Planeamiento estratégico del distrito de Carabayllo

El distrito de Carabayllo, es uno de los distritos más antiguos de Lima Norte. Fundado históricamente en 1571, es considerado como la génesis de Lima Norte, pues a partir del mismo se fueron creando los demás distritos del norte de Lima. Con una población de más de 300 mil habitantes, es uno de los distritos con menor densidad poblacional de la provincia. Esta situación, así como el desarrollo de la industria minera no metálica, constituye un gran atractivo para el desarrollo inmobiliario. Asimismo, su riqueza histórica y arqueológica constituye una gran oportunidad para el desarrollo del turismo y de negocios conexos. Sin embargo, el distrito tiene también grandes debilidades. La inseguridad ciudadana, la falta de mantenimiento de pistas y veredas, y la existencia de servicios públicos deficientes, ha ocasionado que hoy en día haya población que no cuenta con los servicios básicos como agua potable y limpieza pública. La presente investigación ha determinado el Plan Estratégico Integral (PEI) para el distrito de Carabayllo, con una visión al año 2030, en una coyuntura de estabilidad política, fiscal y monetaria. La metodología utilizada para la elaboración del PEI, ha tenido como fundamento lo recomendado por D’Alessio (2013), de acuerdo al modelo secuencial del proceso estratégico, desarrollando a partir de la visión deseada, el futuro esperado para el distrito de Carabayllo. De esta manera, se realizaron los distintos análisis para determinar, la posición externa e interna del distrito, la determinación de sus intereses, el planteamiento de objetivos de largo plazo, la formulación de las estrategias para el cumplimiento de estos objetivos, las políticas que acompañarán las estrategias, la definición de indicadores para evaluar y controlar el cumplimiento de hitos y la determinación de ventajas competitivas para el desarrollo futuro del distrito. La visión propuesta para Carabayllo es que para el año 2030, el distrito se convertirá en el mejor lugar para vivir de Lima Norte, siendo un distrito ecológico, seguro, con gran desarrollo comercial y empresarial, con una gestión municipal eficiente y participativa, en donde lo urbano se fusiona con lo rural y lo histórico. En el proceso estratégico, se determinó que Carabayllo, adolece de diversos problemas que requieren atención. Asimismo, se plantearon objetivos de corto y largo plazo, estrategias y políticas relacionadas para alcanzar la visión deseada. El resultado del proceso estratégico determinó el Plan Estratégico Integral (PEI), que luego de los diversos análisis internos y externos de la metodología sugerida por D’Alessio (2013) plantea las estrategias y políticas para contrarrestar esta situación. Además, se identificaron oportunidades de desarrollo de clústeres de turismo e inmobiliarios, que aprovecharán las ventajas competitivas del distrito. Finalmente, es necesaria la implementación del Plan Estratégico Integral que esta investigación ha propuesto, para lograr alcanzar la visión deseada del distrito de Carabayllo y asegurar su desarrollo futuroThe district of Carabayllo, is one of the oldest districts of Lima Norte. Founded in 1571, it is considered to be the genesis of Lima Norte, since from it, the other districts of Lima Norte were created. With a population of more than 300 thousand inhabitants, it is one of the districts with the lowest population density in the province. This situation, as well as the development of the non-metallic mining industry, constitutes a great attraction for real estate development. Also, its historical and archaeological wealth is a great opportunity for the development of tourism and related businesses. However, the district also has great weaknesses. Insecurity, the lack of maintenance of roads and trails, and the existence of deficient public services, has caused that today there are people who do not have basic services such as drinking water and public cleaning. This investigation has determined the Strategic Integral Plan (PEI) for the district of Carabayllo, with a vision to the year 2030, in a conjuncture of political, fiscal and monetary stability. The methodology used for the development of the PEI, has been based on D'Alessio (2013), according to the sequential model of the strategic process, developing from the desired vision, the expected future for the district of Carabayllo. The process was followed in order to determine the external and internal position of the district, the determination of its interests, the setting of long-term objectives, the formulation of strategies for the fulfillment of these objectives, the policies that will match the strategies, the definition of evaluation and control indicators and the determination of competitive advantages for the future development of the district. The proposed vision for Carabayllo is that, by 2030, the district will become the best place to live in Lima Norte, being an ecological district, safe, with great commercial and business development, with an efficient and participative district management, where the urban merges with the rural and the historical. In the strategic process, it was determined that Carabayllo suffers from various problems that require attention. Likewise, short and long-term objectives, strategies and related policies were proposed to achieve the desired vision. The PEI has proposed strategies and policies to counteract this situation. In addition, opportunities for the development of tourism and real estate clusters were identified, which will draw on of the competitive advantages of the district. Finally, it is necessary to implement the PEI that this research has proposed, in order to achieve the desired vision of Carabayllo district and ensure its future developmentTesi

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants

International audienceSummaryBackground Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension.MethodsWe used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson’s correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI).FindingsThe correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m² (95% CI 2·31–3·28) lower for women and 1·28 kg/m² (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone.InterpretationBMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. Funding: UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified