The Long Term Impact of Micronutrient Supplementation during Infancy on Cognition and Executive Function Performance in Pre-School Children

Brain growth and development are critically dependent on several micronutrients. During early development cellular activity may be sensitive to micronutrient deficiencies, however the evidence from human studies is equivocal. The objective of this study was to examine the long-term cognitive and social-emotional effects of multiple micronutrient supplementation compared with iron supplementation alone, administered during infancy. This study was a follow-up to an initial randomized, double-blind controlled trial (RCT) in 2010 in which 902 infants, aged 6-17 months, from Lima, Peru, were given daily supplements of either iron (Fe) or multiple micronutrients (MMN) including zinc (451 in each group). The supplementation period for both groups was six months. In 2012, a subsample of 184 children from the original cohort (now aged 36-48 months) was randomly selected to participate in a follow-up trial and was assessed for intelligence, working memory, inhibition, and executive function. The tests showed no significant differences between the supplementation groups though there were some gender differences, with girls displaying higher scores than boys across both groups on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) Verbal IQ sentences subtest, the Day-Night cognitive test and on the Brief Infant-Toddler Social Emotional Assessment (BITSEA) social competency, and boys scoring higher than girls in problem behaviour. The results indicate that MMN supplementation had no long term additional effects on cognitive function compared with iron supplementation alone. The timing of supplement administration for maximum impact on a child's cognitive development requires further investigation

Percepción de la calidad de servicio del evento gastronómico internacional Mistura periodo 2014

Hoy en día la calidad de servicio es un elemento fundamental en la gestación de las empresas, Es así que la calidad de servicio está conformado por los elementos tangibles e intangibles que perciben los consumidores al recibir un servicio. Si en las organizaciones, todos estuvieran conscientes que la calidad es un progreso que de alguna manera asegura la permanencia en el mercado e incrementa las utilidades, pueda lograrse que todos conviertan a esta en un estilo de vida, que conlleva en familiarizarse y conocer a los clientes en sus gustos, comodidades, preferencias y lo más importante poder obtener una opinión de ellos para lograr mejoras continuas en la empresa. Por tal motivo la presente investigación desarrolla un estudio sobre como los usuarios perciben calidad de servicio en el evento gastronómico Mistura 2014. El diseño de estudio es descriptiva simple y la muestra se constituyó por 114 asistentes a este evento, donde las edades oscilan entre 23 a 64 años de edad; asimismo se evaluaron a 49 varones y 65 mujeres. A quienes se les aplico el Cuestionario de percepción de calidad de servicio Servqual de Parasuraman, Zeithmahl y Berry (1991). El instrumento compara las expectativas frente a las percepciones del consumidor y se encuentra representado por un cuestionario de 22 preguntas que mide la calidad de un servicio y que se basa en las percepciones y expectativas del consumidor. Los resultados de la investigación mostraron que existe una predominancia del nivel bajo (46.5%) de la calidad de servicio

Gestión de Cuentas Por Cobrar Comerciales y Su Incidencia En La Liquidez de LA EMPRESA ARJEN EXPORT S.A.C. AÑO 2015

En el Perú existen empresas con diversos problemas, en su mayoría enfocados a mala gestión y políticas no determinadas para realizar procedimientos operativos los cuales consideramos son importantes para mantener una empresa en marcha, es por ello presentaremos “Gestión de cuentas por cobrar comerciales y su incidencia en la liquidez de la empresa ARJEN EXPORT S.A.C. año 2015”para mostrar la realidad de las empresas hoy en día. El objetivo principal del trabajo es determinar de qué manera la gestión de cuentas por cobrar comerciales incide en la liquidez de la empresa Arjen Export S.A.C., concluyendo que la empresa viene arrastrando una mala gestión de cobranzas, por lo que no cuenta con políticas de cobros y créditos, así como el otorgamiento de crédito libre a clientes sin una previa evaluación de su línea crediticia. La empresa en estudio por su situación debe implementar lineamientos, parámetros de cobros y créditos que puedan ayudar a un buen desempeño de la entidad, asimismo la delegación de funciones a cada a área; y para la captación de nuevos clientes se debe tomar en cuenta la materia crediticia, una evaluación minuciosa antes de otorgar créditos.In Peru there are companies with various problems, mostly focused on mismanagement and policies not determined to perform operating procedures which we believe are important to keep a company running, that is why we will present "Management of commercial accounts receivable and their incidence in the liquidity of the company ARJEN EXPORT SAC year 2015 "to show the reality of companies today. The main objective of the work is to determine how the management of commercial accounts receivable affects the liquidity of the company Arjen Export SAC, concluding that the company is dragging a bad collection management, so it does not have collection policies and credits, as well as the granting of free credit to clients without a prior evaluation of their credit line. The company under study due to its situation must implement guidelines, parameters of collections and credits that can help a good performance of the entity, as well as the delegation of functions to each area; and for the acquisition of new clients, the credit matter must be taken into account, a thorough evaluation before granting credits.Trabajo de investigació

Development and Validation of a Food Frequency Questionnaire to Estimate Intake among Children and Adolescents in Urban Peru

