Impacto psicosocial del diagnóstico del VIH/sida en la familia / Psychosocial Impact of the HIV/AIDS Diagnosis on the Family

Introducción: En la historia de la humanidad nunca antes una pandemia había causado tanta desolación y tristeza ni destruido a tantas familias con un impacto psicosocial tan alarmante. Objetivo: Determinar el impacto psicosocial del diagnóstico del VIH/sida en las familias de pacientes con ese diagnóstico. Métodos: Se realizó un estudio observacional, descriptivo transversal en las familias de pacientes con el diagnóstico del VIH/sida en el policlínico Armando García Aspurú, de Santiago de Cuba, desde enero del 2018 a enero del 2019. El universo estuvo constituido por las 26 familias que tuvieran al menos un miembro enfermo. Resultados: Las vías más frecuentes de información por las que la familia se enteró fueron por el mismo paciente, seguido de la información por los servicios de salud. La reacción de la familia ante la noticia fue la esperanza de que no fuera cierto, seguido por la depresión y la angustia. En las creencias que manifiesta la familia sobre el VIH prevalecieron las opiniones de que la enfermedad la adquieren personas de vida desorganizada. Sobre las pérdidas laborales, académicas y/o sociales sufridas por la aparición del VIH, 84,6 por ciento refirió rechazo a nivel de la pareja. Ante la estigmatización, la familia determina no hablar de la enfermedad por miedo al rechazo y sensación de vergüenza. Conclusiones: La infección por VIH/sida trasciende con multiplicidad de consecuencias en variados niveles. Los grandes impactos se relacionan con la familia, donde la estigmatización juega un papel fundamental como intensificador de la conducta familiar y social(AU)

Introduction: Never before in the history of humankind had a pandemic caused so much desolation and sadness or destroyed so many families with such an alarming psychosocial impact. Objective: To determine the psychosocial impact of the HIV/AIDS diagnosis on the families of patients with this diagnosis. Methods: An observational, descriptive and cross-sectional study was carried out in the families of patients with the HIV/AIDS diagnosis in the Armando García Aspurú polyclinic, of Santiago de Cuba, from January 2018 to January 2019. The study universe was made up of the 26 families with at least one sick member. Results: The most frequent ways of information by which the family found out were from the patient herself/himself, followed by information from the health services. The family's reaction to the news was hope that it was not true, followed by depression and anguish. In the beliefs expressed by the family about HIV, there was a prevalence of opinions related to the idea that the disease is acquired by people with a disorganized life. Regarding occupational, academic or social losses suffered due to the appearance of HIV, 84.6 percent reported rejection from her/his couple. Before stigmatization, the family determines not to talk about the disease, due to fear of rejection and the feeling of shame. Conclusions: HIV/AIDS infection transcends with a multiplicity of consequences at various levels. The major impacts are related to the family, where stigmatization plays a fundamental role as an intensifier of family and social behavior(AU)

Psychosocial impact of the implementation of COVID-19 protocols

BACKGROUND: The COVID-19 pandemic has spread globally since the first case was diagnosed in Wuhan, China in December 2019 and we are now experiencing the fourth wave. Several measures are being taken to care for the infected and to curtail the spread of this novel infectious virus. The psychosocial impact of these measures on patients, relatives, caregivers, and medical personnel also needs to be assessed and catered for. METHODS: This is a review article on the psychosocial impact of the implementation of COVID-19 protocols. The literature search was done using Google Scholar, PubMed, and Medline. DISCUSSION: Modalities of transportation of the patient to isolation and quarantine centres have led to stigma and negative attitudes towards such individuals. When diagnosed with the infection, fear of dying from COVID-19, fear of infecting family members and close associates, fear of stigmatization, and loneliness are common among COVID-19 patients. Isolation and quarantine procedures also cause loneliness and depression, and the person is at risk of post-traumatic stress disorder. Caregivers are continually stressed out and have the constant fear of contracting SARS-CoV-2. Despite clear guidelines to help with closure for family members of people dying from COVID-19, inadequate resources make this unrealistic. CONCLUSION: Mental and emotional distress resulting from fear of SARS-Cov-2 infection, the mode of transmission, and consequences have a tremendous negative impact on the psychosocial well-being of those affected, their caregivers, and relatives. There is a need for the government, health institutions, and NGOs to establish platforms to cater to these concerns

Criminalización y juvenicidio de culturas juveniles asociadas a organizaciones delincuenciales: caso colombianos / Criminalization and youthcide of youth cultures associated with criminal organizations: the case of the Cholombianos / Criminalização e juvenicídio de culturas juvenis associadas a organizações criminosas: o caso Cholombianos

Resumen (analítico) El artículo propone caracterizar y comprender los procesos de inserción de jóvenes en las organizaciones delincuenciales, tomando el caso de una cultura juvenil del noreste mexicano: los cholombianos. Plantea un marco de referencia construido por la articulación de categorías como violencia posestructural, desciudadanización, construcción de pánicos morales, estigmatización territorial, criminalización y sujeción criminal, para debatir y ampliar la conceptualización sobre el juvenicidio en México. Para ello, se analizan casos documentados por antropólogos y periodistas de jóvenes de distintas clases sociales que participan o son vinculados con la delincuencia organizada. A partir de un análisis teórico conceptual, se realizan observaciones sobre cómo los grupos delincuenciales forjan fuentes de pertenencia, respeto e identidad, y cómo estos y los poderes públicos llevan a cabo acciones de desciudadanización que destruyen culturas juveniles como la de los cholombianos.

