RESUMO
BACKGROUND: Cervical cancer is a leading cause of cancer deaths among women of reproductive age in Peru. Screening and early identification of pre-cancerous lesions are a cornerstone of the cervical cancer prevention strategy. Yet, there is limited literature on barriers to screening among Peruvian women. In this cross-sectional study, we aimed to examine Peruvian women's knowledge, attitudes, and practices regarding cervical cancer screening and identify possible reasons for the gap between knowledge and screening. METHODS: The study was conducted in metropolitan Lima from June-August 2019. We purposefully recruited 12 women who had previously been screened, and 12 who had never been screened for cervical cancer. The women completed a 40-question knowledge and attitude survey and an in-depth interview about barriers to screening. Descriptive analysis was used to calculate a knowledge and attitude score and qualitative analysis was guided by the Health Belief Model constructs. RESULTS: Previously screened participants had greater knowledge of cervical cancer symptoms, risk factors, and prevention (mean score = 28.08, S.D. = 4.18) compared to participants who had never been screened (mean score = 21.25, S.D. = 6.35). Both groups described lack of priority and embarrassment as barriers to cervical cancer screening. For participants who had never been screened before, major barriers included the fear of a cancer diagnosis and lack of information about screening services. Pregnancy, unusual gynecological symptoms and encouragement from friends and family were cues to action for participants seeking screening. Most participants in both groups recognized the benefits of getting screened for cervical cancer. Being previously screened increased participants' self-efficacy for engaging in screening behaviors again. Misconceptions regarding screening procedures and cervical cancer were also noted as barriers for participants accessing screening services. CONCLUSIONS: Improving knowledge and awareness about cervical cancer and screening programs may improve screening behaviors among women. Targeting women who have never been screened before and addressing their fears and concerns around embarrassment may be other areas for intervention. Misconceptions that deter women from screening services are an important issue that should be addressed in order to increase the number of women who get timely screenings.
Assuntos
Neoplasias do Colo do Útero , Estudos Transversais , Detecção Precoce de Câncer , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Peru , Gravidez , Neoplasias do Colo do Útero/diagnósticoRESUMO
The giant tortoises of the Galápagos have become greatly depleted since European discovery of the islands in the 16th Century, with populations declining from an estimated 250 000 to between 8000 and 14 000 in the 1970s. Successful tortoise conservation efforts have focused on species recovery, but ecosystem conservation and restoration requires a better understanding of the wider ecological consequences of this drastic reduction in the archipelago's only large native herbivore. We report the first evidence from palaeoecological records of coprophilous fungal spores of the formerly more extensive geographical range of giant tortoises in the highlands of Santa Cruz Island. Upland tortoise populations on Santa Cruz declined 500-700 years ago, likely the result of human impact or possible climatic change. Former freshwater wetlands, a now limited habitat-type, were found to have converted to Sphagnum bogs concomitant with tortoise loss, subsequently leading to the decline of several now-rare or extinct plant species.
Assuntos
Biodiversidade , Tartarugas , Áreas Alagadas , Animais , Carvão Vegetal , Equador , Fezes/microbiologia , Plantas , Esporos Fúngicos/isolamento & purificaçãoRESUMO
The Galápagos Islands are globally renowned for their ecological value and as a world symbol of scientific discovery; however the native biodiversity of this unique region is currently under threat. One of the primary concerns is the detrimental impact of approximately 750 nonnative plants introduced over the last 500 years of human presence in the archipelago. In addition to these known introduced species, there are an additional 62 vascular plants classified as "doubtful natives," where native status remains unclear. To help address the questions of provenance regarding these doubtfully native species and their impact on highland ecosystems over the past 500-1000 years, we analyzed plant macrofossils in sedimentary records. Appropriate species classification (native or introduced) was determined using baseline data of species presence on the islands. We confirmed that six plants (Ageratum conyzoides, Solanum americanum, Ranunculus flagelliformis, Brickellia diffusa, Galium canescens, and Anthephora hermaphrodita) once considered doubtful natives or introduced are actually native to the Galápagos flora. These results have relevance not just for the Galápagos but also many other oceanic islands in demonstrating the application of palaeobotanical data to conserving and restoring native biodiversity.
Assuntos
Ecossistema , Espécies Introduzidas , Plantas/classificação , Equador , Fósseis , Geografia , Fatores de TempoRESUMO
Paleoecological evidence from the past 8000 years in the Galápagos Islands shows that six presumed introduced or doubtfully native species (Ageratum conyzoides, Borreria laevis/Diodia radula-type, Brickellia diffusa, Cuphea carthagenensis, Hibiscus diversifolius, and Ranunculus flagelliformis) are in fact native to the archipelago. Fossil pollen and macrofossils from four sites in the highlands of Santa Cruz Island reveal that all were present thousands of years before the advent of human impact, refuting their classification as introduced species. These findings have substantial implications not only for conservation in Galápagos but for the management of introduced species and pantropical weeds in general.