Tools to assess intake among children in Latin America are limited. We developed and assessed the reproducibility and validity of a semi-quantitative food frequency questionnaire (FFQ) administered to children, adolescents, and their caregivers in Lima, Peru. We conducted 24-h diet recalls (DRs) and focus groups to develop a locally-tailored FFQ prototype for children aged 0–14 years. To validate the FFQ, we administered two FFQs and three DRs to children and/or their caregivers (N = 120) over six months. We examined FFQ reproducibility by quartile agreement and Pearson correlation coefficients, and validity by quartile agreement and correlation with DRs. For reproducibility, quartile agreement ranged from 60–77% with correlations highest for vitamins A and C (0.31). Age-adjusted correlations for the mean DR and the second-administered FFQ were highest in the 0–7 age group, in which the majority of caregivers completed the FFQ on behalf of the child (total fat; 0.67) and in the 8–14 age group, in which both the child and caregiver completed the FFQ together (calcium, niacin; 0.54); correlations were <0.10 for most nutrients in the 8–14 age group in which the caregiver completed the FFQ on the child’s behalf. The FFQ was reproducible and the first developed and validated to assess various nutrients in children and adolescents in Peru

WHO Global Survey on Maternal and Perinatal Health in Latin America: classifying caesarean sections

<p>Abstract</p> <p>Background</p> <p>Caesarean section rates continue to increase worldwide with uncertain medical consequences. Auditing and analysing caesarean section rates and other perinatal outcomes in a reliable and continuous manner is critical for understanding reasons caesarean section changes over time.</p> <p>Methods</p> <p>We analyzed data on 97,095 women delivering in 120 facilities in 8 countries, collected as part of the 2004-2005 Global Survey on Maternal and Perinatal Health in Latin America. The objective of this analysis was to test if the "10-group" or "Robson" classification could help identify which groups of women are contributing most to the high caesarean section rates in Latin America, and if it could provide information useful for health care providers in monitoring and planning effective actions to reduce these rates.</p> <p>Results</p> <p>The overall rate of caesarean section was 35.4%. Women with single cephalic pregnancy at term without previous caesarean section who entered into labour spontaneously (groups 1 and 3) represented 60% of the total obstetric population. Although women with a term singleton cephalic pregnancy with a previous caesarean section (group 5) represented only 11.4% of the obstetric population, this group was the largest contributor to the overall caesarean section rate (26.7% of all the caesarean sections). The second and third largest contributors to the overall caesarean section rate were nulliparous women with single cephalic pregnancy at term either in spontaneous labour (group 1) or induced or delivered by caesarean section before labour (group 2), which were responsible for 18.3% and 15.3% of all caesarean deliveries, respectively.</p> <p>Conclusion</p> <p>The 10-group classification could be easily applied to a multicountry dataset without problems of inconsistencies or misclassification. Specific groups of women were clearly identified as the main contributors to the overall caesarean section rate. This classification could help health care providers to plan practical and effective actions targeting specific groups of women to improve maternal and perinatal care.</p

Estado nutricional de escolares de nivel primaria en el Perú-2015

Ponencia presentada en: Foro Internacional "Evidencias y tendencias para fortalecer las políticas en Nutrición y Alimentación Escolar", Lima, 30 de enero de 2019.Presenta indicadores relacionados al estado nutricional de estudiantes de Educación Primaria en el Perú al año 2015

Effect of anemia on child development: Long-term consequences

La anemia en niños menores de tres años es un problema de salud pública en el Perú y el mundo. Se estima que la causa principal de la anemia, aunque no la única, es la deficiencia de hierro. Existen muchos estudios y revisiones sobre cómo esta carencia en los infantes impacta negativamente en el desarrollo psicomotor y, a pesar de corregirse la anemia, los niños con este antecedente presentan, a largo plazo, un menor desempeño en las áreas cognitiva, social y emocional. Estos hallazgos se describen en estudios observacionales, de seguimiento, así como en experimentales con grupo control. La anemia puede disminuir el desempeño escolar, y la productividad en la vida adulta, afectando la calidad de vida, y en general la economía de las personas afectadas. Se describen algunos posibles mecanismos de cómo la deficiencia de hierro, con o sin anemia, podría afectar el desarrollo en la infancia; por ello, causa preocupación la alta prevalencia de anemia que se observa en este grupo de edad. La prevención de la anemia en el primer año de vida debe ser la meta para evitar consecuencias en el desarrollo de la persona a largo plazo.Anemia in children younger than 3 years is a public health problem in Peru and worldwide. It is believed that one of the primary causes of anemia is iron deficiency. Numerous studies and reviews have reported that iron deficiency limited psychomotor development in children and that, despite the correction of anemia, children with iron deficiency experienced poorer long-term performance in cognitive, social, and emotional functioning. These outcomes were reported in observational studies, follow-up studies, and experimental studies with a control group. Anemia can decrease school performance, productivity in adult life, quality of life, and the general income of affected individuals. Here we describe possible mechanisms underlying the effect of iron deficiency, with or without anemia, on childhood development. The high rate of anemia in this age group is a cause for concern. Moreover, anemia should be prevented in the first year of life to avoid long-term negative effects on individual development.La investigación ha sido financiada por el Instituto Nacional de Salud de Perú.Revisión por pare