Influencing Factors for Social Acceptance of Noma (Cancrum Oris) Patients in Niger: A Hospital-Based Cross-Sectional Study

Background: Noma, mostly identified in malnourished young children in the world’s low-income countries, causes severe orofacial disfigurement and significant mortality and morbidity. The majority of noma patients surviving with aesthetical effects are exposed to stigmatization and social rejection. Studies focusing on the socio-psychological impact of noma survivors have rarely been done. Our study aimed to identify the differences in social acceptance/rejection and the influencing factors associated with social acceptance in noma patients. Methods: A cross-sectional study was conducted at the NGO-Sentinelles (Niger) reception center on patients with noma from Zinder, Maradi, and Tahoua regions between 9th May 2017 and 2nd June 2017. The survey was conducted through a face-to-face interview on patients admitted to the center and those discharged from the centre after the treatment. The interview questionnaire comprised 45 questions (Cronbach’s alpha coefficient = 0.812) with pathological information, sociodemographic characteristics, and socio-psychological qualitative information. Findings: We recorded 50 noma patients (43 from Zinder and 7 from Maradi and Tahoua). The younger patients (1 - 5 years old), noma patients who stayed in school during follow-up treatment, patients who were referred by a health structure, patients enrolled into the centre in a short time (<30 days), and patients in the acute phase of noma had a significantly high social acceptance rate with 60.0%, 82.9%, 60.0%, 57.1% and 94.3% respectively;whereas single adults and cheek lesion site had the highest social rejection rate when compared to their corresponding factors with 60.0% and 86.7% respectively. There were significant differences in victims’ perception of noma [χ2 = 45.536, (P < 0.001)] and acceptance of their new faces [P = 0.023], between the social acceptance and social rejection rate, therefore all patients who accepted their new faces felt social acceptance. Social acceptance was significantly highly correlated with pathological history (admission method, phase of noma, care, and treatment received at center) with rs ranging from 0.609 to 0.810, moderately correlated with patient’s sociodemographic characteristics (age, marital status, and region) with rs ranging from 0.381 to 0.474. Lowly correlated with clinical evolution after treatment (rs = 0.293). Logistic regression results showed that the likelihood of social acceptance increased when the patient’s age was young (≤15 years), their marital status was minor, they were enrolled at the school before noma appearance, they were referred to the centre after diagnosis, the admission time to the centre was short (≤30 days), acute phase of noma, and care received at the centre was non-surgery. The location of the lesion on the cheek was a risk factor for social acceptance, indicating cheek lesions from noma increased the likelihood of social rejection in our study. Conclusion: The sociodemographic characteristics, pathological history, and psychological aspects of noma patients were correlated and were found to be important factors influencing their social acceptance/rejection rate.

Identity Crisis in Jean Rhys’ Wide Sargasso Sea Revisited

This paper examines the identity crisis experienced by Antoinette in Jean Rhys’ Wide Sargasso Sea (1966) from a predominantly soci-psychological perspective. Since most of the critical attention regarding Wide Sargasso Sea has been devoted to external problems, such as race, gender and colonial politics, this article will concentrate on the psychological relevance of those issues, examining the reasons for the internal conflict and sharp divisions that torment the heroine. It investigates identity crisis faced by the novel’s heroine and her struggle to overcome this crisis in a society where woman is triply marginalized by race, class, gender and colonialism. It also traces Antoinette’s search and struggle for an independent life and examines the extent to which she succeeds or fails in articulating her identity. Special emphasis will be laid on Erik Erikson’s psychological theories of identity crisis and human development. The paper depicts the protagonist’s endeavour to overcome the external forces that impact the construction or destruction of her identity. Ultimately, Antoinette reaches a resolution on her own terms,depending on her own personal decision and the surrounding societal and cultural circumstances.

Children's Deviation in the Acquisition of Variable Linguistic Gender Patterns

This study examines the acquisition of variation from the vernacular Syrian input of 22 parents in the output of their 21 children in the village of Oyoun Al-Wadi in Syria, using the four rural vowel variables (o), (o:), (e), and (e:). Each variable has two realizations: rural [o, o:, e, e:] respectively and urban [a, a:, a, a:] respectively.Fathers use the rural vowels more than mothers, but the difference is statistically insignificant. Like fathers, boys use more rural vowels than girls. However, the difference between boys and girls is statistically significant. No correlation emerged between the children’s and parents’ use of the variants, indicating that children are not acquiring their parents5 exact frequencies, which suggests developmental effect rather than statistical learning of parental input effect. The boys’ higher use of the rural forms after age eight is attributed to a social, psychological polarization process between boys and girls to create a highly differentiated gendered linguistic behavior in line with another highly differentiated gendered linguistic behavior related to a stereotypical consonant variable, (q), which is observed in both parents and children.