Rural Peru Research Articles

Assessment of a Pilot Program for Remote Support on Mental Health for Young Physicians in Rural Settings in Peru: Mixed Methods Study.

Telemedicine-based interventions show promise in addressing mental health issues among rural populations, yet evidence regarding their impact among the health care workforce in these contexts remains limited. This study aimed to evaluate the characteristics and the responses and perceptions of recently graduated physicians who work in rural areas of Peru as part of the Servicio Rural Urbano Marginal en Salud (Rural-Urban Marginal Health Service [SERUMS], in Spanish) toward a telehealth intervention to provide remote orientation and accompaniment in mental health. A mixed methods study was carried out involving physicians who graduated from the Universidad Nacional Mayor de San Marcos and participated in the Mental Health Accompaniment Program (MHAP) from August 2022 to February 2023. This program included the assessment of mental health conditions via online forms, the dissemination of informational materials through a website, and, for those with moderate or high levels of mental health issues, the provision of personalized follow-up by trained personnel. Quantitative analysis explored the mental health issues identified among physicians, while qualitative analysis, using semistructured interviews, examined their perceptions of the services provided. Of 75 physicians initially enrolled to the MHAP, 30 (41.6%) opted to undergo assessment and use the services. The average age of the participants was 26.8 (SD 1.9) years, with 17 (56.7%) being female. About 11 (36.7%) reported have current or previous mental health issues, 17 (56.7%) indicating some level of depression, 14 (46.7%) indicated some level of anxiety, 5 (16.6%) presenting a suicidal risk, and 2 (6.7%) attempted suicide during the program. Physicians who did not use the program services reported a lack of advertising and related information, reliance on personal mental health resources, or neglect of symptoms. Those who used the program expressed a positive perception regarding the services, including evaluation and follow-up, although some faced challenges accessing the website. The MHAP has been effective in identifying and managing mental health problems among SERUMS physicians in rural Peru, although it faced challenges related to access and participation. The importance of mental health interventions in this context is highlighted, with recommendations to improve accessibility and promote self-care among participants.

Cloprostenol effect with and without male stimulation on oestrus synchronization in Peru guinea pigs.

Cloprostenol, a synthetic derivative of prostaglandin F2α, effectively triggers functional and morphological regression of the corpus luteum (luteolysis). In rural Peru, the guinea pig (Cavia porcellus) holds significance within the local economy and serves as a valuable protein source. Enhancing reproductive efficiency is crucial to achieve uniformity in weight, age, and litter size across commercial systems. Thus, our study aimed to evaluate the effect of cloprostenol with and without male stimulation on the onset, duration, and intensity of oestrus in Peru guinea pigs. A total of 128 guinea pigs (120 females and eight males) between 8 and 12 months of age, weighing between 800 and 1200 g, were distributed in cages of 15 females per treatment. Cloprostenol sodium (0 [control], 0.20, 0.25, and 0.30 mg/animal) was IM administered to the groups with and without male stimulation. Four isolated males in individual cages, different from the one used for the treatment, were considered to detect oestrus. The oestrus intensity was assessed by observing sexual behaviour signs such as restlessness, moaning, attempts to mount, pelvic elevation, loin stretching, and vulvar inflammation. The oestrus was manifested 2 days after the administration of cloprostenol sodium. At a dose of 0.30 mg/animal and with male stimulation, the earliest oestrus was observed at 46.9 h. There was a reduction in the oestrus duration (p < .05) in guinea pigs that received the three doses of cloprostenol sodium compared to the control group. The highest percentages of frank oestrus intensity (66.7%) were strongly associated with the administered doses of cloprostenol sodium (p < .01). In conclusion, the cloprostenol sodium administration was proper for rapid oestrus induction in Peru guinea pigs.

