Districts Of Lima Research Articles

Association between air pollution in Lima and the high incidence of COVID-19: findings from a post hoc analysis.

BackgroundCoronavirus disease 2019 (COVID-19) originated in the People’s Republic of China in December 2019. Thereafter, a global logarithmic expansion of cases occurred. Some countries have a higher rate of infections despite the early implementation of quarantine. Air pollution might be related to high susceptibility to the virus and associated case fatality rates (deaths/cases*100). Lima, Peru, has the second highest incidence of COVID-19 in Latin America and also has one the highest levels of air pollution in the region.MethodsThis study investigated the association of levels of PM2.5 exposure in previous years (2010–2016) in 24 districts of Lima with cases, deaths and case fatality rates for COVID-19. Multiple linear regression was used to evaluate this association controlled by age, sex, population density and number of food markets per district. The study period was from March 6 to June 12, 2020.ResultsThere were 128,700 cases in Lima and 2382 deaths due to COVID-19. The case fatality rate was 1.93%. Previous exposure to PM2.5 (2010—2016) was associated with the number of COVID-19- cases (β = 0.07; 95% CI: 0.034–0.107) and deaths (β = 0.0014; 95% CI: 0.0006–0.0.0023) but not with the case fatality rate.ConclusionsAfter adjusting for age, sex and number of food markets, the higher rates of COVID-19 in Metropolitan Lima are attributable to the increased PM2.5 exposure in the previous years, among other reasons. Reduction in air pollution from a long-term perspective and social distancing are needed to prevent the spread of virus outbreaks.

Impacto de la contaminación ambiental en el desarrollo sostenible de lima metropolitana (2015 – 2020)

Resume the purpose of this original article is to determine the impact of environmental pollution produced by the vehicle fleet, the use and distribution of water, and the collection and treatment of solid waste in the sustainable development of Metropolitan Lima. The research is descriptive, we triangulate the qualitative and quantitative method. The sampling is intentional non-probability. The instruments used are in-depth interviews and discussion groups; the survey of 120 people located in the vulnerable areas of the districts of Lima, Caraballo and Villa el Salvador de Lima Metropolitan. The results indicate the relationship between the high rate of environmental pollution caused primarily by the vehicle fleet, followed by the use and distribution of water and solid waste that limit sustainable development in Metropolitan Lima, because they compromise health, quality of life and the right of Lima people to a healthy life and well-being. For these reasons, it is concluded that the State must intervene to solve the problems generated by the three polluting factors explained and thus comply with the Sustainable Development Goals by 2030.

Changing Perceptions of the Role of Food Assistance Programs in the Development and Prevention of Obesity in Lima, Peru

Abstract Objectives The purpose of this study is to assess the perceived role of food assistance programs (FAPs) in the development and prevention of overweight/obesity (OW/OB) in two low-income districts of Lima, Peru and analyze how these perceptions have changed across time. Methods In 2009, we conducted focus groups with FAP beneficiaries and in-depth interviews with FAP administrators (N = 34) from three common FAPs in two low-income districts of Lima, Peru. These data captured participants’ perceptions of OW/OB and their recommendations to address them. We conducted grounded theory analysis on this dataset to identify dominant themes and structure a second round of data collection. In January-February 2021, we are conducting in-depth interviews with FAP beneficiaries and administrators from the same programs and districts (current N = 16, expected N = 36). We will conduct grounded theory analysis on the second dataset and cross-analyze the two datasets to measure differences and similarities. Results In 2009, nearly all FAP beneficiaries and half of FAP administrators identified OW/OB as a public health problem in their community. They expressed need for more nutrition education, potentially through FAPs. Most FAP administrators and some beneficiaries also recommended offering healthier food in one particular FAP (Community Kitchens). Preliminary results from 2021 reveal that nearly all FAP beneficiaries and administrators perceived OW/OB to be a problem in their community. Educational resources about OW/OB were limited and participants continued to recommend increased outreach, potentially through FAPs. Most beneficiaries of Community Kitchens cited the need for healthier food options. Conclusions From 2009 to 2021, more FAP beneficiaries and administrators perceived OW/OB to be a problem in their communities; however, resources to address this problem remained limited. Our findings suggest the need for increased nutrition education through FAPs and adjustments to foods available in specific FAPs. Funding Sources Tulane University.

