RESUMO
Background and Objectives: Little is known about patients' and caregivers' experiences with atopic dermatitis (AD) in Argentina, so a survey was administered to learn more. Materials and Methods: A 53-item anonymous survey was administered in Spanish to adult AD patients (n = 334) and caregivers (n = 339) of pediatric AD patients in Argentina (total n = 673). Demographics, healthcare provider information, financial burden, disease severity, disease burden, level of disease-specific education, and experience with shared physician/patient decision making were collected. Linear and logistic regression models were used for statistical comparisons. Results: Survey respondents were overwhelmingly female (90.8%), as was the overall patient population (72.8%). Patients were seen mostly by healthcare specialists (66.8% dermatologists, 13.5% pediatricians, 7.7% allergists, and 7.2% general practitioners). Only 2.8% of respondents reported no symptoms, while 33.3%, 52.4%, and 11.5% reported mild, moderate, and severe AD disease, respectively. Anxiety/depression and pain/discomfort were the most impactful on respondents' quality of life. Caregivers of children with moderate to severe AD and adult patients with severe AD reported a significant financial burden, including using savings or not purchasing food or other essentials to afford medical care. Few people reported receiving disease-specific education or having their own treatment priorities taken into consideration. For adult patients, receiving disease education and being asked about treatment priorities were associated with higher treatment satisfaction and AD control. Discussion: Mental health, pain/discomfort, and financial worries are the most important burdens for adult AD patients and caregivers of children with AD in Argentina. We recommend prioritizing disease-specific education and shared decision making to improve AD care in Argentina.
Assuntos
Cuidadores , Efeitos Psicossociais da Doença , Dermatite Atópica , Humanos , Feminino , Dermatite Atópica/psicologia , Dermatite Atópica/terapia , Argentina , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Masculino , Adulto , Inquéritos e Questionários , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Adolescente , Criança , Índice de Gravidade de DoençaRESUMO
Artificial reefs are often discouraged in shallow waters over concerns of storm damage to structures and surrounding habitat. Biorock coral reef restoration projects were initiated in waters around 5m deep in Grand Turk, at Oasis (October 2006) and at Governors Beach (November 2007). Hemi-cylindrical steel modules, 6m long were used, four modules at Oasis and six at Governors Beach. Each project has over 1200 corals transplanted from sites with high sedimentation damage, and are regularly monitored for coral growth, mortality and fish populations. Corals show immediate growth over wires used to attach corals. Growth has been measured from photographs using a software program and is faster at Governors Beach. After hurricanes Hanna and Ike (September 2008) the Governors Beach structure was fully standing since the waves passed straight through with little damage, the Oasis structures which were tie-wired rather than welded had one module collapse (since been replaced with a new, welded structure). Hurricane Ike was the strongest hurricane on record to hit Grand Turk. Most cables were replaced following the hurricanes due to damage from debris and high wave action. The projects lost about a third of the corals due to hurricanes. Most of those lost had only been wired a few days before and had not yet attached themselves firmly. These projects have regenerated corals and fish populations in areas of barren sand or bedrock and are now attractive to snorkelers. High coral survival and low structural damage after hurricanes indicate that Biorock reef restoration can be effective in storm-impacted areas. Rev. Biol. Trop. 58 (Suppl. 3): 141-149. Epub 2010 October 01.
Con frecuencia no se favorece la creación de arrecifes artificiales en aguas someras debido a que se estima que las tormentas pueden producir daños en las estructuras y en el hábitat circundante. En las aguas de Grand Turk, a unos 5m de profundidad, se iniciaron proyectos de restauración de arrecifes coralinos en Oasis (octubre 2006) y en Governors Beach (noviembre 2007). Se utilizaron módulos de acero semicilíndricos, 4 en Oasis y 6 en Governors Beach. A cada proyecto se han trasplantado más de 1200 corales desde sitios con un elevado daño por sedimentación y se monitorean regularmente para evaluar crecimiento y mortalidad de los corales, así como la población de peces. Los corales muestran un crecimiento inmediato sobre los alambres utilizados para asegurar los corales. Este crecimiento se ha medido usando fotografías y un programa de computación y es más rápido en Governors Beach. Después de los huracanes Hanna e Ike (setiembre 2008), las estructuras en Governors Beach se mantuvieron erectas debido a que las olas pasaron a través de las mismas sin afectarlas, una de las estructuras en Oasis colapsó debido a que todas se amarraron con alambre en vez de soldarse (desde entonces se sustituyó con una nueva, soldada esta vez). El huracán Ike ha sido el más fuerte de los históricamente registrados que ha impactado Grand Turk. La mayor pare de los cables fueron reemplazados debido a daños causados por la acción de detritus y de las grandes olas. Los proyectos perdieron alrededor de un tercio de los corales debido a los huracanes. La mayoría de los corales perdidos habían sido amarrados a las estructuras unos días antes de los huracanes y consecuentemente no se habían adosado firmemente a las mismas. Estos proyectos han regenerado poblaciones de corales y peces en áreas inhóspitas de arena o roca y constituyen ahora una atracción para el buceo superficial. La alta tasa de supervivencia de corales y el bajo daño a las estructuras después de los huracanes indican que la tecnología Biorock para restauración de arrecifes coralinos es efectiva en áreas impactadas por tormentas.
Assuntos
Animais , Antozoários/crescimento & desenvolvimento , Recifes de Corais , Tempestades Ciclônicas , Conservação dos Recursos Naturais/métodos , Peixes , Índias OcidentaisRESUMO
Artificial reefs are often discouraged in shallow waters over concerns of storm damage to structures and surrounding habitat. Biorock coral reef restoration projects were initiated in waters around 5 m deep in Grand Turk, at Oasis (October 2006) and at Governor's Beach (November 2007). Hemi-cylindrical steel modules, 6m long were used, four modules at Oasis and six at Governor's Beach. Each project has over 1200 corals transplanted from sites with high sedimentation damage, and are regularly monitored for coral growth, mortality and fish populations. Corals show immediate growth over wires used to attach corals. Growth has been measured from photographs using a software program and is faster at Governor's Beach. After hurricanes Hanna and Ike (September 2008) the Governor's Beach structure was fully standing since the waves passed straight through with little damage, the Oasis structures which were tie-wired rather than welded had one module collapse (since been replaced with a new, welded structure). Hurricane Ike was the strongest hurricane on record to hit Grand Turk. Most cables were replaced following the hurricanes due to damage from debris and high wave action. The projects lost about a third of the corals due to hurricanes. Most of those lost had only been wired a few days before and had not yet attached themselves firmly. These projects have regenerated corals and fish populations in areas of barren sand or bedrock and are now attractive to snorkelers. High coral survival and low structural damage after hurricanes indicate that Biorock reef restoration can be effective in storm-impacted areas.