Abstract (analytical) This article aims to characterize and comprehend the processes of young people joining criminal organizations by using a case study of a youth culture in the northeastern region of Mexico, the Cholombianos. The authors propose a reference framework based on the articulation of categories such as post-structural violence, de-citizenization, fabrication of moral panic, territorial stigmatization, criminalization and criminal subjection to discuss and expand the conceptualization of youthcide in Mexico. To achieve this process, the authors analyze cases documented by anthropologists and journalists of young people from different social classes who participate in or are linked to organized crime. Using a conceptual theoretical analysis, the authors discuss how criminal groups fabricate senses of belonging, respect and identity and how they and public authorities carry out de-citizenization actions that destroy youth cultures like the Cholombianos.

Resumo (analítico) O artigo se propõe a caracterizar e compreender os processos de inserção de jovens em organizações criminosas, tomando o caso de uma cultura juvenil do nordeste mexicano, os cholombianos, propõe um quadro de referência construído pela articulação de categorias como violência pós-estrutural, descidadania, construção de pânicos morais, estigmatização territorial, criminalização e sujeição criminal, para debater e ampliar a conceituação do assassinato juvenil no México. Para isso, são analisados casos, documentados por antropólogos e jornalistas, de jovens de diferentes classes sociais que participam ou estão ligados ao crime organizado. A partir de uma análise teórica conceitual, são feitas observações sobre como grupos criminosos forjam fontes de pertencimento, respeito e identidade, como eles e o poder público realizam ações de descidadania que destroem culturas juvenis como a dos cholombianos.

Endomarketing para la adherencia al tratamiento de enfermedades dermatológicas estigmatizantes / Endomarketing for adherence to the treatment of stigmatizing dermatological diseases

Las enfermedades cutáneas son una amplia gama de afecciones que afectan la piel, de origen bacteriano, viral, fúngica, reacción alérgica, cáncer, parásito, hereditarias, ideopáticas; por sus sintomatologías pueden generar estigma. Por tal motivo, la Organización Mundial para la Salud, alienta a los Estados miembros a que se involucren en actividades de promoción para aumentar la concienciación con el fin de combatir la discriminación que perciben los pacientes con enfermedades dermatológicas estigmatizantes (EDE), tanto por la comunidad y en los establecimientos de salud, pudiendo repercutir negativamente en la adherencia del tratamiento. El objetivo de este estudio fue valorar el uso de endomarketing para la adherencia al tratamiento de EDE. Se realizó una investigación cuantitativa. Se les aplicó encuesta de endomarketing a 279 participantes; además con 147 pacientes con EDE se indago la percepción de actitudes estigmatizantes. Los resultados mostraron un alcance sobre el endomarketing de 0,62 en personal de atención directa y 0,45 para atención indirecta; los pacientes con mayor percepción de actitudes estigmatizantes fueron los que presentaban afecciones en piel tipo infecciosas, mayormente proveniente de la atención indirecta. Se infiere que el conocimiento sobre las EDE disminuye las expresiones de rechazos. Como alternativas para la formación del personal con una mayor satisfacción en el trabajo, competencia para gestionar y elevado sentido de espiritualidad corporativa, que garantice atención humanitaria a estos pacientes, se sugiere el uso de endomarketing, para conciliar los objetivos e intereses del recurso humano interno a las necesidades y expectativas de los pacientes con EDE(AU)

Skin diseases are a wide range of conditions that affect the skin, of bacterial, viral, fungal origin, allergic reaction, cancer, parasite, hereditary, idiopathic; due to their symptoms they can generate stigma. For this reason, the World Health Organization encourages Member States to engage in promotional activities to raise awareness in order to combat the discrimination perceived by patients with stigmatizing dermatological diseases (SDD), both for the community and in health establishments, which may have a negative impact on adherence to treatment. The objective of this study was to assess the use of endomarketing for adherence to DTS treatment. A quantitative investigation was carried out. An endomarketing survey was applied to 279 participants; In addition, with 147 patients with EDE, the perception of stigmatizing attitudes was investigated. The results showed a reach on endomarketing of 0.62 in direct attention personnel and 0.45 for indirect attention; The patients with the highest perception of stigmatizing attitudes were those who presented infectious-type skin conditions, mostly from indirect care. It is inferred that knowledge about DTS decreases the expressions of rejections. As alternatives for the training of personnel with greater job satisfaction, competence to manage and a high sense of corporate spirituality, which guarantees humanitarian attention to these patients, the use of endomarketing is suggested, to reconcile the objectives and interests of internal human resources. to the needs and expectations of patients with DTS(AU)

The effect of Son-Rise and Floor-Time programs on social interaction skills and stereotyped behaviors of children with Autism Spectrum Disorders: a clinical trial / O efeito dos programas Son-Rise e Floor-Time nas habilidades de interação social e comportamentos estereotipados de crianças com Transtornos do Espectro do Autismo: um ensaio clínico