The association between asthma emergency department visits and satellite-derived PM2.5 in Lima, Peru

BackgroundAsthma affects millions of people worldwide. Lima, Peru is one of the most polluted cities in the Americas but has insufficient ground PM2.5 (particulate matter that are 2.5 μm or less in diameter) measurements to conduct epidemiologic studies regarding air pollution. PM2.5 estimates from a satellite-driven model have recently been made, enabling a study between asthma and PM2.5. ObjectiveWe conducted a daily time-series analysis to determine the association between asthma emergency department (ED) visits and estimated ambient PM2.5 levels in Lima, Peru from 2010 to 2016. MethodsWe used Poisson generalized linear models to regress aggregated counts of asthma on district-level population weighted PM2.5. Indicator variables for hospitals, districts, and day of week were included to account for spatial and temporal autocorrelation while assessing same day, previous day, day before previous and average across all 3-day exposures. We also included temperature and humidity to account for meteorology and used dichotomous percent poverty and gender variables to assess effect modification. ResultsThere were 103,974 cases of asthma ED visits during the study period across 39 districts in Lima. We found a 3.7% (95% CI: 1.7%–5.8%) increase in ED visits for every interquartile range (IQR, 6.02 μg/m3) increase in PM2.5 same day exposure with no age stratification. For the 0–18 years age group, we found a 4.5% (95% CI: 2.2%–6.8%) increase in ED visits for every IQR increase in PM2.5 same day exposure. For the 19–64 years age group, we found a 6.0% (95% CI: 1.0%–11.0%) increase in ED visits for every IQR in average 3-day exposure. For the 65 years and up age group, we found a 16.0% (95% CI: 7.0%–24.0%) decrease in ED visits for every IQR increase in PM2.5 average 3-day exposure, although the number of visits in this age group was low (4,488). We found no effect modification by SES or gender. DiscussionResults from this study provide additional literature on use of satellite-driven exposure estimates in time-series analyses and evidence for the association between PM2.5 and asthma in a low- and middle-income (LMIC) country.

Whole genome analysis of extensively drug resistant Mycobacterium tuberculosis strains in Peru

Peru has the highest burden of multidrug-resistant tuberculosis in the Americas region. Since 1999, the annual number of extensively drug-resistant tuberculosis (XDR-TB) Peruvian cases has been increasing, becoming a public health challenge. The objective of this study was to perform genomic characterization of Mycobacterium tuberculosis strains obtained from Peruvian patients with XDR-TB diagnosed from 2011 to 2015 in Peru. Whole genome sequencing (WGS) was performed on 68 XDR-TB strains from different regions of Peru. 58 (85.3%) strains came from the most populated districts of Lima and Callao. Concerning the lineages, 62 (91.2%) strains belonged to the Euro-American Lineage, while the remaining 6 (8.8%) strains belonged to the East-Asian Lineage. Most strains (90%) had high-confidence resistance mutations according to pre-established WHO-confident grading system. Discordant results between microbiological and molecular methodologies were caused by mutations outside the hotspot regions analysed by commercial molecular assays (rpoB I491F and inhA S94A). Cluster analysis using a cut-off ≤ 10 SNPs revealed that only 23 (34%) strains evidenced recent transmission links. This study highlights the relevance and utility of WGS as a high-resolution approach to predict drug resistance, analyse transmission of strains between groups, and determine evolutionary patterns of circulating XDR-TB strains in the country.

Use of Formal and Informal Food Resources by Food Insecure Families in Lima, Peru: A Mixed-Methods Analysis

The goal of this study was to measure food insecurity among families with children in a low-income district of Lima, Peru and to identify the formal and informal food resources available to them that may affect their food security status. In June-July 2019, we collected data from 329 randomly selected households in Villa El Salvador (Lima, Peru). Following a mixed methods approach, we found that the percentage of households using food assistance programs (FAPs) increased with increasing levels of food insecurity, but two FAPs were heavily used by households regardless of food (in)security. The main reasons for using FAPs included financial need, already being signed up in the program, and believing that the food was of nutritional value; the main reasons for non-use were finding the program unnecessary, dislike or poor perceived quality of the food, and not being able to sign up for the program. Similarly, informal food resources, such as buying food on credit or receiving food from someone outside the household, were incrementally used with increased levels of food insecurity. Our study clarifies the relationship between level of household food insecurity and FAP use – FAPs more commonly used by food insecure households were used because of financial need, whereas the FAPs most commonly used by food secure households were those with automatic enrollment. At a programmatic level, our research highlights the need for making nutritious and preferred foods available in FAPs and standardizing the application of enrollment criteria.