Pre-pregnancy body mass index and caesarean section in Andean women in Peru: a prospective cohort study

BackgroundDuring the last two decades, Caesarean section rates (C-sections), overweight and obesity rates increased in rural Peru. We examined the association between pre-pregnancy body mass index (BMI) and C-section in the province of San Marcos, Northern Andes-Peru.MethodsThis is a prospective cohort study. Participants were women receiving antenatal care in public health establishments from February 2020 to January 2022, who were recruited and interviewed during pregnancy or shortly after childbirth. They answered a questionnaire, underwent a physical examination and gave access to their antenatal care card information. BMI was calculated using maternal height, measured by the study team and self-reported pre-pregnancy weight measured at the first antenatal care visit. For 348/965 (36%) women, weight information was completed using self-reported data collected during the cohort baseline. Information about birth was obtained from the health centre’s pregnancy surveillance system. Regression models were used to assess associations between C-section and BMI. Covariates that changed BMI estimates by at least 5% were included in the multivariable model.ResultsThis study found that 121/965 (12.5%) women gave birth by C-section. Out of 495 women with pre-pregnancy normal weight, 46 (9.3%) had C-sections. Among the 335 women with pre-pregnancy overweight, 53 (15.5%) underwent C-sections, while 23 (18.5%) of the 124 with pre-pregnancy obesity had C-sections. After adjusting for age, parity, altitude, food and participation in a cash transfer programme pre-pregnancy overweight and obesity increased the odds of C-section by more than 80% (aOR 1.82; 95% CI 1.16–2.87 and aOR 1.85; 95% CI 1.02–3.38) compared to women with a normal BMI.ConclusionsHigh pre-pregnancy BMI is associated with an increased odds of having a C-section. Furthermore, our results suggest that high BMI is a major risk factor for C-section in this population. The effect of obesity on C-section was partially mediated by the development of preeclampsia, suggesting that C-sections are being performed due to medical reasons.

Working together, learning apart: a multicommunity study in rural Peru

ABSTRACT This article is based on a team ethnographic study in the province of Yauyos in the Peruvian Andes. It focuses on rural education and the inequalities surrounding it. Teachers and parents exchange mutual recriminations as they seek to explain why some children have greater difficulties than others and why urban schools achieve superior results as shown in tests and verified in popular imaginaries. We examine two arenas where cultural misreadings, compensatory mechanisms and children’s agency come into play. One concerns verbal expression and classroom participation. The other concerns extracurricular mutual support networks and complements, from homework help to exposure to urban settings. Parents, teachers, and children all shared aspirations for children’s academic success. How that can be achieved, against high odds, is a source of tensions that the research documented and is the subject of ongoing debate in the Peruvian education sector.

Prevalence of urinary tract infections in pregnancy in rural Andean communities of Peru.

Urinary tract infections (UTIs) can adversely affect pregnancy, yet their prevalence in rural communities remains poorly understood. For an initial evaluation of the UTI burden among pregnant women in the San Marcos province of rural Andean Peru, we aimed to determine the UTI prevalence in the region. A cross-sectional study was conducted in a subsample of 250 pregnant women enrolled in the Peruvian Andes Multigenerational High Altitude Cohort (ALTO) from 2021 to 2022. Structured questionnaires were administered to collect demographic, socioeconomic, maternal health and behavioural data. Urine samples were obtained for dipstick analyses. Descriptive and logistic regression analyses were performed to investigate the association between risk factors and UTI. The study participants had a median age of 28 years (IQR: 22-33). A UTI prevalence of 27.6% (CI: 22.4%-33.5%) was observed, surpassing estimates from other regions of Peru. Notably, nearly all pregnant women (96%) utilised antenatal care (ANC) services at least once, primarily visiting health centres and community health posts where doctors and obstetricians were the main care providers. In this population, none of the risk factors exhibited statistically significant associations with UTIs. Our study highlights the prevalence of UTIs among Andean pregnant women in San Marcos and underscores the critical need for routine UTI screening and treatment during ANC visits as recommended by national guidelines. While accessibility to ANC services is not a barrier in this region, enhancing the availability and quality of UTI screening services is crucial.

