Mental health of AIDS Orphans in Sub-Saharan Africa: A narrative literature review / 国際保健医療

  Objectives  In Sub-Saharan Africa, acquired immunodeficiency syndrome (AIDS) orphans account for a large proportion; however, their mental health problems have been overlooked. We presented an investigation of literature to provide a comprehensive overview of associated factors of mental health among AIDS orphans in Sub-Saharan Africa. Methods  Databases (PubMed and Japan Medical Abstracts Society) were searched by using relevant keywords including AIDS orphans, Sub-Saharan Africa, mental health, psychological support, education, and poverty. A total of nine papers met the inclusion criteria and were included in this literature review.Results  AIDS orphans were at high risk of various mental disorders relevant to low self-esteem, anxiety, and depression. Associated factors of the mental health of AIDS orphans were classified into the following three categories: psycho-social-cultural factors such as social discrimination, abuse, and bullying etc.; physical environmental and economic factors such as education, lack of foster care, and poverty etc; and family and community relevant factors such as lack of connection and social support from family and school etc. Regarding psycho-social-cultural factors, AIDS orphans experienced more abuse, social discrimination, and social stigma, especially those who were living in poverty. AIDS orphans living in the urban experienced severe bullying. Regarding family and community factors, due to the loss of parents and changes in living environment, AIDS orphans who were living in households headed by children tend to experience depression, anxiety, fear, and stigma. The loss of a parent resulted in lower academic performance and limited access resources including inadequate mental health services, which consequently led to poor development and adverse health outcomes in AIDS orphans including poor psychosocial well-being. Regarding environmental and economic factors. Lack of care from caregivers and parental mental health were also shown to be related to child development and mental health in AIDS orphans. Regarding physical environmental and economic factors, limited available social support in the physical environment where AIDS orphans lived was associated with impaired development and mental health. Poverty led to AIDS orphans being affected by food shortage and malnutrition (e.g., stunting), child labor, as well as risky sexual behaviors towards female AIDS orphans. Better social support from caregivers and teachers had a positive impact on the mental health of AIDS orphans. With regard to education, AIDS orphans have a high school dropout rate, resulting in fewer school connections. School connections have been shown to be an important protective factor for AIDS orphans’ mental health. Conclusions  This review identified risk and protective factors of mental health among AIDS orphans in sub-Saharan Africa. Our results, especially the positive influence of social support, encourage the development of effective mental health care programs for AIDS orphans in sub-Saharan Africa. The results suggest looking at various problems that AIDS orphans are facing from multiple perspectives.

Calidad de vida relacionada con la salud de niños y adolescentes que viven en un hogar temporal, Colombia / Health-related quality of life for children and adolescents living in a temporary home, Colombia / Qualidade de vida relacionada com a saúde de crianças e adolescentes que moram em lar temporário, Colômbia

Resumen (analítico) Estudio transversal cuyo objetivo fue determinar la calidad de vida relacionada con la salud (CVRS) en 92 niños y adolescentes, entre los 8 y los 18 años de edad, que vivían en un hogar temporal de un municipio colombiano. Se aplicaron pruebas para la diferencia de promedios, de correlación y se construyó un modelo logístico con el fin de identificar los factores que se asociaron al desenlace, la CVRS. No se encontraron diferencias entre los promedios del puntaje de la CVRS según sexo (p = 0.094) y además estos en las dimensiones actividad física y salud, sentimientos, autopercepción, autonomía, vida familiar, relación con los pares y entorno escolar fueron mayores que el promedio de la CVRS; ser mujer y haber sufrido algún tipo de limitación, influyen en tener puntajes de la CVRS menores de 70 puntos.

Abstract (analytical) This is a cross-sectional study that had the objective of determining the health-related quality of life (HRQoL) for 92 children and adolescents between 8 and 18 years of age who lived in a temporary home in a Colombian municipality. Tests were applied for the correlation of the difference of averages and a logical model was developed to identify the factors that were associated with the HRQoL outcome. No differences were found between the averages of the HRQoL scores according to sex (p = 0.094). The aspects of physical activity and health, feelings, self-perception, autonomy, family life, relationships with peers and school environment were higher than the average HRQoL. Being a woman and having suffered some type of limitation caused participants to have HRQoL scores below 70 points.

Resumo (analítico) Foi realizado um estudo transversal que teve por objetivo determinar a Qualidade de Vida Relacionada com a Saúde (QVRS) de 92 crianças e adolescentes, com idade entre 8 e 18 anos, que moram em um lar temporário em um município colombiano. Foram realizadas avalições para determinar a diferencia média e suas correlações, além disso, foi determinado um modelo logístico com o fim de identificar os principais fatores associados a QRVS. Não se encontraram diferencias entre as medias do valor da QRVS para o gênero (p = 0.094), entretanto, para o caso de atividade física y saúde, sentimentos, autoimagem, autonomia, vida familiar, relacionamento com os pais e ambiente escolar os valores foram maiores do que a média da QRVS; o fato de ser mulher e ter sofrido algum tipo de Deficiência, influenciaram na obtenção de valores da QRVS abaixo de 70 pontos.