Abstract Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder in which difficulty in social interaction skills and performing limited and stereotyped activities are among its symptoms. This study aims to determine the effect of Son-Rise and Floor Time programs on social interaction skills and stereotyped behaviors in children with ASD. The present study was a Clinical Trial. The participant were 60 children with ASD who were selected by convenience sampling method and randomly assigned to three groups (Son-Rise intervention, Floor-Time intervention, and control group with routine occupational therapy interventions). For data gathering, Autism Spectrum Screening Questionnaire, Gilliam Autism Rating Scale, and Autism Social Skills Profile were used, respectively. For data analysis, repeated measures and analysis of variance were used (two-way between and within- subjects). The results of data analysis showed that Son-Rise and Floor Time programs had a positive effect on social interaction skills of children with ASD, and reduced stereotyped behaviors of these children; Also, there is a significant difference between the effectiveness of Son-Rise and Floor-Time programs on social interaction skills and stereotyped behavior in the post-test, which is more effective in the Floor Time compared to Son-Rise program.

Resumo O Transtorno do Espectro do Autismo (TEA) é um transtorno do neurodesenvolvimento que tem entre seus sintomas a dificuldade nas habilidades de interação social e a realização de atividades limitadas e estereotipadas. O objetivo deste estudo foi determinar o efeito dos programas Son-Rise e Floor Time nas habilidades de interação social e comportamentos estereotipados em crianças com TEA. O presente estudo foi um Ensaio Clínico. Os participantes foram 60 crianças com TEA que foram selecionadas pelo método de amostragem de conveniência e distribuídas aleatoriamente em três grupos (intervenção Son-Rise, intervenção Floor-Time e grupo controle com intervenções de terapia ocupacional de rotina). Para a coleta de dados, foram utilizados o Autism Spectrum Screening Questionnaire, a Gilliam Autism Rating Scale e o Autism Social Skills Profile, respectivamente. Para a análise dos dados foi utilizada a análise de variância de medidas repetidas (bidirecional entre e dentro dos sujeitos). Os resultados da análise dos dados mostraram que os programas Son-Rise e Floor Time tiveram um efeito positivo nas habilidades de interação social das crianças com TEA e reduziram os comportamentos estereotipados dessas crianças; Além disso, há uma diferença significativa entre a eficácia dos programas Son-Rise e Floor-Time nas habilidades de interação social e comportamento estereotipado no pós-teste, que é mais eficaz no Floor Time comparado ao programa Son-Rise.

Stigmatization of People Living with HIV/AIDS in Ndokwa West Local Government Area of Delta State Nigeria

Background: HIV/AIDS related stigmatization has been reported to be traced to several factors. Little or no knowledge on the illness, misapprehensions, as well as chauvinism against sufferers, to mention just a few.Aim: In this study, the stigmatization of people living with HIV/AIDS in Ndokwa West Local Government Area (NWLGA) of Delta State, Nigeria, was investigated.Methods: A total of 300 individuals comprising of, or related to HIV/AIDS sufferers were ethically recruited from the ten (10) communities in NWLGA using a well-structured and validated questionnaire. The data obtained from their responses were carefully analyzed and expressed in simple percentage.Results: The results showed that about 61 (20.5%) subjects were individuals who resided in urban community and 237 (79.5%) of them in the rural settings. The results on the stigmatization against HIV/AIDS patients due to prejudice revealed that 100 (33.6%) of the respondents strongly disagreed that HIV/AIDS sufferers in the community should be disliked, while 128 (43%) of them disagree with about 50 (16.8%) agreeing and 20 (6.7%) of the respondents strongly agreeing. Furthermore, stigmatization attributable to stereotyping showed that 68 (22.8%) of the respondents strongly disagreed to that everyone infected with HIV/AIDS have high level of sexual promiscuity; were as, about 114 (38.3%) disagreed to that notion with 57 (19.1%) agreeing and 59 (19.8%) strongly agreeing to it. Moreover, HIV/AIDS stigmatization due to discrimination revealed that 66 (22.1%) of the respondents strongly disagreed on never hiring an HIV/AIDS sufferer as a worker. About 98 (32.9%) disagreed on this notion, while 106 (35.6%) of the respondents agreed and 74 (24.8%) strongly disagreeing. Respondents further added that PLWHA should not be employed in any institution or organization and that they should never rent accommodation to them.Conclusion: Based on the results, stigmatization level of PLWHA was society and awareness dependent.Recommendations: To cope with the associated menace of HIV/AIDS stigmatization, it is recommended that society be encouraged to evolve strategies, programs and governmental policies, geared towards enlightening and sensitizing the public on the non-transmittability of HIV/AIDS through contact with sufferers as erroneously believed.

