Macrolitter and microplastics along the East Pacific coasts - A homemade problem needing local solutions.

The East Pacific (EP) region, especially the central and southern EP, has been fairly less studied than other world's regions with respect to marine litter pollution. This comprehensive literature review (257 peer-reviewed publications) showed that both macrolitter (mostly plastics) and microplastics tend to accumulate on EP shorelines. Moreover, they were also reported in all the other compartments investigated: sea surface, water column, seafloor and 'others'. Mostly local, land-based sources (e.g., tourism, poor waste management) were identified across the region, especially at continental sites from low and mid latitudes. Some sea-based sources (e.g., fisheries, long-distance drifting) were also identified at high latitudes and on oceanic islands, likely enhanced by the oceanographic dynamics of the EP that affect transport of floating litter. Our results suggest that effective solutions to the problem require local and preventive strategies to significantly reduce the levels of litter along the EP coasts.

Plastic pollution transcends marine protected area boundaries in the eastern tropical and south-eastern Pacific.

The Eastern Tropical and South-Eastern Pacific region is of global biodiversity importance. At COP26, the governments of Costa Rica, Panama, Colombia, and Ecuador committed to the expansion of existing MPAs to create a new Mega MPA, safeguarding the Eastern Tropical Pacific Marine Corridor. It offers a profound step forward in conservation efforts but is not specifically designed to protect against the more diffuse anthropogenic threats, such as plastic pollution. We combine published data with our own unpublished records to assess the abundance and distribution of plastic pollution in the region. Macro- and microplastic concentrations varied markedly and were not significantly different when comparing areas inside and outside existing MPA boundaries. These findings highlight the diffuse and complex nature of plastic pollution and its ubiquitous presence across MPA boundaries. Understanding the sources and drivers of plastic pollution in the region is key to developing effective solutions.

Population-Level Portal-Based Anxiety and Depression Screening Perspectives in HIV Care Clinicians: Qualitative Study Using the Consolidated Framework for Implementation Research.

BACKGROUND: Depression and anxiety are common among people with HIV and are associated with inadequate viral suppression, disease progression, and increased mortality. However, depression and anxiety are underdiagnosed and undertreated in people with HIV owing to inadequate visit time and personnel availability. Conducting population-level depression and anxiety screening via the patient portal is a promising intervention that has not been studied in HIV care settings. OBJECTIVE: We aimed to explore facilitators of and barriers to implementing population-level portal-based depression and anxiety screening for people with HIV. METHODS: We conducted semistructured hour-long qualitative interviews based on the Consolidated Framework for Implementation Research with clinicians at an HIV clinic. RESULTS: A total of 10 clinicians participated in interviews. In total, 10 facilitators and 7 barriers were identified across 5 Consolidated Framework for Implementation Research domains. Facilitators included advantages of systematic screening outside clinic visits; the expectation that assessment frequency could be tailored to patient needs; evidence from the literature and previous experience in other settings; respect for patient privacy; empowering patients and facilitating communication about mental health; compatibility with clinic culture, workflows, and systems; staff beliefs about the importance of mental health screening and benefits for HIV care; engaging all clinic staff and leveraging their strengths; and clear planning and communication with staff. Barriers included difficulty in ensuring prompt response to suicidal ideation; patient access, experience, and comfort using the portal; limited availability of mental health services; variations in how providers use the electronic health record and communicate with patients; limited capacity to address mental health concerns during HIV visits; staff knowledge and self-efficacy regarding the management of mental health conditions; and the impersonal approach to a sensitive topic. CONCLUSIONS: We proposed 13 strategies for implementing population-level portal-based screening for people with HIV. Before implementation, clinics can conduct local assessments of clinicians and clinic staff; engage clinicians and clinic staff with various roles and expertise to support the implementation; highlight advantages, relevance, and evidence for population-level portal-based mental health screening; make screening frequency adaptable based on patient history and symptoms; use user-centered design methods to refine results that are displayed and communicated in the electronic health record; make screening tools available for patients to use on demand in the portal; and create protocols for positive depression and anxiety screeners, including those indicating imminent risk. During implementation, clinics should communicate with clinicians and clinic staff and provide training on protocols; provide technical support and demonstrations for patients on how to use the portal; use multiple screening methods for broad reach; use patient-centered communication in portal messages; provide clinical decision support tools, training, and mentorship to help clinicians manage mental health concerns; and implement integrated behavioral health and increase mental health referral partnerships.

