ORCID Profile
0000-0003-4969-8959
Current Organisation
Universidad Peruana Cayetano Heredia
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Publisher: Elsevier BV
Date: 10-2022
Publisher: Frontiers Media SA
Date: 22-04-2021
DOI: 10.3389/FNEUR.2021.661570
Abstract: Background and Aims: Despite known Indigenous health and socioeconomic disadvantage in countries with a Very High Human Development Index, data on the incidence of stroke in these populations are sparse. With oversight from an Indigenous Advisory Board, we will undertake a systematic review of the incidence of stroke in Indigenous populations of developed countries or regions, with comparisons between Indigenous and non-Indigenous populations of the same region, though not between different Indigenous populations. Methods: Using PubMed, OVID-EMBASE, and Global Health databases, we will examine population-based incidence studies of stroke in Indigenous adult populations of developed countries published 1990-current, without language restriction. Non-peer-reviewed sources, studies including & Indigenous People, or with insufficient data to determine incidence, will be excluded. Two reviewers will independently validate the search strategies, screen titles and abstracts, and record reasons for rejection. Relevant articles will undergo full-text screening, with standard data extracted for all studies included. Quality assessment will include Sudlow and Warlow's criteria for population-based stroke incidence studies, the Newcastle-Ottawa Scale for risk of bias, and the CONSIDER checklist for Indigenous research. Results: Primary outcomes include crude, age-specific and/or age-standardized incidence of stroke. Secondary outcomes include overall stroke rates, incidence rate ratio and case-fatality. Results will be synthesized in figures and tables, describing data sources, populations, methodology, and findings. Within-population meta-analysis will be performed if, and where, methodologically sound and comparable studies allow this. Conclusion: We will undertake the first systematic review assessing disparities in stroke incidence in Indigenous populations of developed countries. Data outputs will be disseminated to relevant Indigenous stakeholders to inform public health and policy research.
Publisher: MDPI AG
Date: 09-12-2022
DOI: 10.3390/SU142416502
Abstract: Bio ersity and ecosystem conservation in the Amazon play a critical role in climate-change mitigation. However, institutional responses have had conflicted and complex relations with Indigenous peoples. There is a growing need for meaningful engagement with—and recognition of—the centrality of Indigenous peoples’ perceptions and understanding of the changes they are experiencing to inform successful and effective place-based adaptation strategies. To fill this gap, this study focuses on the value-based perspectives and pragmatic decision-making of Shawi Indigenous men in the Peruvian Amazon. We are specifically interested in their perceptions of how their food system is changing, why it is changing, its consequences, and how/whether they are coping with and responding to this change. Our results highlight that Shawi men’s agency and conscious envisioning of their future food system intersect with the effects of government policy. Shawi men perceive that the main driver of their food-system changes, i.e., less forest food, is self-driven population growth, leading to emotions of guilt and shame. During our study, they articulated a conscious belief that future generations must transition from forest-based to agricultural foods, emphasising education as central to this transition. Additionally, results suggest that the Peruvian government is indirectly promoting Shawi population growth through policies linking population size to improved service delivery, particularly education. Despite intentional Shawi moves to transition to agriculture, this results in a loss of men’s cultural identity and has mental-health implications, creating new vulnerabilities due to increasing climatic extremes, such as flooding and higher temperatures.