Co-Circulation of Multiple Coronavirus Genera and Subgenera during an Epizootic of Lethal Respiratory Disease in Newborn Alpacas (Vicugna pacos) in Peru: First Report of Bat-like Coronaviruses in Alpacas.

Coronaviruses (CoVs) infect a wide range of hosts, including humans, domestic animals, and wildlife, typically causing mild-to-severe respiratory or enteric disease. The main objective of this study was to identify CoV genera and subgenera detected in Peruvian alpacas. Lung lavage specimens were collected from 32 animals aged 1 to 6 weeks. CoVs were identified by using RT-PCR to amplify a pan-CoV conserved region of the RNA-dependent RNA polymerase-encoding gene. A nested PCR was performed to identify β-CoVs. Then, β-CoV-positive samples were subjected to RT-PCR using specific primers to identify the Embecovirus subgenus. Out of 32 analyzed samples, 30 (93.8%) tested positive for at least one CoV genus. β-, α-, or unclassified CoVs were identified in 24 (80%), 1 (3.3%), and 1 (3.3%) of the positive samples, respectively. A CoV genus could not be identified in two (6.7%) samples. A mixture of different CoV genera was detected in two (6.7%) samples: one was co-infected with β- and α-CoVs, and the other contained a β- and an unclassified CoV. A sequence analysis of the amplicons generated by the PCR identified 17 β-CoV strains belonging to the subgenus Embecovirus and two α-CoV strains belonging to Decacovirus. A phylogenetic analysis of two strains revealed a relationship with an unclassified Megaderma BatCoV strain. A subgenus could not be identified in nine β-CoV samples. Our data show a high prevalence and a high genetic diversity of CoV genera and subgenera that infect alpacas, in which the β-CoV subgenus Embecovirus predominated. Our data also suggest a new role for bats in the dissemination and transmission of uncommon CoVs to alpacas raised in rural Peru.

Effectiveness of free financial education provided by for-profit financial institutions: Experimental evidence from rural Peru

The rural poor in developing countries often save and borrow in the non-formal financial sector. Providing financial education and access to formal savings products can help to improve their livelihoods. Nonetheless, financial education has traditionally been delivered on a not-for-profit basis. This paper experimentally evaluates the impact of a free in-person financial education program for rural women in Peru, implemented by a for-profit microfinance institution along with the marketing for a new microsavings account. We find very high take-up of the free financial education program (57.7% participation in at least one session), and using data collected 3 to 6 months after the intervention we observe a significant increase in the familiarity with and trust in the implementing financial institution. Also, we observe a significant positive impact on formal savings with the implementing financial institution, but no significant negative impact on savings with other formal financial institutions. These findings suggest that free financial education provided by for-profit financial institutions, paired with financial products tailored to the target population, could be a viable alternative to promote formal savings among the poor. However, we do not observe a significant short-term impact of the program on credit, income, assets, consumption, poverty, or female empowerment.

From Slavery to Servitude: Transformations and Continuities in Hacienda Labor, Well-Being, and Foodways in Eighteenth- and Nineteenth-Century Nasca

Abstract The nineteenth century was a dynamic period for hacienda workers on the south coast of Peru. Former Jesuit vineyards with two of the largest enslaved African-descended populations in rural coastal Peru—the haciendas of San Joseph (San José) and San Francisco Xavier (San Javier)—and their annexes in Nasca's Ingenio Valley underwent dramatic transformations with the replacement of their grapevines with cotton and the introduction of new types of workers. Cantonese indentured workers were contracted beginning in the 1830s, and the majority-enslaved workforce was legally emancipated in 1854. Seasonally, highland Andean workers joined the demographically shifting permanent hacienda population. We use evidence from excavated midden contexts at San Joseph, San Xavier, and San Joseph's annex of Hacienda La Ventilla to explore these changing agroindustrial dynamics and worker well-being in the eighteenth and nineteenth centuries. Despite the transformations at the estates, we find that culinary practices developed by enslaved Africans and their descendants during the Jesuit administration, such as the preparation of one-pot meals and stews, continued into the republican era among Cantonese indentured laborers and wage workers of Indigenous, mestizo, and Cantonese origins. We argue that such strategies centered on foodways were a crucial aspect of worker self-care regimes and broader well-being.