Strategy for the provision of drinking water and environmental sanitation based on the community in Sidodadi Village, Pesawaran Regency

The provision of community-based drinking water and sanitation (PAMSIMAS) is one of the programs implemented by the government to address environmental sanitation problems. This study aims to analyze the success strategy of the PAMSIMAS Program, which is measured based on the success indicators of the PAMSIMAS Program. The research was conducted using a quantitative approach method in Sidodadi Village Way, Lima District in 2020. In this research used the snowball sampling technique. This technique is useful for finding, identifying, selecting and taking samples in a network or chain of relationships. Snowball sampling technique has strengths and weaknesses in its application. Field research housing sector become the case study to explain this sampling technique. The analysis used in this study is a SWOT analysis. The results shows that still have obstacles in several aspects such as the willingness of the community to participate in the form of input and ideas is still low, coordination between agencies has not been going well, there is no legal protection for water sources in order to maintain quality and quantity. The SWOT analysis used aims to formulate a strategic plan so that the PAMSIMAS Program can be sustainable in the fulfillment of clean water. The results of this study are the identification of the position of the PAMSIMAS. Program after the EFAS and IFAS calculations are carried out based on interviews that have been distributed to the implementers of the PAMSIMAS program, and then proceed with recommendations for priority strategies that will be carried out for the development of the PAMSIMAS Program.

PROPOZYCJA MONITORINGU GATUNKU KAWII GÓRSKIEJ W PERU

The work presents a proposal for the monitoring of a species of medium size South American rodent – Montane Guinea Pig. The population of this species is not constantly monitored, so it is impossible to determine exactly how many individuals are in the wild. In recent years, the area of its habitat has been significantly reduced. Therefore, it was necessary to develop methods of its monitoring. Monitoring has been proposed in several areas of its occurrence: the province of the Lima district – Cercado de Lima, the Junín National Reserve, and the province of the city of Ambo. The main aim of the article is to define population status indicators, habitat quality indicators, and to establish examples of dates and frequency of tests.

COVID-19 case fatality rate and tuberculosis in a metropolitan setting.

In this study, we aimed to assess the relationship between tuberculosis case rate and COVID‐19 case fatality rate (CFR) among districts within a tuberculosis‐endemic metropolitan area. We analyzed data from 43 districts in Lima, Peru. We used districts as the units of observation. Linear regressions were used to investigate the relationship between COVID‐19 CFRs and tuberculosis case rates. The mean COVID‐19 CFR in each district for reporting Weeks 5–32 was used as the dependent variable. Independent variable was the mean rate of confirmed pulmonary tuberculosis cases for 2017–2019 period. Analyses were adjusted by population density, socioeconomic status, crowded housing, health facility density, and case rates of hypertension, diabetes mellitus, and HIV infection. The mean COVID‐19 CFR in Lima was 4.0% ± 1.1%. The mean tuberculosis rate was 16.0 cases per 10,000 inhabitants. In multivariate analysis, tuberculosis case rate was associated with COVID‐19 CFR (β = 1.26; 95% confidence interval: 0.24–2.28; p = .02), after adjusting for potential confounders. We found that Lima districts with a higher burden of tuberculosis exhibited higher COVID‐19 CFRs, independent of socioeconomic, and morbidity variables.

Analysis of Tourist Systems Predictive Models Applied to Growing Sun and Beach Tourist Destination

This study aims to present a new diagnosis model of Sun and beach destinations, we analyzed a set of explanatory theories about the tourism system, because current models do not reflect the real dynamics of an emerging tourist destination. We create a new predictive model so it served us to be used as a diagnostic method for the tourism system. Ancon district is a coastal town of Peru, it is the second-largest and oldest of Metropolitan Lima district. The study analyzed all tourist attractions and local resources including reserved zone Lomas de Ancón, with 10,962 hectares. It used a qualitative method and its design is grounded theory and phenomenological. The research covers the period from May 2018 to March 2019, where it was possible to appreciate the high tourist demand and wild flora and fauna of the Lomas de Ancón in its two seasons: winter season (2018) and summer 2019 (dry season). The study concludes that the new analysis model allows us identifying and understanding the dynamic and potential of sun and beach tourist destinations in the growth phase. The Ancón district has resources and attractions that would allow it to develop new tourist products and diversify the local tourist offer.