Citizen scientists study beach litter along 12,000 km of the East Pacific coast: A baseline for the International Plastic Treaty.

Anthropogenic Marine Litter (AML) accumulating on beaches causes damage to coastal ecosystems and high costs to local communities. Volunteers sampled AML on 130 beaches along the central and southern East Pacific coasts, with AML densities ranging from 0.46 to 2.26 items m-2 in the different countries. AML composition was dominated by plastics and cigarette butts, the latter especially in Mexico and Chile. The accumulation of AML in the upper zones of the beaches and substantial proportions of cigarette butts, glass and metal pointed mainly to local sources. Statistical modelling of litter sources on continental beaches revealed that tourism, access and related infrastructure (e.g. parking lots) best explained AML densities, while plastic densities were also influenced by the distance from river mouths and national Gross Domestic Product. Large-scale monitoring can be a useful tool to evaluate the effectiveness of public policies that should primarily focus on land sources.

Mountain streams flushing litter to the sea - Andean rivers as conduits for plastic pollution.

Rivers polluted by anthropogenic litter are major transport routes of litter from inland to the coastal zone and the ocean. However, litter studies have primarily focused on marine environments, and the litter dynamics in rivers are still poorly understood. Herein, we explored the abundances, composition and sources of litter at the riversides and in surface waters of mountain rivers from continental Chile in two different years. Additionally, we evaluated whether different temporal, geographic, topographic, hydrologic or anthropogenic factors influence the abundances of litter. Anthropogenic litter was prevalent in Chilean rivers, both at the riversides and in surface waters. Average abundances of riverside litter, floating macrolitter, and small floating plastics were 1.8 items m-2, 10.1 items h-1 and 5.8 items h-1, respectively, and abundances were generally higher in northern Chile. Plastics dominated in all compartments, comprising 29% of riverside litter and more than 70% of small floating litter, but other litter categories were also present at riversides. Sources of litter in Chilean rivers were mostly local, such as recreational visitors, residents, and illegal dumping, and there were no clear effects of the different tested factors on the abundances of litter. Litter densities in surface waters were low compared to those in lowland slow-flowing rivers in other countries, suggesting that retention of litter is limited in the highly dynamic and rapidly flushing mountain rivers, and thus most litter (primarily plastics) is transported directly to the sea. The results suggest that to adequately address this problem in Chile, prevention measures should be aimed at the identified local sources, by means of education, public policies, legislation, and enforcement.

Composition, abundance and sources of anthropogenic marine debris on the beaches from Ecuador - A volunteer-supported study.

This study represents an inter-institutional effort that was supported by more than 400 volunteers. We sampled Anthropogenic Marine Debris (AMD) on 26 beaches, including one beach from Galapagos Islands. AMD was mainly composed of plastics (>60%), followed by cigarette butts, paper and metal. Average AMD density on the continental beaches was 1.31 ± 1.03 items m-2 (mean ± SD). AMD densities and the proportion of plastics were higher on some beaches located on the Gulf of Guayaquil, suggesting that many of the plastic items found on these beaches were, likely, drifted by the swift currents of the Guayas River. Additionally, the overall results indicate that most litter on continental beaches from Ecuador has local sources. Recommendations include marine pollution education and public awareness campaigns to reduce the consumption of plastic bags, as well as a ban on harmful single-use plastics.

Inter-hemispherical shoreline surveys of anthropogenic marine debris - A binational citizen science project with schoolchildren.

Anthropogenic marine debris (AMD) is a global problem and the identification of its sources is essential for adequate mitigation strategies. Herein we examined whether AMD density and composition differed between two countries with contrasting socio-economic backgrounds and marine litter sources (i.e. Chile and Germany). In nationwide beach litter surveys, we used a citizen science approach with schoolchildren and their teachers. Litter densities were substantially higher in Chile than in Germany. The different geographic zones surveyed in both countries showed strong grouping tendencies according to their main economic activities (tourism, shipping, fisheries/aquaculture), major litter sources, and AMD composition, in terms of dominance and diversity of AMD types. The results suggest that beach litter composition can be used as a simple proxy to identify AMD sources, and also that law enforcement and education can help mitigate the problem; however, for efficient solutions, production and consumption of plastics must be reduced.