Exposure–response relationships for personal exposure to fine particulate matter (PM2·5), carbon monoxide, and black carbon and birthweight: an observational analysis of the multicountry Household Air Pollution Intervention Network (HAPIN) trial

Household air pollution (HAP) from solid fuel use is associated with adverse birth outcomes, but data for exposure-response relationships are scarce. We examined associations between HAP exposures and birthweight in rural Guatemala, India, Peru, and Rwanda during the Household Air Pollution Intervention Network (HAPIN) trial. The HAPIN trial recruited pregnant women (9-<20 weeks of gestation) in rural Guatemala, India, Peru, and Rwanda and randomly allocated them to receive a liquefied petroleum gas stove or not (ie, and continue to use biomass fuel). The primary outcomes were birthweight, length-for-age, severe pneumonia, and maternal systolic blood pressure. In this exposure-response subanalysis, we measured 24-h personal exposures to PM2·5, carbon monoxide, and black carbon once pre-intervention (baseline) and twice post-intervention (at 24-28 weeks and 32-36 weeks of gestation), as well as birthweight within 24 h of birth. We examined the relationship between the average prenatal exposure and birthweight or weight-for-gestational age Z scores using multivariate-regression models, controlling for the mother's age, nulliparity, diet diversity, food insecurity, BMI, the mother's education, neonate sex, haemoglobin, second-hand smoke, and geographical indicator for randomisation strata. Between March, 2018, and February, 2020, 3200 pregnant women were recruited. An interquartile increase in the average prenatal exposure to PM2·5 (74·5 μg/m3) was associated with a reduction in birthweight and gestational age Z scores (birthweight: -14·8 g [95% CI -28·7 to -0·8]; gestational age Z scores: -0·03 [-0·06 to 0·00]), as was an interquartile increase in black carbon (7·3 μg/m3; -21·9 g [-37·7 to -6·1]; -0·05 [-0·08 to -0·01]). Carbon monoxide exposure was not associated with these outcomes (1·7; -3·1 [-12·1 to 5·8]; -0·003 [-0·023 to 0·017]). Continuing efforts are needed to reduce HAP exposure alongside other drivers of low birthweight in low-income and middle-income countries. US National Institutes of Health (1UM1HL134590) and the Bill & Melinda Gates Foundation (OPP1131279).

Sustainable volume sweep imaging lung teleultrasound in Peru: Public health perspectives from a new frontier in expanding access to imaging.

Pulmonary disease is a common cause of morbidity and mortality, but the majority of the people in the world lack access to diagnostic imaging for its assessment. We conducted an implementation assessment of a potentially sustainable and cost-effective model for delivery of volume sweep imaging (VSI) lung teleultrasound in Peru. This model allows image acquisition by individuals without prior ultrasound experience after only a few hours of training. Lung teleultrasound was implemented at 5 sites in rural Peru after a few hours of installation and staff training. Patients were offered free lung VSI teleultrasound examination for concerns of respiratory illness or research purposes. After ultrasound examination, patients were surveyed regarding their experience. Health staff and members of the implementation team also participated in separate interviews detailing their views of the teleultrasound system which were systematically analyzed for key themes. Patients and staff rated their experience with lung teleultrasound as overwhelmingly positive. The lung teleultrasound system was viewed as a potential way to improve access to imaging and the health of rural communities. Detailed interviews with the implementation team revealed obstacles to implementation important for consideration such as gaps in lung ultrasound understanding. Lung VSI teleultrasound was successfully deployed to 5 health centers in rural Peru. Implementation assessment revealed enthusiasm for the system among members of the community along with important areas of consideration for future teleultrasound deployment. This system offers a potential means to increase access to imaging for pulmonary illness and improve the health of the global community.