A cross-sectional study of behavioural disorders in children with human immunodeficiency virus / acquired immuno deficiency syndrome attending an anti-retroviral therapy centre

Background: HIV is a chronic disease which also significantly affects the behavior. This study aims at evaluating behavioral disorders in children with HIV/AIDS.Methods: This Cross-sectional study utilized the Child Behaviour Check List.Results: The overall prevalence of borderline and clinically significant behavioral problems were 69.3% (n=104). The prevalence of behavioral disorders were observed in the eight categories - anxious/depressed (borderline-7.7%, clinically significant-18.3%), withdrawn/depressed (6.7%, 18.3%), somatic problems (7.7%, 6.7%), rule-breaking behavior (7.7%, 18.3%), aggressive behavior (10.6%, 21.1%), attention problems (15.4%, 2.9%) and thought problems (9.6%, 2.9%). No social problems were observed. Internalizing problems were common in girls and externalizing problems were common in boys. As age advanced a simple linear progression in prevalence of Behavior Problems was found. There were 47.1% of Orphans in study and behavioral problems were more common in them.Conclusions: High prevalence of behavioural abnormalities warrants comprehensive management including Behavioural counselling and therapy and not just drugs for these children.

PRIMAVERA 2017: Errare humanum est

Cuando escribimos algo, el registro puede quedar para siempre… Y si aquello que escribimos tiene la característica de reproducirse ad infinitum, puede que no sea tan bueno. Los errores durante el trabajo de edición son comunes, tanto en el trabajo gráfico como en el fílmico; aunque menos frecuentes en el trabajo con sonido. En nuestro campo, son comúnmente llamados "errores de imprenta" debido a que es gracias a la imprenta que se reproducen, aunque pueden deberse a otros motivos y no a fallas técnicas durante el proceso de impresión. Pueden ser de diseño, de tipeo, ortográficos, semánticos, gramaticales, referenciales, de ordenamiento… Todos estos corresponden a la fase de edición. Esta se subdivide en fase computacional y fase de prueba de imprenta: La primera se realiza frente a un ordenador, página por página, cuidando que no ocurran, y ayudado por el corrector automático (el que a veces puede transformarse en un gran farsante). Una vez que la fase computacional está finalizada, se realizan impresiones en papel que se reparten a varias personas para que las lean y marquen los errores. Cuando la fase de edición no existe, los errores ocurren en gran profusión. Un tipo particular (llamado error por "copypaste") denota la ausencia de una fase de edición adecuada. Otro error interesante es el error por uso inadecuado de un término. Esto puede ocurrir por ignorancia del que redacta, por corrección automática del ordenador, o por asociación inadvertida con otro concepto similar, en la vorágine de la redacción. Un error (cuya publicación suele ser en extremo divertida para los lectores) ocurre cuando un miembro del equipo editorial ha hecho alguna broma escrita asociada a un texto, y ésta no se ha borrado Un tema estético ampliamente trabajado en edición, parte de la tradición e historia de este trabajo, es el llamado "control de viudas y huérfanas". Esto corresponde al manejo tipográfico (estético y de espacio) que hay que realizar con las líneas y palabras que quedan solas al final de un párrafo (viudas) o al principio o final de una página. Una línea viuda es aquella que, siendo la última de un párrafo, aparece al principio de la página o columna siguiente, por lo que se muestra aislada de su contexto y, por norma general, seguida de una línea en blanco que la separa del siguiente párrafo. Por contraparte, las huérfanas son la primera línea de un párrafo que queda sola al final de una página, con todo el resto del párrafo, que la contextualiza, en la siguiente. Si bien un artículo puede leerse sin mayores contratiempos sin controlar las viudas y huérfanas, es parte del trabajo de edición evitarlas, y entre nosotros su presencia es considerada un error (...)

Implicaciones familiares y sociales de la muerte materna / Family and social implications of maternal death

Introducción: La mortalidad materna es considerada un indicador sensible al desarrollo social, porque muchas de estas muertes ocurren por razones evitables, vinculadas a condiciones de pobreza. Hay datos estadísticos sobre el número de muertes maternas a nivel internacional y local, que resaltan la magnitud del problema, así como el conocimiento científico de las causas de estos fallecimientos; pero escasa información publicada sobre el impacto familiar y el desequilibrio que se produce cuando ocurre una muerte materna, situación que trae consigo desconocimiento sobre la real situación de los hijos huérfanos y la familia. Objetivo: Conocer las implicaciones familiares y sociales de la muerte materna a través de la revisión sistemática de la literatura científica publicada. Materiales y métodos: Se realizó una búsqueda en las bases de datos incluidas en los servicios LILACS, ProQuest, MEDLINE y en la biblioteca virtual de salud SciELO. La muestra final fue de 20 artículos. Resultados: Los estudios mostraron que la pérdida inesperada de la madre genera consecuencias emocionales, económicas y de salud en todos los miembros del hogar. Conclusiones: Los hallazgos indican que esta problemática debe ser abordada de manera integral con el fin de mitigar el impacto que genera la muerte materna.