SARS-CoV-2 Infections in Households in a Peri-Urban Community of Lima, Peru: A Prospective Cohort Study

Background: Few studies have prospectively evaluated SARS-CoV-2 infections in households. We assessed the prevalence and incidence of SARS-CoV-2 infections in a prospective study of households in Lima, Peru.Methods: We conducted a prospective cohort study in a peri-urban district of Lima, Peru. Households with at least a child, a young adult (age 18 to 50 years) and an older adult age >50 years, were followed with twice-a-week household visits during a two-month period for health surveillance. Nasal swabs and saliva specimens were collected twice weekly, and nasopharyngeal swabs were collected weekly from each participant, regardless of symptoms. Laboratory-confirmed SARS-CoV-2 infection was defined by two RT-PCR tests from any of the collected specimens within a week. Blood samples collected at enrolment and end of follow­-up were tested with rapid serological tests. We calculated the prevalence and incidence of laboratory-confirmed SARS-CoV-2 infections during the study period.Findings: We enrolled 132 participants from 44 households, including 44 children, 44 young adults and 44 older adults. A total of 13 SARS-CoV-2 infections were detected in 9 households, for an overall period prevalence of 9·85% (95% confidence interval [CI]:5·35-16·25). Most (66·67%) infections were symptomatic. Eight of 11 (72·73%) SARS-CoV-2 detections corresponded to the Lambda variant. During 218·79 person-months at risk of follow-up there were six new SARS-CoV-2 infections detected (2·74 per 100 person-month, 95% CI: 1·25– 6·04). At enrollment, 59 of 128 participants tested had positive SARS-CoV-2 IgG serology (46·09%, 95% CI: 37·25-55·12). Five of six new infections occurred among participants with negative baseline serology.Interpretation: We demonstrated high incidence of SARS-CoV-2 infections in households during periods of active circulation of the Lambda variant, especially among subjects without evidence of prior infection, most of them not detected by the Ministry of Health system.Funding Information: Consejo Nacional de Ciencia y Tecnología – CONCYTEC-PROCIENCIA, Lima, Peru (contract No. 082-2020); Vanderbilt University Medical Center, Nashville TN, USA; and Instituto de Investigación Nutricional, Lima, Peru. Declaration of Interests: None to declare. Ethics Approval Statement: The study was approved by the ethics review boards (ERBs) of the Instituto de Investigacion Nutricional and Vanderbilt University. All adults signed their own ERB approved written informed consent form (ICF). For individuals under 18 years of age, either the mother or the father signed an ICF. Additionally, children 8 years and older signed a written informed assent form.

Factors Related to Lung Function In Wood Furniture Workers In Oesapa Village, Kelapa Lima Sub District Kupang City

Workers of wooden furniture is the workers who are at risk for decreased lung function caused by exposure to wood dust in the working environment. Wood dust will enter the respiratory organs, thereby affecting lung function. Decreased pulmonary function can be seen by the method of Harvard Step Test. This research aims to analyse the relationship between age, working period, nutritional status, smoking habits, long exposure to dust, and use of PPE with lung function in wooden furniture workers in Oesapa Village, Kelapa Lima Sub District, Kupang City. The study was analytic survey with Cross Sectional approach. This research was conducted in the wood furniture industry in Oesapa Vilage, Kelapa Lima District, Kupang City in July 2020. The population in this study was 33 workers of wooden furniture. Data collection is done by questionnaire, weight measurement, height measurement and the Harvard Step Test to determine the level of lung fitness workers. Data analysis technique used is the Chi Square test with level of significance . The results showed that there was a significant relationship between age (0.002), working period (0.023), nutritional status (0.039), and use of PPE (0.016) with lung function in workers of wooden furniture. There is no relationship smoking habits (0.093), long exposureto dust (0.057) and lung function in workers of wooden furniture.