It is over there, next to that fat lady: a qualitative study of fat womens own body perceptions and weight-related discriminations / É lá, perto da moça gorda: estudo qualitativo sobre as percepções de mulheres gordas acerca de seus corpos e discriminações relacionadas ao peso corporal

Abstract We investigated fat women's perceptions of their own bodies and their experiences with weight-related discriminations, and how these situations affected their well-being. Thirty-nine obese women were interviewed, and three axes of analysis were identified: (1) repercussions of being fat, (2) living with a fat body, and (3) am I a person or just a fat body? These axes were composed of eight themes which had similar meaning or complemented each other. The results showed our participants had mechanisms to diminish the magnitude of their stigmatized bodies (e.g., attempting to lose weight and changing their current food choices). Participants also reported being fat had physical and psychological consequences for them. Most notably, their larger bodies influenced their self-evaluation, making them feel devalued, unlovable, incapable, and incomplete. They reported stigmatizing experiences in familiar situations, at the workplace and in public spaces, and reported being stigmatized by both close and unknown individuals, including healthcare professionals. These professionals were reported to treat patients disrespectfully, which urges attention to health care inequalities for obese people. Our results stress stigmatizing attitudes towards fat people and their own considerations about themselves have negative consequences in their physical and mental well-being.

Resumo Investigamos a percepção de mulheres gordas sobre seu próprio corpo e suas experiências com discriminações relacionadas ao peso e como essas situações afetavam seu bem-estar. Trinta e nove mulheres obesas foram entrevistadas, sendo identificados três eixos de análise: (1) repercussões de ser gorda, (2) vivendo com um corpo gordo, e (3) eu sou uma pessoa ou apenas um corpo gordo? Esses eixos eram compostos por oito temas que se complementavam ou tinham significado semelhante. Os resultados mostraram que nossas participantes utilizavam mecanismos para diminuir a magnitude de seus corpos estigmatizados (por exemplo, tentando perder peso e modificando suas escolhas alimentares atuais). As participantes também relataram que ser gorda teve consequências físicas e psicológicas para elas. É importante ressaltar que seus corpos maiores influenciaram sua autoavaliação, fazendo com que se sentissem desvalorizadas, incapazes, incompletas e sem possibilidade de se sentirem amadas. Elas relataram experiências estigmatizadoras em situações familiares, no local de trabalho e em espaços públicos, e relataram serem estigmatizadas por pessoas próximas e desconhecidas, bem como por profissionais de saúde. Foi relatado que esses profissionais tratam os pacientes com desrespeito, o que exige atenção quanto às desigualdades na assistência à saúde de pessoas obesas. Nossos resultados enfatizam que atitudes estigmatizadoras em relação às pessoas gordas e suas próprias considerações sobre si mesmas têm consequências negativas para seu bem-estar físico e mental.

Estigmatización social en el ámbito escolar generada por un diagnóstico psicológico / Social stigmatization in the school field generated by a psychological diagnosis

La presente investigación surge de la pregunta por la estigmatización social en el ámbito escolar, generada por un diagnóstico psicológico. El contexto educativo es escenario de diversas dinámicas que influyen en el proceso de desarrollo de los estudiantes, allí se viven etapas de transición como el paso de primaria a bachillerato, en un período de la vida en el cual el adolescente está en plena construcción de su identidad. Es una etapa de adaptación al entorno, siendo éste un período de vulnerabilidad que puede ser afectado significativamente cuando además, el estudiante lleva consigo un diagnóstico psicológico que puede generar estigmatización social. Esta investigación se llevó a cabo a partir de un rastreo teórico y un estudio de caso único, en el cual se le realizó una entrevista a un estudiante con un diagnóstico psicológico establecido, otra a su madre, una a un docente y finalmente a dos psicólogos de la institución educativa. Se lograron identificar las categorías de diagnóstico, sujeto escolar e identidad en relación a la estigmatización; y a partir de un trabajo riguroso de rastreo y análisis, se concluyó que tener un diagnóstico psicológico sí está altamente relacionado con la estigmatización social y la rotulación por parte de otras personas, lo cual tiene implicaciones importantes en el desarrollo psicosocial de la persona estigmatizada, generando repercusiones negativas como baja autoestima, inseguridad, depresión, aislamiento, agresividad, estrés, temor social, timidez, sensación de incapacidad, entre otras afectaciones que pueden surgir a partir de procesos de estigmatización.

This research arises from the question of social stigmatization in the school field generated by a psychological diagnosis. The educational context is the scene of various dynamics that influence the process of student development, there are stages of transition such as the transition from elementary to high school, in a period of life in which the adolescent is in full construction of his identity. It is a stage of adaptation to the environment, this being a period of vulnerability that can be significantly affected when the students also carries with them a psychological diagnosis that can generate social stigma. This research was conducted on the basis of a theoretical trace and a unique case study, in which an interview was conducted with a student with an established diagnosis, another to its mother, a teacher and two psychologists of the educational institution. It was possible to identify the categories of diagnosis, school subject and identity in relation to stigmatization, and from rigorous work of tracking and analysis, it was concluded that having a psychological diagnosis is highly related to social stigma and labeling by other people, which has important implications for the psychosocial development of the stigmatized person, generating negative repercussions such as low self-esteem, insecurity, depression, isolation, aggressiveness, stress, social fear, shyness, feeling incapacity, among other impacts that can arise from stigmatization processes.

Familias conformadas por padres y madres con orientaciones sexuales e identidades de género diversas en Colombia. Avances y tendencias en la investigación / Families Made up of Parents with Sexual Orientations and Diverse Gender Identities in Colombia: Advances and Trends in Research

Resumen Este artículo presenta una revisión sobre avances y tendencias de la investigación en Colombia sobre el tema de familias conformadas por padres y madres con orientaciones sexuales e identidades de género diversas. Se desarrolló a partir de una revisión sobre la producción académica, la cual comprendió un periodo de diez años (2009-2019). En los resultados se identificaron tres temas de mayor interés: I) el reconocimiento y vulneración de derechos, II) las percepciones y vivencias de las familias en contextos de estigmatización, y III) la vivencia o expectativa de la paternidad/maternidad en hombres y mujeres con orientaciones sexuales diversas.