Publisher: Colegio Medico del Peru
Date: 07-2020
DOI: 10.35663/AMP.2020.372.1030
Abstract: -
Publisher: BMJ
Date: 03-2021
Publisher: Springer Science and Business Media LLC
Date: 19-12-2022
DOI: 10.1186/S12939-022-01773-7
Abstract: Biomedical technologies have the potential to be advantageous in remote communities. However, information about barriers faced by users of technology in general and in remote Indigenous communities is scarce. The purpose of this study was to characterize the leading challenges faced by researchers who have used biomedical technologies in the Peruvian Amazon. This exploratory, qualitative study with a phenomenological approach depicts the lived experience of participants who were researchers with experience working with biomedical technologies in the Peruvian Amazon in the past five years. Analysis was based on three core themes: design, implementation, and acceptability. Sub-themes included environment, community, and culture. Of the 24 potential participants identified and contacted, 14 agreed to participate, and 13 met inclusion criteria and completed semi-structured interviews. Results were sent to each participant with the opportunity to provide feedback and partake in a 30-minute validation meeting. Five participants consented to a follow-up meeting to validate the results and provide further understanding. Participants recognized significant challenges, including technologies designed out-of-context, difficulty transporting the technologies through the Amazon, the impact of the physical environment (e.g., humidity, flooding), and limited existing infrastructure, such as electricity and appropriately trained health personnel. Participants also identified cultural factors, including the need to address past experiences with technology and health interventions, understand and appropriately communicate community benefits, and understand the effect of demographics (e.g., age, education) on the acceptance and uptake of technology. Complementary challenges, such as corruption in authority and waste disposal, and recommendations for technological and health interventions such as co-design were also identified. This study proposes that technological and health interventions without efforts to respect local cultures and health priorities, or understand and anticipate contextual challenges, will not meet its goal of improving access to healthcare in remote Amazon communities. Furthermore, the implications of corruption on health services, and improper waste disposal on the environment may lead to more detrimental health inequities.
Publisher: Springer Science and Business Media LLC
Date: 28-10-2021
Publisher: F1000 Research Ltd
Date: 26-06-2023
DOI: 10.12688/WELLCOMEOPENRES.18235.2
Abstract: Background : Undernutrition is projected to be a major consequence of climate change. Bio ersity could enhance climate change resilience by improving nutritional outcomes and providing healthy food resources during and/or after climate-related events. For Indigenous populations who currently base their diet on local bio ersity, rapid climate changes may affect their ability to produce, access or gather food and consequently impact their nutritional status. There is a knowledge gap regarding whether nutritional status among Indigenous populations is better among those who consume a diet with greater bio ersity than those who have a diet with low bio ersity. Objective : This study aims to investigate the role of food bio ersity (FBD) in nutritional resilience to extreme flooding events of Shawi Amazon Indigenous adults living in Peruvian communities that have experienced extreme floods in the past five years. Methods : This study will use a mixed-method sequential explanatory design. The quantitative component includes a cross-sectional survey to assess the association between food bio ersity (FBD) and the prevalence of anaemia in adults aged 15 to 60 years old (n=365). Anaemia will be evaluated using blood hemoglobin and serum ferritin. FBD will be measured with a food frequency questionnaire and a 24-hour dietary recall. Soil-transmitted helminth infections, malaria, and inflammatory biomarkers will also be evaluated. Qualitative component will include a community-based participatory approach to investigate the role of FBD in the responses to extreme floods. Male (n=14) and female (n=14) participants, previously identified in the quantitative phase with high and low levels of FBD, will be invited to participate in a Photovoice activity and semi-structured interviews. A analytical framework for climate change resilience will be used to integrate the data. Discussion : Findings will be integrated to identify features of diet quality to suggest nutritional interventions that are resilient to changing climatic conditions in the Amazon and respect Indigenous views.