Spatio-temporal variation of anthropogenic marine debris on Chilean beaches.

We examined the hypothesis that in an emerging economy such as Chile the abundances of Anthropogenic Marine Debris (AMD) on beaches are increasing over time. The citizen science program Científicos de la Basura ("Litter Scientists") conducted three national surveys (2008, 2012 and 2016) to determine AMD composition, abundance, spatial patterns and temporal trends. AMD was found on all beaches along the entire Chilean coast. Highest percentages of AMD in all surveys were plastics and cigarette butts, which can be attributed to local sources (i.e. beach users). The Antofagasta region in northern Chile had the highest abundance of AMD compared with all other zones. Higher abundances of AMD were found at the upper stations from almost all zones. No significant tendency of increasing or decreasing AMD densities was observed during the 8years covered by our study, which suggests that economic development alone cannot explain temporal trends in AMD densities.

Triagem auditiva escolar no município de Porto Alegre: resultados do estudo piloto / School hearing screening in the city of Porto Alegre: results of the pilot study

OBJETIVO: descrever os resultados do estudo piloto realizado para orientar o processo de implementação da triagem auditiva escolar, no Município de Porto Alegre. MÉTODOS: foram aplicados 134 protocolos em crianças de seis a oito anos de idade de uma Escola Municipal de Ensino Fundamental de Porto Alegre. Os resultados apresentados no protocolo de triagem eram: medida do Nível de Pressão Sonora no ambiente, durante a realização da triagem audiométrica; resposta à triagem audiométrica em 20 dB nas frequências de 1000Hz, 2000Hz e 4000Hz, em ambas as orelhas; Medidas de Imitância Acústica: curva timpanométrica e reflexos acústicos ipsilaterais nas frequências de 500Hz, 1000Hz, 2000Hz e 4000Hz, em 100 dB nas duas orelhas, utilizando o critério passa-falha. RESULTADOS: em relação ao sexo, 50,75% eram meninos. A idade média foi 6,86 anos (± 0.46). Na triagem audiométrica a grande maioria das crianças passou e a curva timpanométrica mais encontrada foi a Tipo A (51,7%), seguida da Tipo C (24,1%) na orelha direita, e na orelha esquerda 55,7% eram Tipo A e 21,6% Tipo C. O ruído ambiental manteve-se abaixo de 50 dBNA em 90,5%. CONCLUSÃO: a maioria das crianças que falharam na TAE tinha seis anos de idade. A curva timpanométrica mais prevalente foi do Tipo A, seguida do Tipo C. Não se observou diferenças estatisticamente significantes ao comparar as orelhas testadas e os sexos. .

PURPOSE: to describe the results of the pilot study carried out to guide the implementation process of the hearing screening in schools in the City of Porto Alegre. METHODS: 134 protocols were applied to children between the ages of six and eight, from a Municipal Elementary School in Porto Alegre. The results presented in the screening protocol were: the measurement of the Sound Pressure Level in the environment during the audiometric screening; response to audiometric screening at 20 dB with frequencies of 1000Hz, 2000Hz and 4000Hz in both ears; Acoustic Immittance Measures: tympanometric curve and ipsilateral acoustic reflexes at the frequencies of 500Hz, 1000Hz, 2000Hz and 4000Hz, at 100 dB in both ears, using the pass-fail criterion. RESULTS: in relation to sex, 50.75% were boys. The average age was 6.86 (±0.46). Most children passed the audiometric screening and the most frequent tympanometric curve was Type A (51.7 %), followed by Type C (24.1 %) in the right ear. In the left ear, 55.7% were Type A and 21.6%, Type C. The environmental noise remained below 50dBSPL in 90.5%. CONCLUSION: the majority of children who failed the audiometric screening were six years old. The most prevalent tympanometric curve was Type A, followed by Type C. No statistically significant differences were observed when genders and tested ears were compared. .