Abstract This article presents a review on advances and trends in research in Colombia on the subject of families made up of parents with different sexual orientations and gender identities. It was developed from a review on academic production, which included a ten-year period (2009-2019). The results identified three topics of greatest interest: I) the recognition and violation of rights, II) the perceptions and experiences of families in contexts of stigmatization, and III) the experience or expectation of parenthood in men and women with diverse sexual orientations.

Síndrome de Gardner-Diamond. Presentación de un caso / Gardner-Diamond syndrome: A case report

RESUMEN El sindrome de Gardner- Diamond conocido también como púrpura psicógena o síndrome de autosensibilización eritrocitaria es muy poco frecuente. Se presenta el caso de un hombre de 50 años, blanco, ingresado en el Servicio de Medicina Interna del Hospital Clínico Quirúrgico Docente "Faustino Pérez Hernández" por síndrome febril agudo, cefalea holocraneana, epistaxis y hemolacria. En el examen físico realizado se notó la salida de lágrimas con sangre, por el ángulo interno de ambos ojos y epistaxis. La inyección intradérmica en la cara dorsal del muslo izquierdo de 0,1 mL de sangre autóloga, no indujo reacción equimótica. La inyección de 0,1 mL de solución salina al 0,9 % como control en el muslo contralateral resultó negativa. Sobre la base del examen clínico y otras pruebas, se concluyó como un Síndrome de Gardner-Diamond. Esta infrecuente enfermedad debe ser considerada en el diagnóstico diferencial de un síndrome purpúrico de etiología no bien precisada, fundamentalmente en pacientes con problemas psiquiátricos.

ABSTRACT The Gardner-Diamond syndrome, also known as psychogenetic purpura or erythrocyte autosensitization syndrome is very few frequent. The case of a white patient aged 50 years is presented. He entered the Service of Internal Medicine of the Teaching Clinic-surgical Hospital "Faustino Pérez Hernández" because of an acute fever syndrome, holocraneal headache, epistaxis and haemolacria. At the physical examination it was stated the flow of tears with blood, through the internal angle of both eyes and epistaxis. The intradermal injection of 0.1 ml of autologous blood in the left thigh dorsal side did not induce an ecchymotic reaction. The injection of 0.1 ml of 0.9 % saline solution as control in the contralateral side was negative. On the basis of the clinical examination and other tests, the authors arrived to the conclusion it is a Gardner-Diamond syndrome. This infrequent disease should be considered in the differential diagnosis of a purpuric syndrome of non-good précised etiology, mainly in patients with psychiatric problems.

Psychometric properties of a brief Spanish version of Stigmatizing Situations Inventory / Propiedades psicométricas de una versión breve en español del Inventario de Situaciones Estigmatizantes

Abstract Overweight and obese people are a frequent target of weight stigma. However, there are no Spanish-Language validated inventories measuring weight stigma situations. Therefore, we sought to validate a brief Spanish version of the Stigmatizing Situations Inventory (SSI) in a sample of Chilean adults. A psychometric study with 377 adults was designed (Mage = 45.0, SD = 8.7; 62% female). Twenty-four items available from two previous versions of the SSI developed were back-translated from English to Spanish, and semantically adapted to the Chilean sample. We explored the factorial structure with 173 participants, and then confirmed it with 204 subjects. We obtained evidence of concurrent validity with other psychological measures, as well as evidence of reliability. Our results identified a single factor structure grouping 10-items, with factorial loadings greater than .60. The overall fit indices are excellent. There is evidence of concurrent validity with body mass index (r = .43), anger (r = .19), anxiety (r = .29), and daily life discrimination (r = .26); all with p < .05. The reliability of our version is high (α = .91). The brief Spanish version of the SSI is a 10-items reliable and valid scale with one-dimensional factorial structure. This scale can be used by researchers and healthcare professionals studying psychological consequences of obesity.

Resumen Las personas con sobrepeso u obesidad enfrentan frecuentemente situaciones de estigmatización por el peso; sin embargo, no existen instrumentos validados en español que midan este constructo. En consecuencia, el objetivo de este estudio fue examinar las propiedades psicométricas una versión breve del Inventario de Situaciones Estigmatizantes (ISE) en población chilena. Participaron 377 adultos (Medad = 45.0, DE = 8.7; 62% mujeres). Veinticuatro ítems disponibles en versiones previas del ISE fueron retrotraducidos del inglés al español y adaptados semánticamente. La estructura factorial fue explorada con los registros de 173 de los participantes, y posteriormente confirmada con los 204 restantes. Fue identificada una estructura uni-factorial, con cargas factoriales > .60 e indicadores de bondad de ajuste excelentes. La consistencia interna del inventario fue alta (α = .91). Además se obtuvo evidencia de la validez concurrente del ISE con otras medidas: índice de masa corporal (r = .43), ira (r = .19), ansiedad (r = .29) y discriminación en la vida diaria (r = .26); todos con p < .05. La versión breve en español del ISE mostró ser válida y confiable. Esta escala puede ser utilizada por investigadores y profesionales de la salud que estudian las consecuencias psicológicas de la obesidad.