Publisher: Elsevier BV
Date: 09-2020
Publisher: F1000 Research Ltd
Date: 04-10-2022
DOI: 10.12688/WELLCOMEOPENRES.18235.1
Abstract: Background : Undernutrition is projected to be a major consequence of climate change. Bio ersity could enhance climate change resilience by improving nutritional outcomes and providing healthy food resources during and/or after climate-related events. For Indigenous populations who currently base their diet on local bio ersity, rapid climate changes may affect their ability to produce, access or gather food and consequently impact their nutritional status. There is a knowledge gap regarding whether nutritional status among Indigenous populations is better among those who consume a diet with greater bio ersity than those who have a diet with low bio ersity. Objective : This study aims to investigate the role of food bio ersity (FBD) in nutritional resilience to extreme flooding events of Shawi Amazon Indigenous adults living in Peruvian communities that have experienced extreme floods in the past five years. Methods : This study will use a mixed-method sequential explanatory design. The quantitative component includes a cross-sectional survey to assess the association between food bio ersity (FBD) and the prevalence of anaemia in adults aged 15 to 60 years old (n=365). Anaemia will be evaluated using blood hemoglobin and serum ferritin. FBD will be measured with a food frequency questionnaire and a 24-hour dietary recall. Soil-transmitted helminth infections, malaria, and inflammatory biomarkers will also be evaluated. Qualitative component will include a community-based participatory approach to investigate the role of FBD in the responses to extreme floods. Male (n=14) and female (n=14) participants, previously identified in the quantitative phase with high and low levels of FBD, will be invited to participate in a Photovoice activity and semi-structured interviews. A analytical framework for climate change resilience will be used to integrate the data. Discussion : Findings will be integrated to identify features of diet quality to suggest nutritional interventions that are resilient to changing climatic conditions in the Amazon and respect Indigenous views.
Publisher: IOP Publishing
Date: 13-02-2023
Abstract: Past influenza pandemics including the Spanish flu and H1N1 have disproportionately affected Indigenous Peoples. We conducted a systematic scoping review to provide an overview of the state of understanding of the experience of Indigenous peoples during the first 18 months of the COVID-19 pandemic, in doing so we capture the state of knowledge available to governments and decision makers for addressing the needs of Indigenous peoples in these early months of the pandemic. We addressed three questions: (a) How is COVID-19 impacting the health and livelihoods of Indigenous peoples, (b) What system level challenges are Indigenous peoples experiencing, (c) How are Indigenous peoples responding? We searched Web of Science, Scopus, and PubMed databases and UN organization websites for publications about Indigenous peoples and COVID-19. Results were analyzed using descriptive statistics and content analysis. A total of 153 publications were included: 140 peer-reviewed articles and 13 from UN organizations. Editorial/commentaries were the most (43%) frequent type of publication. Analysis identified Indigenous peoples from 19 different countries, although 56% of publications were centered upon those in Brazil, United States, and Canada. The majority (90%) of articles focused upon the general adult population, few ( %) used a gender lens. A small number of articles documented COVID-19 testing (0.04%), incidence (18%), or mortality (16%). Five themes of system level challenges affecting exposure and livelihoods evolved: ecological, poverty, communication, education and health care services. Responses were formal and informal strategies from governments, Indigenous organizations and communities. A lack of ethnically disaggregated health data and a gender lens are constraining our knowledge, which is clustered around a limited number of Indigenous peoples in mostly high-income countries. Many Indigenous peoples have autonomously implemented their own coping strategies while government responses have been largely reactive and inadequate. To ‘build back better’ we must address these knowledge gaps.
Publisher: Research Square Platform LLC
Date: 29-01-2021
DOI: 10.21203/RS.3.RS-100873/V1
Abstract: We present the first systematic, global stocktake of the academic literature on human adaptation. We screen 48,316 documents and identify 1,682 articles that present empirical research documenting human efforts to reduce risk from climate change and associated hazards. Coding and synthesizing this literature highlights that the overall extent of adaptation across global regions and sectors is low. Adaptations are largely local and incremental rather than transformative. Behavioural adjustments by in iduals and households are more prevalent than any other type of response, largely motivated by drought and precipitation variability. Local governments and civil society are engaging in risk reduction across all sectors and regions, particularly in response to flooding. Urban technological and infrastructural adaptations to flood risk are prevalent in Europe, while shifts in farming practices dominate reporting from Africa and Asia. Despite increasing evidence of adaptation responses, evidence that these responses are reducing risks (observed and projected) remains limited.
Start Date: 2020
End Date: 2022
Funder: Engineering and Physical Sciences Research Council
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