Association between environmental pollution by PM 2.5 exposure and childhood overweight/obesity in children from 6 to 59 months in Lima and Callao, Perú

Background: Air pollution by PM2.5 is an important public health problem of considerable impact worldwide due to its deleterious effects in human beings. A recent report ranked Lima (Peru) as the second most polluted South American city by PM2.5. Recent evidences suggest that PM2.5 may be a obesogenic factor. Overweight and obesity in childhood is related with PM2.5 exposure by inflammation, methylation of adipogenic receptors and also associated to a fat consumption behavior. There is no time-series studies in Peru that associated PM2.5 with overweight/obesity in pre-school children (PSC). Methods: Average daily PM2.5 concentrations were calculated for 43 districts of Lima and Callao using an advanced machine learning model to estimate daily PM2.5 concentrations at a 1 km2 spatial resolution in Lima, Peru. Daily PM2.5 concentrations were attributed to overweight/obese PSC by day of medical control. Overweight/obesity cases were diagnosed when Z score of weight per stature were >2DS. The time-series study used Distributed Lag model and Poisson regression to estimate RR for daily overweight/obesity diagnoses with daily PM2.5, controlling by relative humidity, temperature, year and Lima area. Results: An increase of 10 ug/m3 of PM2.5 90 days before medical control was significantly associated with the development of overweight/obesity (RR 1.92, 95% CI: 1.90-1.94) in children aged 6 to 59 months when controlled by temperature, relative humidity, year and Lima area. The highest concentrations of PM2.5 were found in East Lima districts. Overweight/obesity risk was highest also in East Lima (RR 2.53, 95% CI: 2.49-2.57). Conclusions: Data in PSC children in Lima and Callao, Peru demonstrate that PM2.5 is obesogenic.

An Assessment of Education Quality in Private Schools

The objective of this research project was to evaluate the quality of private school education in the Chaclacayo District of Lima. The study was performed with a qualitative, descriptive methodology. The quality of education at five private high schools was assessed using a sample of 209 participants, including students, teachers and parents. Three questionnaires were applied: the first with 108 questions for students, the second with 121 questions for teachers, and the third with 83 questions for parents. Results showed that the level of education at these schools was found to be “medium quality”, according to the assessed criteria: customer satisfaction (50.23%), educational leadership (51.37%), strategic planning applied to education (48.30%), human talent satisfaction (51.67%), human talent management (48.15%), teaching methods and processes (51.13%), impact on society (52.80%), educational outcomes (50.17%) and educational resources (47.93%). In conclusion, the quality of high school private education in the Chaclacayo District is found to be at a medium level, represented by a score of 50.93%, according to the average perceptions of the external customers (students and parents), as well as internal customers (teachers).

A pragmatic stepped-wedge cluster randomized trial to evaluate the effectiveness and cost-effectiveness of active case finding for household contacts within a routine tuberculosis program, San Juan de Lurigancho, Lima, Peru

BackgroundActive case finding (ACF) in household contacts of tuberculosis (TB) patients is now recommended for National TB Programs (NTP) in low- and middle-income countries. However, evidence supporting these recommendations remains limited. This study evaluates the effectiveness and cost-effectiveness of ACF for household contacts of TB cases in a large TB endemic district of Lima, Peru. MethodsA pragmatic stepped-wedge cluster randomized controlled trial was conducted in 34 health centers of San Juan de Lurigancho district. Centers were stratified by TB rate and randomly allocated to initiate ACF in groups of eight or nine centers at four-month intervals. In the intervention arm, NTP providers visited households of index patients to screen contacts for active TB. The control arm was routine passive case finding (PCF) of symptomatic TB cases. The primary outcomes were the crude and adjusted active TB case rates among household contacts. Program costs were directly measured, and the cost-effectiveness of the ACF intervention was determined. Findings3222 index TB cases and 12,566 household contacts were included in the study. ACF identified more household contact TB cases than PCF, 199.29/10,000 contacts/year vs. 132.13 (incidence rate ratio of 1.51 (95% CI 1.21–1.88)). ACF was associated with an incremental cost-effectiveness ratio of US $16,400 per disability-adjusted life year averted and not cost-effective assuming a willingness-to-pay threshold for Peru of US $6360. ConclusionACF of TB case household contacts detected significantly more secondary TB cases than PCF alone, but was not cost-effective in this setting. In threshold analyses, ACF becomes cost-effective if associated with case detection rates 2.5 times higher than existing PCF programs.