O estigma e o ódio contra si mesmo / Stigma and self-hate / El estigma y el odio de sí mismo / Le stigmate et la haine de soi

Este trabalho aborda a questão do estigma, que evoca inúmeros problemas ligados ao social e ao psíquico. Um estigma é uma anomalia, mas torna-se estigmatizante quando se desenvolve ódio contra si mesmo, quando nos depreciamos. O autor considera que o ambiente familiar representa um papel nessa evolução que não pode ser negligenciado. Estuda diferentes derivações e, em especial, as consequências do olhar do outro. Se o grupo social e o grupo familiar desempenham um papel nessa evolução, é com o grupo e escorando-se nele que a situação da estigmatização se inverterá e o estigma poderá tornar-se uma força. Um caso clínico permite ilustrar os efeitos do ódio contra si mesmo. As contribuições da filosofia e da sociologia ampliam esse debate.

The author discusses the problem of stigmatization, evoking many problems related to the social and the psychic orders. A stigma is a defect, but when it is stigmatized, self-hate develops and the subject depreciates him or herself. The author considers that family environment has an important role in this evolution. He studies diverse aspects, principally the consequences of the gaze of others. Since family and social groups play an important part in this development, it is in groups and with their support that the situation of stigmatization is reverted and stigma may become strength. A clinical case illustrates effects of self-hate. Contributions from philosophy and sociology expand this debate.

Este trabajo aborda el problema de la estigmatización: evoca numerosos problemas relacionados con lo social y lo psíquico. Un estigma es um defecto, pero cuando se lo estigmatiza, se desarrolla odio contra sí mismo, el sujeto se deprecia. Para el autor, el entorno familiar juega un papel importante en esta evolución. Estudia diversas derivas, principalmente las consecuencias de la mirada de los demás. Si los grupos familiar y social desempeñan un papel importante en tal evolución, es com estos grupos y apoyándose sobre ellos que la situación de la estigmatización se revertirá y que el estigma podrá transformarse en una fuerza. Un caso clínico ilustra los efectos del odio de sí. Las aportaciones de la filosofía y la sociología amplían este debate.

Ce travail aborde le problème du stigmate : il évoque de nombreux problèmes liés au social et au psychique. Un stigmate est un défaut mais il devient stigmatisant lorsqu'on développe de la haine à l'encontre de soi, que l'on se déprécie. Pour l'auteur, l'environnement familial joue une fonction non négligeable dans cette évolution. Il étudie différentes dérives et notamment les conséquences du regard d'autrui. Si le groupe social et le groupe familial jouent un rôle dans cette évolution, c'est avec le groupe et en s'étayant sur lui que la situation de la stigmatisation se renversera et que le stigmate pourra devenir une force. Un cas clinique permet d'illustrer les effets de la haine de soi. Les contributions de la philosophie et de la sociologie élargissent ce débat.

Propriedades psicométricas da versão turca da escala Tuberculosis-Related Stigma / Propiedades psicométricas versión turca de la escala Tuberculosis-Related Stigma / Psychometric properties of the Turkish version of the Tuberculosis-Related Stigma scale

Resumo Objetivo O objetivo deste estudo foi investigar a validade e confiabilidade da escala Tuberculosis-Related Stigma. Métodos Estudo metodológico com 263 indivíduos não diagnosticados com tuberculose pulmonar. Também foi utilizada a análise de correlação de Pearson, o coeficiente alfa de Cronbach, correlação item total e análise fatorial dos dados do estudo. Resultados Neste estudo, o coeficiente alfa de Cronbach foi 0,83 para a subescala perspectivas da comunidade e 0,89 para a subescala perspectivas dos pacientes. O RMSEA foi 0,077, NFI: 0,91, CFI: 0,94, RMR: 0,056, SRM: 0,079, GFI: 0,95, AGFI: 0,94, x2: 582,84, DP: 228 e x2/SD: 2,55 (p=0,000). Claramente, todos os índices de ajuste do modelo foram aceitáveis. Conclusão À luz dos resultados, a versão turca da escala Tuberculosis-Related Stigma tem validade e confiabilidade aceitáveis para uso na população turca.

Resumen Objetivo El objetivo de este estudio fue investigar la validez y confiabilidad de la escala Tuberculosis-Related Stigma. Métodos Estudio metodológico con 263 sujetos no diagnosticados con tuberculosis pulmonar. También se utilizó el análisis de correlación de Pearson, el coeficiente alfa de Cronbach, correlación ítem total y análisis factorial de los datos del estudio. Resultados En este estudio, el coeficiente alfa de Cronbach fue del 0,83 para las perspectivas de la subescala de la comunidad y del 0,89 para las perspectivas de la subescala de pacientes. El RMSEA fue del 0,077, NFI: 0,91, CFI: 0,94, RMR: 0,056, SRM: 0,079, GFI: 0,95, AGFI: 0,94, x2: 582,84, DP: 228 y x2 / SD: 2,55 (p = 0,000). Claramente, todos los índices de ajuste del modelo fueron aceptables. Conclusión Conforme los resultados, la versión turca de la escala Tuberculosis-Related Stigma es confiable y posee validez aceptable para su uso en la población turca.