Introduction: Maternal mortality is considered a sensitive indicator of social development, as many of these deaths occur for preventable reasons, linked to poverty. There is statistical data on the number of internationally and locally maternal deaths, which highlights the magnitude of the problem as well as the scientific knowledge of the causes of these deaths; but there is limited published information on the family impact and imbalance that occurs when a maternal death occurs, which leads to lack of knowledge about the real situation of orphaned children and family. Objective: To know the family and social implications of maternal death through a systematic review of the published scientific literature. Materials and methods: A search in the databases including LILACS, PROQUEST, MEDLINE services and virtual health library SCIELO was conducted. The final sample consisted of 20 articles. Results: The studies showed that the unexpected loss of the mother generates emotional, economic and health consequences for all household members. Conclusions: The findings indicate that this problem must be addressed comprehensively in order to mitigate the impact generated by maternal death.

Improving Education Opportunity, Health, and Quality of Life of Orphans and Vulnerable Children: The Sustainable Action against HIV and AIDS in Communities (SAHACOM).

Aims: This study evaluated the impact of the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project in improving education opportunity, health, and quality of life of orphans and vulnerable children (OVC) in Cambodia. Study Design: Operational intervention study. Place and Duration of the Study: Five provinces in Cambodia, from 2010 to 2014. Methodology: A two-stage cluster sampling method was used to select 756 OVC at midterm and 785 OVC at end line for face-to-face interviews. Outcome indicators from end line (2014) were compared to those obtained at midterm (2012). Where possible, the data were also compared with data obtained from baseline documentation (2010). Results: The percentage of OVC receiving external support for child care surged from 30.0% at baseline to 84.0% at midterm but decreased to 76.8% at end line. Compared to children at midterm, children at end line were significantly more likely to report having attended school regularly in the past 12 months, less likely to suspend study in order to work to help feed the family in the past 12 months, less likely to respond that food supports and other basic needs such as clothes and other household materials were the most important needs for their family today, more likely to perceive that supports for child education were the most important for their family today, less likely to report that their family reduced times for daily meals due to the shortage of food in the past 12 months, and more likely to rate their general health and overall quality of life as fair, good, or very good. Conclusion: This study indicates significant impact of the SAHACOM on education, health, and quality of life of OVC in Cambodia. This community-based model should be adapted for future interventions, taking into account the available resources.

Nível de atividade física de crianças e adolescentes órfãos por aids / Physical activity level among children and adolescents orphaned by AIDS

OBJETIVO: Estimar o nível de atividade física em crianças e adolescentes órfãos por aids, segundo características sociodemográficas e relativas à orfandade. MÉTODOS: Inquérito populacional realizado no município de São Paulo, SP, entre 2006 e 2007, com 235 crianças e adolescentes de 7 a 14 anos. As crianças foram classificadas como ativas e sedentárias com o ponto de corte em 300 minutos por semana de atividade física. Todas as variáveis foram comparadas entre os dois grupos e entre os sexos. RESULTADOS: Foi observada prevalência de 42 por cento de sedentarismo. A maioria das crianças e adolescentes apresentou locomoção e brincadeiras infantis como principais atividades físicas. Quanto ao nível de atividade física foi observada diferença significativa entre os sexos (p < 0,001). Os meninos eram mais ativos e brincavam mais na rua do que as meninas. CONCLUSÕES: Há alta magnitude de prevalência de sedentarismo entre crianças e adolescentes órfãos por aids, sendo maior entre as meninas.

OBJECTIVE: To estimate the level of physical activity among children and adolescents orphaned by AIDS according to socio-demographic and orphanhood-related characteristics. METHODS: A population-based study was carried out with 235 children and adolescents aged 7 to 14 years in the municipality of São Paulo, SP, in 2007. Children were classified as active and inactive. The cut-off point established was 300 minutes of weekly physical activity. All variables were compared between both groups and sexes. RESULTS: An overall prevalence of 42 percent of inactivity was found. Active commuting and child's play were the main physical activities for most of the children and adolescents. As for physical activity level, a significant difference was observed between sexes (p < 0.001). Boys were more active and played outdoors more than girls. CONCLUSIONS: There is a high prevalence of physical inactivity among children and adolescents orphaned by AIDS, especially girls.

Investigation of psychological status of the AIDS affected orphans settled in Sunshine Homestead / 中国艾滋病性病

Objective To understand the psychological status of the AIDS affected orphans in Henan Sunshine Homestead.Methods One hundred orphans from three Henan Sunshine Homesteads were investigated by questionnaire and depth-interviews.Results The study showed that the AIDS affected orphans were satisfied with their present living conditions in general,but still had some dissatisfaction.They valued peer relations,but were passive to contact strangers,and also felt lacking of care from the elderly.Nearly 70% of the orphans were some what introverted in nature,and some were in lack of thankful heart to managers of the Homestead and their patrons.