Children as sentinels of tuberculosis transmission: disease mapping of programmatic data

BackgroundIdentifying hotspots of tuberculosis transmission can inform spatially targeted active case-finding interventions. While national tuberculosis programs maintain notification registers which represent a potential source of data to investigate transmission patterns, high local tuberculosis incidence may not provide a reliable signal for transmission because the population distribution of covariates affecting susceptibility and disease progression may confound the relationship between tuberculosis incidence and transmission. Child cases of tuberculosis and other endemic infectious disease have been observed to provide a signal of their transmission intensity. We assessed whether local overrepresentation of child cases in tuberculosis notification data corresponds to areas where recent transmission events are concentrated.MethodsWe visualized spatial clustering of children < 5 years old notified to Peru’s National Tuberculosis Program from two districts of Lima, Peru, from 2005 to 2007 using a log-Gaussian Cox process to model the intensity of the point-referenced child cases. To identify where clustering of child cases was more extreme than expected by chance alone, we mapped all cases from the notification data onto a grid and used a hierarchical Bayesian spatial model to identify grid cells where the proportion of cases among children < 5 years old is greater than expected. Modeling the proportion of child cases allowed us to use the spatial distribution of adult cases to control for unobserved factors that may explain the spatial variability in the distribution of child cases. We compare where young children are overrepresented in case notification data to areas identified as transmission hotspots using molecular epidemiological methods during a prospective study of tuberculosis transmission conducted from 2009 to 2012 in the same setting.ResultsAreas in which childhood tuberculosis cases are overrepresented align with areas of spatial concentration of transmission revealed by molecular epidemiologic methods.ConclusionsAge-disaggregated notification data can be used to identify hotspots of tuberculosis transmission and suggest local force of infection, providing an easily accessible source of data to target active case-finding intervention.

Dental caries in three-year-old preschool children in Lima, Peru assessed according to the CAST instrument.

The aim of this study was to determine the caries situation of three-year-old preschool children residing in low socioeconomic status districts in Lima, Peru. The study is a crosssectional analysis of the caries situation of suburban areas of Lima. A stratified sampling procedure by geographical distribution, considering healthcare centers with a motherand- child health clinic and surrounding preschools as factors, identified 45 randomly selected preschools, of which 17 accepted to participate. Children from 3-year-old classrooms were examined by two independent calibrated dentists using the Caries Assessment Spectrum and Treatment (CAST) instrument at their premises using artificial light, sterile examination mirrors and gauze for drying each tooth before evaluation. ANOVA and the Tamhane method were used to analyze the data. 308 children, mean age 3.4 years (min: 3 years; max: 3 years, 7 months), were examined. The sample prevalence of enamel and dentine carious lesions (CAST code 3-7) was 91.2% while the prevalence of dentine carious lesions (CAST code 4-7) was 58.8%. The mean number of teeth with cavities that had reached the pulp and those that had an abscess or fistula were 2.0% and 0.5% respectively. The majority of enamel and dentine carious lesions were observed in molars. The CAST severity score was 7.0. Mean examination time was 57 seconds. The burden of dental caries of the children at this young age was high.

Caregiver and family factors promoting child resilience in at-risk families living in Lima, Peru