Identifying the origin of acrylamide in Peruvian panela production to inform strategies for its reduction

Maximum levels of acrylamide have been set by the European Commission (EU) 2017/2158 for several food products due to its carcinogenic properties. Although not regulated yet, European buyers are requesting maximum levels of 0.8 mg kg−1 in artisanal panela (raw cane sugar) from northern Peru. Panela in this area is produced by 600 small holder farmers and exportation guarantees a respectable price in an area with a high index of poverty. The objective here was to determine the cause of high acrylamide concentrations in panela to inform cost effective minimisation strategies. We monitored panela production from field to final product to understand the scale of the problem, identify the cause of acrylamide formation, as well as the effect of storage on its concentration. We also determined the utility of rapid kits for asparagine quantification. Our results indicate that high acrylamide levels are a widespread problem (85% of samples analysed) and there was a correlation between acrylamide and asparagine of R2 = 0.58 (p < 0.001), but not with any post-harvest processing variable. We estimate that with a concentration of asparagine of <0.1 g l−1 in sugarcane juice, the threshold set by buyers for acrylamide can be met. Potential solutions to reduce asparagine include varietal selection, improved agronomic practices and the use of asparaginase during panela production. However, any proposed measure should be applicable in the context of the rural Peru. Additionally, we confirm the utility of rapid and low-cost kits for measuring asparagine. This pioneering study provides a baseline for effective management for acrylamide minimization in panela.

Factors Associated with Mortality in Patients with COVID-19 from a Hospital in Northern Peru

We aimed to identify the factors associated with mortality in patients with COVID-19 from the hospitalization service of the Cayetano Heredia Hospital, Piura, Peru, from May to June 2020. A prospective study was conducted in hospitalized patients with a confirmed diagnosis of COVID-19 through serological and/or molecular reactive testing. The dependent variable was death due to COVID-19, and the independent variables were the epidemiological, clinical and laboratory characteristics of the patient. The chi-square test and the non-parametric Mann–Whitney U test were used, with a significance level of 5%. Of 301 patients with COVID-19, the majority of them were male (66.1%), and the mean age was 58.63 years. Of the patients analyzed, 41.3% of them died, 40.2% of them were obese and 59.8% of them had hepatic steatosis. The three most frequent signs/symptoms were dyspnea (90.03%), fatigue (90.03%) and a cough (84.72%). Being an older adult (p = 0.011), being hospitalized in the ICU (p = 0.001), overweight (p = 0.016), obese (p = 0.021) and having compromised consciousness (p = 0.039) and thrombocytopenia (p = 0.024) were associated with mortality due to COVID-19. Overall, the mortality rate due to COVID-19 was 41.3%. Having an older age, being hospitalized in the ICU, overweight, obese and having compromised consciousness and thrombocytopenia were positively associated with mortality in patients with COVID-19. These findings highlight the need to establish an adequate system of surveillance and epidemiological education in hospitals and communities in the event of new outbreaks, especially in rural and northern Peru.

A drop of love? Rainfall shocks and spousal abuse: Evidence from rural Peru

We investigate whether exposure to rainfall shocks affects the experience of physical intimate partner violence (P-IPV) among women in rural areas of the Peruvian Andes. Using data from the Demographic and Health Surveys over 2005–2014, we track changes in the probability that a woman experiences recent instances of P-IPV after being exposed to a rainfall shock during the last cropping season. Our results indicate that the probability that a woman experiences P-IPV increases by 8.5 percentage points (65 percent) after exposure to a dry, but not a wet, shock during the cropping season. We identify two complementary causal pathways of this effect: increased economic insecurity and poverty-related stress that deteriorates men’s emotional well-being and mental health, and reduced female empowerment that affects women’s ability to negotiate their preferences within the relationship.

