A mixed-methods, cross-sectional study of perceived stigma among Ugandans with epilepsy

Background: Epilepsy is associated with stigma and negatively impacts the lives of people living with epilepsy (PLWE) and their immediate families. More understanding of the stigma and discrimination experienced by PLWE in sub-Saharan Africa is needed. Methods: In a cross-sectional, mixed methods study, forty- eight PLWE who met the study inclusion criteria were enrolled. In depth interviews and focus group discussions were conducted and were audiotaped and transcribed verbatim. Analysis was conducted using a thematic, constant comparative approach with an emphasis on dominant themes. Perceived stigma was measured using the Kilifi epilepsy stigma score. Associations between socio-demographic factors and Kilifi epilepsy stigma score were assessed. Results: The median age of the study participants was 25 years, with median age (IQR) of epilepsy onset of 12 (6-18) years. The prevalence of high-perceived stigma was 31.9% (15/48). Seizure frequency was associated with high levels of perceived stigma (p-value of 0.038). Psychological abuse, rejections at home, places of employment and schools, poor relationships and intimacy and unmet engagements in social activities were cited as the perceived stigmatizing aspects among PLWE. Conclusion: In this Ugandan sample perceived stigma remains unacceptably high and interventions to address it are urgently needed in our settings.

Los manglares como ecosistemas prioritarios para aumentar la resiliencia ante el cambio climático: Retos y oportunidades en el Pacífico de Guatemala / The mangroves as pririty ecosystems to increase the serilience to climate change: challenges and opportunities in the pacific of Guatemala

Los manglares se distribuyen en las zonas tropicales y subtropicales del planeta. Se ubican en zonas inundables, en suelos de alta salinidad y anaerobios. Estos bosques son reconocidos como ecosistemas fundamentales para el mantenimiento de la resiliencia ante el cambio climático en los hábitats marino-costeros ya que actúan como defensa ante tormentas y tsunamis, además participan en la estabilización microclimática y en la absorción de CO2. Sin embargo, estos ecosistemas han disminuido a través de los años debido a factores principalmente antro-pogénicos; se prevé que el cambio climático también influirá negativamente en su conservación. En el pacífico de Guatemala se ha registrado una cobertura de 22,763.25 ha de bosque de manglar, compuestas por seis especies. A pesar de lo anterior, únicamente el 23% está protegido dentro del sistema de áreas protegidas, por lo que, la cobertura vegetal de manglar ha disminuido a través de los años debido a cambios de uso de suelo, crecimiento urbano, contaminación, tala ilegal, entre otros. Asimismo, existen diversos retos que dificultan su conservación, como la falta de ordenamiento territorial y falta de conocimiento legal. Es necesario realizar acciones que pro-muevan la gestión sostenible de este ecosistema, y trabajar en las oportunidades existentes que podrían contribuir a la conservación, como el turismo sostenible e incentivos forestales que pueden disminuir los retos planteados.

Mangroves are distributed in tropical and subtropical zones of the planet. They are located in flood zones, in high salinity and anaerobic soils. These forests are recognized as fundamental ecosystems for maintaining resilience to climate change in marine-coastal habitats, as they act as a defense against storms and tsunamis and participate in microclimatic stabilization and CO2 absorption. However, these ecosystems have declined over the years due mainly to anthropogenic factors, and it is expected that climate change will also negatively influence their conservation. In the Pacific region of Guatemala, 22,763.25 ha of mangrove forest, composed of six species, have been recorded. Despite the above, only 23% is protected within the protected areas system, therefore mangrove vegetation cover has decreased over the years due to changes in land use, urban growth, pollution, illegal logging, among others. Likewise, there are several challenges that hinder its conservation, such as the lack of land use plan-ning and lack of legal knowledge. It is necessary to carry out actions that promote the sustainable management of this ecosystem, and to work on existing opportunities that could contribute to conservation, such as sustainable tourism and forestry incentives that can reduce the challenges posed.

Câncer infantil: uma análise do impacto do diagnóstico / Childhood cancer: an impact analysis diagnosis / Cáncer infantil: un análisis del impacto de diagnóstico

O diagnóstico de câncer representa um impacto significativo tanto para os pacientes quanto para suas famílias, na medida em que estressores potenciais os colocam em uma situação de vulnerabilidade. Com o objetivo de analisar o impacto psicossocial do diagnóstico de câncer, este estudo teve como participantes 12 crianças, com idade entre 6 e 12 anos (M = 8,75; DP = 2,05), de um hospital na Grande Vitória, no Espírito Santo, e seus cuidadores. Foram avaliados o enfrentamento da hospitalização (Instrumento de Avaliação das Estratégias de Enfrentamento da Hospitalização/AEH) e o risco psicossocial (Psychosocial Assessment Tool/PAT). Dados sociodemográficos e clínicos foram obtidos pela consulta ao prontuário. Os dados foram submetidos a análise estatística descritiva. O risco psicossocial apresentou classificação clínica. Sobre o enfrentamento, foram verificadas estratégias adaptativas, como distração e suporte social, assim como estratégias menos adaptativas, como ruminação. Este estudo contribui para a área do coping pediátrico e indica possíveis focos de intervenção psicológica.

