identify as the current political implication of the concept. To this end, I show that whereas mid-twentieth century authors displaced cosmopolitanism in favour of more politically expedient concepts, authors now plot it in their novels as a means of discussing issues of identity and citizenship in an increasingly globalized world.