World Health Organization myth busters and indigenous perceptions of COVID-19: Quechua and Shipibo communities

When the COVID (SARS-V2) pandemic swept across the world, it impacted Indigenous communities more than others. This is due to a variety of reasons: socioeconomic injustice and racialization, lack of access to equitable healthcare, and linguistic discrimination. As a result, several communities and community types demonstrated this effect when perceptions of inferences or other COVID-related information were measured. This paper reports on a participatory collaborative study with two Indigenous communities in rural Peru—ten Quechua-speaking communities in Southern Cuzco and three Shipibo-speaking communities in Ucayali regions. We investigate the communities' level of preparedness for the crisis by eliciting answers based on the World Health Organization COVID ‘MythBusters’ in a form of a semi-structured interview. Interviews were transcribed, translated, and analyzed in search of the effect of three variables: gender (male/female), language group (Shipibo/Quechua), and proficiency in the Indigenous language (from 0 to 4). Data reveal that all three variables have some effect on the target comprehension of COVID-related messages. Additionally, we explore other possible explanations.

Power and culture in Peru: A sociological study from the perspective of representatives of the Frankfurt School

Today, political, social and economic norms constantly strive to reduce poverty, boost economic growth, achieve demographic improvements and promote equality and security within a population. However, the urban centralism observed in Peru does not meet these objectives at all levels. Despite the fact that rural communities represent about a third of the population, for many years and as the basis of a historical cultural agreement, they have been little talked about and their potential for development has been underestimated. The exploitation of indigenous labour was normalised under capitalism, making the population identify with this reality as a social norm. Thus, people began to identify with the lifestyle imposed by the culture industry. In the case of the urban population, they came to identify with the associated social factors, such as social status. And in the case of the rural population, they were indoctrinated by being passive recipients of a world that apparently cannot change. This study analyses this problem from an economic, political and cultural perspective under the thinking of the representatives of the Frankfurt School from the perspective of power and culture issues. It seeks to make Peruvian society aware of the need to create a continuing and adult education proposal that stimulates and transforms learning processes in vulnerable populations, as is the case in rural Peru, thus optimising their development as a community for the struggle for social recognition on a cultural and legal level, reducing oppression and achieving reconciliation between the urban and rural areas.

Violence against Women and Social Development in Rural Peru

The present research aimed to determine the relationship between violence against women and social development in rural areas of La Libertad, 2022, for this I work with the type of basic research, with a quantitative approach, non-experimental design correlational level – descriptive cross-section, for this we analyzed 374 women from the province of Otuzco de la Libertad, by applying the questionnaire for both study variables. Therefore, as a result of the 374 women, 57% perceive violence against women at a high level, of which 2.9% perceived a fair level and 23.5% good and 0.55% deficient in relation to social development. On the other hand, it was possible to contrast the hypothesis where a Rho = 0.734 ** (high negative correlation) and a (p&lt;0.05) was obtained for both cases, therefore the Ha is admitted and the Ho is refuted, therefore, it is evident that violence against women is related to social development in rural areas of La Libertad, 2022. Conclusion, it was demonstrated that if violence against women decreases, it would improve social development in rural areas of the province of Otuzco.

Climate Change Perceptions and Adaptation Strategies: A Mixed Methods Study with Subsistence Farmers in Rural Peru

In Peru, subsistence farmers experience firsthand the direct and indirect impacts of climate change (CC). To understand how farmers adapt their livelihoods to climatic variability, this mixed methods study explored their perceptions and climate adaptability strategies implemented in Huayhuay, Peru. Twenty farmers participated in semi-structured interviews, and 103 completed a survey questionnaire. The results indicated that most farmers perceive changes in temperature, precipitation, and drought that negatively affect agricultural production and local natural resources. To deal with CC, farmers are implementing twenty-six climate adaptation strategies. Diversifying agricultural products and practices, and exploring new economic activities were adaptability strategies identified in this study that the literature has previously documented as having positive implications for agricultural livelihoods. However, some farmers reported that adaptability strategies are failed attempts at local climate action. The results, along with the adaptability literature, revealed that farmers implement locally accessible adaptability strategies based on their climate variability perceptions. Therefore, this study recommends exploring CC perceptions and adaptability strategies with a site-based approach. It is also recommended that future research, local climate planning, and action must focus on the efficiency and inclusiveness of strategies rather than their frequency or levels of adoption. Finally, strengthening the technical capacities and knowledge of CC among subsistence farmers must be a priority for authorities and practitioners in Huayhuay, Peru.