BackgroundChild victimization is one of the most serious, preventable threats to child health and wellbeing around the world. Contemporary research has demonstrated that polyvictimization, or children’s experience of multiple types of victimization, is particularly detrimental. ObjectiveThe current study aims to evaluate relationships between child victimization and child resilience with a particular focus on caregiver and family promotive factors. Participants and settingParticipants included N = 385 caregiver-child dyads from a high-risk neighborhood in San Juan de Lurigancho district in Lima, Peru. MethodsData were collected in the context of a representative survey of houses in the neighborhood; an index child (ages 4-17) was randomly selected for each household and caregivers provided reports on core study constructs. ResultsChild victimization (β = .35, p < .001) and harsh punishment (β = .17, p < .001) were associated with higher levels of child adjustment problems. Caregiver depression was associated with both higher adjustment problems (β = .22, p < .001) and higher prosocial skills (β = .14, p = .003). Caregiver resilience was associated with lower adjustment problems (β = -.15, p = .01) and higher prosocial skills (β = .14, p = .04). Positive parenting was associated with lower adjustment problems (β = -.15, p < .001) and higher prosocial skills (β = .20, p < .001). Family cohesion (β = .23, p = .001) was positively associated only with children’s prosocial skills. ConclusionsFindings suggest that caregiver resilience and positive parenting are consistent promotive factors for child resilience across indicators, including both adjustment problems and prosocial skills. These promotive factors may therefore be promising potential targets address in the context of interventions aimed at promoting child resilience.

Food for Thought: The Perceived Food Environment and its Association with Food Insecurity in a Low-Income District of Lima, Peru

Abstract Objectives To examine the association between food insecurity – the inability to acquire adequate nutritious foods due to economic constraints – and perceptions of food accessibility, quality, and variety in one's neighborhood in a low socioeconomic district of Lima, Peru. Methods A household survey was conducted among randomly selected households with at least one child &amp;lt;18 years of age in Villa El Salvador (Lima, Peru; N = 329). The language-validated questionnaire included questions from the Perceived Nutrition Environment Measures Survey (NEMS), which were adapted to the local setting and translated into Spanish. These NEMS questions assessed perceived accessibility, quality, and variety of foods in the neighborhood of residence on a Likert scale (e.g., 1 = completely agree to 5 = completely disagree) and were later dichotomized for analysis. The questionnaire also included the Household Food Insecurity Access Scale (HFAIS), to measure food insecurity. Multivariable logistic regression was used to assess the association between the perceived neighborhood food environment and food insecurity, adjusting for sociodemographic variables. Results About 77% of the households reported having food insecurity. Adjusting for age, gender, and education of the homemaker, food insecurity was associated with perceptions of decreased accessibility to fresh fruits and vegetables (OR = 5.05; 95% CI = 2.03–12.60) and low-fat products (OR = 2.07; 95% CI = 1.18, 3.65); low quality of fresh fruits and vegetables (OR = 3.28; 95% CI = 1.84, 5.86) and low-fat products (OR = 2.13; 95% CI = 1.22, 3.73); and a low variety of fresh fruits and vegetables (OR = 2.62; 95% CI = 1.43, 4.79) in the neighborhood. Conclusions Food insecure families living in a low-income district in Lima, Peru share negative perceptions of access, quality, and variety of food in their surrounding neighborhood. Efforts to improve the availability of affordable healthy foods in low-income neighborhoods in Lima may help ameliorate food insecurity. Funding Sources This work was supported by the National Institute on Minority Health and Health Disparities’ Minority Health and Health Disparities International Training Grant, the Fulbright U.S. Student Program, and the Carol Lavin Bernick Faculty Grant Program (Tulane University).

Percepción de la población respecto al ruido producido por el transporte público en el distrito de Barranca, Lima, Perú

En el presente trabajo se muestran los resultados de la investigación realizada sobre la percepción de los habitantes del distrito de Barranca en Lima, Perú, respecto a la influencia del ruido ambiental producido por el transporte vehicular. Como metodología de recolección de información se aplicó una encuesta, con la que se confirmó si las personas consideraban que el ruido vehicular afectaba su quehacer diario y luego, a los que respondieron positivamente, se les aplicó el instrumento con cinco preguntas y cuatro niveles de respuesta. Los resultados se trataron con estadística descriptiva (análisis de frecuencias) e inferencial (varianza de Friedman) a fin de establecer el grado de relevancia de cada factor. Se obtuvo que la mayoría considera que el ruido vehicular no afecta (58.2%) y los que consideran que sí afecta ubican a la falta de concentración como el problema más importante, seguido del estrés y la agresividad. Se corrobora que existe diferencia significativa entre los resultados de las preguntas con nivel de confianza de 95%; asimismo, las preguntas se ubicaron en tres grupos de acuerdo a la prueba de Friedman (mal humor y pérdida de audición, estrés y agresividad, concentración), los cuales presentan igualdad estadística intragrupos y diferencias extragrupos.