Abstract Objective The aim of this study was to investigate the validity and reliability of the Turkish "Tuberculosis-Related Stigma Scale". Methods This study used methodological design. This methodological study was conducted with 263 with individuals who not being diagnosed as pulmonary tuberculosis. We also used Pearson correlation analysis, Cronbach alpha coefficient, item total correlation and factor analysis for the study data. Results In this study, Cronbach's alpha coefficient was .83 for the subscale community perspectives and .89 for the subscale patient perspectives. RMSEA was 0.077, NFI was 0.91, CFI was 0.94, RMR was 0.056, SRM was 0.079, GFI was 0.95, AGFI was 0.94, x2 was 582.84, SD was 228 and x2/SD was 2.55 (p= 0.000). Clearly, all model fit indices were acceptable. Conclusion In the light of the findings, Turkish version of Tuberculosis-Related Stigma Scale has acceptable validity and reliability for use in Turkish population.

Concepciones y valoraciones del cuerpo en jóvenes del noroeste de México / Conceptions and values of the body in young adults of Northwestern Mexico

Resumen Mientras que la delgadez actualmente constituye el ideal corporal (IDC) preponderante en las sociedades occidentales, la obesidad prevalece con niveles nunca antes vistos. Esto ha influido en cómo hombres y mujeres se perciben y viven su cuerpo. El objetivo de este estudio fue describir las concepciones y valoraciones del IDC y la percepción y aceptación del propio cuerpo en jóvenes universitarios del noroeste de México, un contexto sociocultural en el que prevalece la obesidad. A partir de una perspectiva socio-antropológica, se trabajó con 308 jóvenes universitarios, de entre 18 y 24 años de edad (202 mujeres y 106 hombres). La construcción del IDC en los jóvenes concuerda con el discurso aceptado y difundido socialmente, basado en valoraciones estéticas y de salud. En general, los jóvenes expresaron moderada insatisfacción corporal y rechazo de la obesidad; mientras que el IDC fue delgado, firme y curvilíneo para las mujeres, en tanto que fuerte y musculoso para los hombres. Por tanto, se identificó un desfase entre lo que ellos y ellas desean, lo que perciben de su imagen corporal y la propia aceptación, con claras diferencias por sexo.

Abstract Currently thinness is the ideal body (IB) while in western societies obesity has reached levels never seen before. This situation has influenced how men and women perceive their bodies. The aim of this paper was to describe conceptions and values of the IB as well as the perception and acceptance of the body in university students from the northwestern Mexico, a sociocultural context where obesity prevails. From a socio-anthropological approach, we worked with 308 university students among 18 and 24 years old (202 women and 106 men). The construct of IB matches with the socially accepted discourse based on aesthetic and health values. In general, participants expressed moderated body dissatisfaction and rejected obesity; the IB for women was slim, firm and curved while for men was muscled. Therefore, a gap was identified between what women and men want and perceive of their body image and self-acceptance, with clear differences by sex.

Abuse and neglect of Mentally Ill Destitute and the burden of Rehabilitation in Benin Metropolis, Southern Nigeria

@#The incidence and prevalence of mentally ill destitute in metropolitan Benin, Nigeria has become a subject of public discourse particularly as they appear to lack care and the desired attention from their relatives, society and the government. Apart from the Lunacy Act (1958), Nigeria currently does not have any Act of parliament dealing with mental health and rehabilitation. This study therefore examined the abuse and neglect of mentally ill destitute and the burden of rehabilitation in Benin Metropolis, Southern Nigeria. Though a onetime survey design, the quantitative technique was adopted with the aid of both purposive and snowballing sampling methods to gather data from 610 respondents made up of medical practitioners, nurses, staff of Ministry of Women Affairs, Benin City, care givers and social workers, personnel in traditional and prayer houses, relations, friends and neighbours of mentally ill persons in Benin Metropolis. Informed consent was individually obtained from all the respondents before the commencement of the study. The data collected were analysed with the aid of inferential and descriptive statistics and the three null hypotheses formulated were rejected while the alternate hypotheses were accepted. The study found that mentally ill destitute were not only abused and neglected due to prejudice, beliefs and attitude of the people, but that there were no social or legal policy on their rehabilitation. The findings indicate that enlightenment of the populace should be done to change their negative beliefs, attitude and prejudice against the mentally ill destitute. The government on its part should enact legislation on mental health and rehabilitation.

