Fatores associados à qualidade de vida de crianças com epilepsia em um hospital nacional de Honduras / Factors associated to the quality of life in children with epilepsy in a national hospital in Honduras

A epilepsia representa um problema de grande escala que afeta a esfera social dos pacientes que dela sofrem. O presente estudo tem como objetivo avaliar a qualidade de vida de pacientes pediátricos com epilepsia e identificar os fatores associados à sua menor qualidade de vida. Foi realizado um estudo transversal, descritivo e analítico em pacientes com diagnóstico clínico e eletroencefalográfico de epilepsia, atendidos no ambulatório do serviço de neuropediatria do Hospital Universitário. Foi aplicado um questionário subdividido em dados da criança, dados dos pais ou cuidador, tipo de epilepsia, tratamento e Escala de Qualidade de Vida para Crianças com Epilepsia (CAVE). As variáveis foram analisadas por meio de estatística descritiva e modelo de regressão múltipla para encontrar preditores de qualidade de vida. Dos 187 pacientes, 68 (36,4%) apresentaram boa qualidade de vida. Não foram observadas diferenças significativas por sexo em nenhum dos itens estudados, nem na pontuação geral do questionário. Ter menos necessidades básicas insatisfeitas (P=<0,0001) e não ter epilepsia refratária foram preditores de melhor qualidade de vida (P=<0,0001). A qualidade de vida relatada pelos pais foi em sua maioria boa ou razoável, ter um maior número de necessidades básicas insatisfeitas e ser classificado como tendo epilepsia de difícil manejo foram preditores de piora na qualidade de vida medida pelo questionário CAVE.

Epilepsy represents a large-scale problem that affects the social sphere of the patients who suffer from it. The following study aims to assess the quality of life of pediatric patients with epilepsy and to identify the factors associated with a lower quality of life. A cross-sectional, descriptive and analytical study was carried out in patients with clinical and electroencephalographic diagnosis of epilepsy, who attended the outpatient clinic of the neuropediatric service of the Teaching Hospital. A survey was administered, subdivided into data on the child, data on the parents or caregiver, type of epilepsy, treatment and the Quality of Life Scale for Children with Epilepsy (CAVE). The variables were analyzed using descriptive statistics and a multiple regression model to find predictors of quality of life. Of the 187 patients, 68 (36.4%) had a good quality of life. No significant gender differences were observed, nor in the overall score of the survey. Having fewer unmet basic needs (P=<0.0001) and not having refractory epilepsy were predictors of better quality of life (P=<0.0001). Parent-reported quality of life was mostly good or fair, having a higher number of unmet basic needs and being classified as having difficult-to-manage epilepsy were predictors of worsening quality of life as measured by the CAVE scale.

The voice of Mexican small-scale fishers in times of COVID-19: Impacts, responses, and digital divide.

The COVID-19 pandemic has dramatically, quickly, and extensively affected fisheries, the effects of which have yet to be quantified globally, although some efforts have already been made locally and regionally. This study provides insights regarding the impacts of the pandemic in Mexican small-scale fisheries, explores community responses and digital divide. A total of 1493 interviews were conducted, and a social media analysis that reviewed 9079 posts from April to December 2020 was performed. The results show large socio-economic and environmental impacts (e.g. 89% of the markets closed in April, and 72% of respondents perceived an increase in the amount of solid waste). Women have faced increased inequalities when accessing fishing resources or healthcare. Responses have been varied and include closing communities, and fishing organizations distributing emergency funds. Fishers relate feeling very or moderately comfortable with technology and have spent more time using digital platforms during the pandemic than before. While the effects are still unfolding, there is an urgent need to breach the digital divide to guarantee equal opportunities for all. Efforts are needed to ensure that the most vulnerable groups (e.g. women, indigenous people, and elderly individuals) are not excluded from opportunities to access, use or manage resources, including technology. This global crisis may also bring opportunities for adaptation and the implementation of local solutions (e.g. reducing the fishing effort for high-value products), to prepare for future shocks. The findings in this study serve to promote development strategies that build resilience in fishing communities for healthier oceans.

Agricultural Food Production Diversity and Dietary Diversity among Female Small Holder Farmers in a Region of the Ecuadorian Andes Experiencing Nutrition Transition.