Incidence and predictors of frailty in Latin America and China: evidence from 10/66 cohort studies

Abstract Introduction Evidence on the incidence and risk factors of frailty in low- and middle-income countries is very limited. We aimed to compare the incidence of frailty and explore its determinants in rural and urban areas in six Latin American countries and China. Methods The 10/66 is a multi-site cohort study in older adults. We conducted baseline and follow-up surveys in 2003-2006, and 2007-2010. We assessed frailty using a modified Fried frailty phenotype criterion, and adjudicated frailty (yes/no) when two or more of the following indicators were present: exhaustion, low physical activity, slow gait speed, and weight loss. We excluded frail participants at baseline and calculated person-years as the time interval between baseline and follow-up for frailty-free people who were survived and reinterviewed or the midpoint of it for incident frailty cases. We used Poisson and Cox regressions to model the incidence of frailty and its risk factors. Results We included 9,747 participants (≥65 years) for the analysis of frailty risk factors. Of whom, 8,212 were reinterviewed with an average of 4.0 years of follow-up, the incidence of frailty was lowest in Venezuela (21.9 per 1000 person-years) and rural Peru (24.3 per 1000 person-years), highest in rural Mexico (110.5 per 1000 person-years) and urban Peru (84.0 per 1000 person-years). In the overall Cox regression, we found significant prospective associations of incident frailty with living in rural areas (HR: 1.97, 95% CI: 1.69, 2.29), dementia (HR: 1.76, 95% CI: 1.42, 2.18), depression (HR: 1.69, 95% CI: 1.49, 1.93), comorbidity, female gender, older age, disability, hearing, and vision problems. Higher arm circumference was associated with a lower frailty risk (HR: 0.97, 95% CI: 0.96, 0.98). Conclusions The incidence of frailty varied substantially in Latin America and China, and between urban and rural areas. The identified risk factors could be potential intervention targets to decrease the global burden of frailty. Key messages • In Latin America and China, the incidence of frailty varied from 21.9 to 110.5 cases per 1000 person-years. • We identified 9 risk factors and 1 protective factor for developing frailty, and the most relevant risk factors were living in the rural area, dementia, and depression.

Volume sweep imaging lung teleultrasound for detection of COVID-19 in Peru: a multicentre pilot study

ObjectivesPulmonary disease is a significant cause of morbidity and mortality in adults and children, but most of the world lacks diagnostic imaging for its assessment. Lung ultrasound is a portable,...

Agricultural culture among secondary school students in rural Peru

The research problem is centered on the lack of agricultural education proposals for a sustainable life project in rural Peruvian students at the secondary level. The present study has the purpose of developing a documentary diagnosis on the situation of agricultural education of students in rural areas, at the secondary level, considering as bases of the model the didactic, psycho-pedagogical and gnoseological characterization that allows the systematization of a proposal, exercising for it a bibliographic scrutiny of the state of the art in its heuristic and hermeneutic phases with the historiographic analysis on the teaching-learning of students according to the secondary level in rural areas. The present work is descriptive and propositive, so it is based on an urgent requirement within Peruvian institutions. Theoretical aspects will be contributed as support for other studies concerning the education sector. Within the framework of a practical significance is the preparation of an agricultural education offer for the improvement of the sustainable life project. It is concluded that the curricula offered by the educational institutions do not cover the training deficiencies of the students in their agricultural activities.