The diagnosis of cancer has a significant impact on both patients and their families, as potential stressors put them in a situation of vulnerability. With the purpose of analyzing the psychosocial impact of childhood cancer diagnosis this research was attended by 12 children, aged from 6 to 12 years (M = 8.75, SD = 2.05), and theirs caregivers, in a hospital in Grande Vitória, in Espirito Santo, Brazil. The coping with the hospitalization (Coping with Hospitalization Scale) and psychosocial risk (Psychosocial Assessment Tool / PAT) were evaluated. Social-demographic and clinical variables were evaluated (medical records). Data were submitted to descriptive statistical analysis. The family presented clinical psychosocial risk. About coping, adaptive strategies were verified, as distraction and social support and also less adaptive strategies, as rumination. This study presents contributions to children coping and indicates possible sources of psychological intervention.

El diagnóstico de cáncer es un impacto significativo tanto para los pacientes como para su familia, en la medida en que los factores estresantes potenciales los pusieron en una situación vulnerable. Con el objetivo de analizar el impacto del diagnóstico del cáncer la presente investigación tuvo como participantes a 12 niños, de edades comprendidas entre los 6 y 12 años (M = 8,75; DP= 2,05), en un hospital en la Grande Vitória/ES. Se evaluó, el momento del diagnóstico, el enfrentamiento a la hospitalización (AEH); riesgo psicosocial (Psychosocial Assessment Tool/PAT); y variables sociodemográficas y clínicas (Ficha Médica). Datos fueron sometidos a análisis de estadística descriptiva. El riesgo psicosocial se mostró elevado durante el periodo evaluado. Sobre el enfrentamiento, fueron verificadas estrategias adaptativas (distracción, apoyo social), así como estrategias menos adaptativas (rumia). Este estudio presenta contribuciones para el área del coping pediátrico e indica posibles focos de intervención psicológica.

Relationship between anthropogenic impacts and bleaching-associated tissue mortality of corals in Curaçao (Netherlands Antilles) / Relación entre los impactos antropogénicos y la mortalidad tisular asociada al blanqueamiento de corales en Curaçao (Antillas Holandesas)

Chronic anthropogenic impacts can have a negative effect on coral health and on coral energy budgets needed for regeneration of lesions. I therefore hypothesise that during massive bleaching events, the degree of corals showing bleaching-related tissue mortality is higher in areas subject to chronic anthropogenic impacts than in relatively pristine areas. In the present study, the degree of bleaching and bleaching-related tissue mortality was estimated for eight abundant coral species in Curaçao, at the onset of a massive Caribbean bleaching event in 1995, and three months afterwards. To study the possible effects of anthropogenic disturbances, the study was done at four unpolluted control sites, two polluted sites (sedimentation, sewage), and four sites at the mouth of lagoons with outflow of nutrient-rich, warm and turbid seawater. No pattern of an overall difference in bleaching between impacted and control sites was found for the degree of bleaching. However, the percentage of corals showing bleaching-related tissue mortality was higher at the impacted sites than at the control sites for the total number of corals and for corals with < 50% of their surface area bleached. Highest and most significant values of tissue mortality were found at a reef site experiencing chronic pollution by raw sewage. The data thus suggest that unfavourable conditions caused by anthropogenic influences, such as increased sedimentation, eutrophication and seawater temperature, have an additional negative effect on the tissue survival of coral colonies during bleaching episodes. Rev. Biol. Trop. 54 (Suppl. 3): 31-43. Epub 2007 Jan. 15.

Los impactos antropogénicos crónicos pueden tener efectos negativos en la salud y en las cantidades de energía necesarias para la regeneración de lesiones en los corales. Mi hipótesis fue que durante los casos de blanqueamiento masivo, el grado en que los corales muestren mortalidades de tejido relacionadas con el blanqueamiento, será mayor en áreas sujetas a impactos antropogénicos crónicos que en áreas relativamente prístinas. Estimé los grados de blanqueamiento y mortalidad tisular en ocho especies de coral abundantes en Curaçao, durante el comienzo de un de blanqueamiento masivo en el Caribe en 1995 y tres meses después. El estudio se realizó en cuatro sitios control no contaminados, dos sitios contaminados (sedimentación, aguas residuales), y cuatro sitios en la boca de lagunas con aguas tibias, ricas en nutrientes y turbias. En general, no se encontró ningún patrónx de diferencias en el grado de blanqueamiento entre sitios. Sin embargo, el porcentaje de corales que mostraron mortalidad tisular relacionada con el blanqueamiento fue mayor en los sitios impactados que en los controles, tanto en el número total de corales como en corales con <50% de su superficie blanquedada. Los valores más altos y más significativos de mortalidad tisular se encontraron en un arrecife que experimentaba contaminación crónica por aguas residuales crudas. La información sugiere que las condiciones desfavorables causadas por la influencia antropogénica, como el incremento en la sedimentación, eutrofización y la temperatura del agua, tienen un efecto negativo adicional en la supervivencia del tejido de las colonias de coral, durante el blanqueamiento.