Some rural areas of Ecuador, including the Imbabura Province of the Andes Highlands, are experiencing a double burden of malnutrition where micronutrient deficiencies persist at the same time obesity is increasing as many traditional home-grown foods are being replaced with more commercially prepared convenience foods. Thus, the relationships among agricultural food production diversity (FPD), dietary diversity (DD), and household food insecurity (HFI) of the rural small holder farmers need further study. Therefore, we examined these associations in small holder farmers residing in this Province in the Andes Highlands (elevation > 2500 m). Non-pregnant maternal home managers (n = 558, x age = 44.1, SD = 16.5 y) were interviewed regarding the number of different agricultural food crops cultivated and domestic animals raised in their family farm plots. DD was determined using the Minimum Dietary Diversity for Women Score (MDD-W) based on the number of 10 different food groups consumed, and household food insecurity (HFI) was determined using the 8-item Household Food Insecurity Experience Scale. The women reported consuming an average of 53% of their total food from what they cultivated or raised. Women with higher DD [MMD-W score ≥ 5 food groups (79% of total sample)] were on farms that cultivated a greater variety of crops (x = 8.7 vs. 6.7), raised more animals (x = 17.9 vs. 12.7, p < 0.05), and reported lower HFI and significantly higher intakes of energy, protein, iron, zinc, and vitamin A (all p < 0.05). Multiple regression analyses demonstrated that FPD was only modestly related to DD, which together with years of education, per capita family income, and HFI accounted for 26% of DD variance. In rural areas of the Imbabura Province, small holder farmers still rely heavily on consumption of self-cultivated foods, but greater diversity of crops grown in family farm plots is only weakly associated with greater DD and lower HFI among the female caretakers.

Resilience in Caregivers: A Systematic Review.

BACKGROUND: Resilience is a multidimensional construct that explains why people facing the consequences of adversity and stress can have a positive outcome, emphasizing adjustment to experiences that are perceived as threatening. OBJECTIVE: The aim of this study is to review the construct of resilience and associated variables in caregivers of patients with chronic, advanced illness and at the end of life. METHODS: The review included studies published between January 2009 and January 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide reporting. The Medline, ScienceDirect, HINARI, PsychINFO, and SciELO databases were used for bibliographic exploration to identify research studies that examined the impact of resilience on adaptation and overall well-being in caregivers of patients with chronic and advanced illness. RESULTS: A total of 23 quantitative and qualitative studies were identified whose aim was to describe the role of resilience in adaptation and coping in caregivers. In these studies, resilience was associated with a positive impact on the quality of life and emotional distress. Communication and social support increase resilient coping strategies. In most selected articles, the sampling strategy used was convenience sampling. Data collection used evaluation scales related to resilience and associated variables for quantitative studies, and semistructured interviews were used for qualitative studies. CONCLUSION: Promoting a resilient coping style in caregivers reduces the distress that normally results from illness-related changes in the biopsychosocial and spiritual dimensions. A resilient coping style can diminish the risk of stress and burden, and promote adaptation in the caregiver.

Estudio microbiológico en jarabe de carao (Cassia grandis L. ) con mayor demanda a nivel ambulatorio en la ciudad de León / Microbiological study in syrup from Carao (Cassia Grandis L. ) with greater demand at ambulatory level in the city of León

El presente trabajo realiza el ensayo microbiológico en jarabe de carao (Cassia grandis L.), identifica la presencia de bacterias patogenias: Escherichia Coli, Staphyloccus aureus, Pseudomona aeruginosa y Salmonella Spp en jarabe de Cassia grandis L., determina la cantidad de hongos y levaduras en jarabe de Cassia grandis L., así como también cuantifica la presencia de bacterias aerobias mesofilas en jarabe de Cassia grandis L. Se decidió realizar el presente estudio de investigación debido a que muchas personas ingieren productos naturales que se comercializaron libremente en las calles como es el caso del jarabe de carao el cual ha tenido una importante introducción en el Mercado Nicaragüense, teniendo como principal demandante la población infantil, pero sin embargo no se le realiza un control microbiológico adecuado, pudiendo representar un peligro a las personas que lo ingieren.