Abuse and neglect of Mentally Ill Destitute and the burden of Rehabilitation in Benin Metropolis, Southern Nigeria

@#The incidence and prevalence of mentally ill destitute in metropolitan Benin, Nigeria has become a subject of public discourse particularly as they appear to lack care and the desired attention from their relatives, society and the government. Apart from the Lunacy Act (1958), Nigeria currently does not have any Act of parliament dealing with mental health and rehabilitation. This study therefore examined the abuse and neglect of mentally ill destitute and the burden of rehabilitation in Benin Metropolis, Southern Nigeria. Though a onetime survey design, the quantitative technique was adopted with the aid of both purposive and snowballing sampling methods to gather data from 610 respondents made up of medical practitioners, nurses, staff of Ministry of Women Affairs, Benin City, care givers and social workers, personnel in traditional and prayer houses, relations, friends and neighbours of mentally ill persons in Benin Metropolis. Informed consent was individually obtained from all the respondents before the commencement of the study. The data collected were analysed with the aid of inferential and descriptive statistics and the three null hypotheses formulated were rejected while the alternate hypotheses were accepted. The study found that mentally ill destitute were not only abused and neglected due to prejudice, beliefs and attitude of the people, but that there were no social or legal policy on their rehabilitation. The findings indicate that enlightenment of the populace should be done to change their negative beliefs, attitude and prejudice against the mentally ill destitute. The government on its part should enact legislation on mental health and rehabilitation.

Imagens sociais de famílias com filhos em acolhimento e em contexto familiar: um estudo entre Brasil e Portugal / Social images of families with children in sheltered care and in family context: a study between Brazil and Portugal / Imágenes sociales de familias con hijos en acogimiento residencial y en contexto familiar: un estudio entre Brasil y Portugal

A literatura indica que as famílias de crianças e jovens em acolhimento institucional podem ser estigmatizadas socialmente, gerando um impacto negativo no seu bem-estar, na construção da sua identidade e no sucesso da intervenção familiar. No entanto, poucos estudos investigam empiricamente esta imagem social. Este estudo teve como objetivo analisar a imagem social das famílias de crianças e jovens em diferentes contextos em Portugal e no Brasil. Uma amostra de 378 participantes (176 portugueses e 202 brasileiros) foi solicitada a indicar cinco atributos de famílias de crianças e jovens em acolhimento institucional e outros cinco atributos de famílias de crianças e jovens em contexto familiar, de estatutos socioeconômicos baixo e médio. Os dados indicam que em ambos os países existe um predomínio de atributos negativos associados às famílias de crianças e jovens em acolhimento institucional e de estatuto socioeconômico baixo, e um predomínio de atributos positivos associados às famílias em contexto familiar de estatuto socioeconômico médio. Destaca-se a necessidade de intervenções, especialmente com profissionais que atuam junto a essa população, para conscientização sobre essas imagens sociais. (AU)

The literature indicates that families of children and adolescents in sheltered care may be socially stigmatized and this has a negative impact on their well-being, the construction of their identity, and the success of family interventions. However, only a few studies have empirically investigated this social image. This study aimed to analyse the social image of the families of children and adolescents in different contexts in Portugal and Brazil. A sample of 378 participants (176 Portuguese and 202 Brazilian) was asked to indicate five attributes of families of children and adolescents in shelter care, and other five attributes of families of children and adolescents in the family context, varying from low to middle socioeconomic status. The data indicate that in both countries there is a predominance of negative attributes associated with families of children and adolescents in shelter care and low socioeconomic status, whereas a predominance of positive attributes was associated with families of children and adolescents in family context and middle socioeconomic status. It is highlighted the need of interventions, especially with professionals who work with this population, to bring out awareness of these social images. (AU)

La literatura indica que las familias de los niños y jóvenes en acogimiento residencial son estigmatizadas socialmente y esto tiene un impacto negativo en su bienestar, en la construcción de su identidad y en el éxito de la intervención familiar. Sin embargo, pocos estudios han investigado empíricamente esta imagen social. Este estudio tuvo como objetivo analizar la imagen social de las familias de los niños y jóvenes en diferentes contextos en Portugal y Brasil. Se le pidió a una muestra de 378 participantes (176 portugueses y 202 brasileños) para indicar cinco atributos de las familias de niños y jóvenes en acogimiento residencial y otros cinco atributos de las familias de niños y jóvenes en el contexto familiar, nivel socioeconómico bajo y medio. Los datos indican que en ambos países hay un predominio de los atributos negativos asociados a las familias de niños y jóvenes en acogimiento residencial y el estatus socioeconómico bajo, y un predominio de los atributos positivos asociados al nivel socioeconómico promedio de las familias. Se destaca la necesidad de la intervención, sobre todo con los profesionales que trabajan con esta población, a la concientización con respecto a estas imágenes sociales. (AU)

Assessment of anxiety, depression, loneliness and stigmatization in patients with tuberculosis

Abstract Objective: The purpose of this study was to assess anxiety, depression, loneliness, and stigmatization in patients with pulmonary tuberculosis. Methods: A descriptive and cross sectional study was conducted with 208 out-patients in a state hospital due to PT. A patient identification form, Tuberculosis Patients Stigma Scale (TPSS), Hospital Anxiety and Depression Scale (HAD) and University California of Los Angeles (UCLA) Loneliness Scale were used as data gathering forms. Arithmetic averages, standart deviation (SD), pergentage, and correlation were used in statistical analysis. Results: The prevalence of anxiety (26.0%), depression (60.5%), and loneliness (49.0%) was observed to be among patients with PT. It was found that patients with PT suffered from stigmatization (47.6%). Conclusion: In conclusion, patients with PT experience high level of depression, moderate-high level of loneliness, mild level of anxiety, and moderate level of stigmatization.

Cuidado y otredad en la convivencia escolar: una alternativa a la ley del talión / Care and Therness in the School Culture: An Alternative View to the Law of Retaliation / Cuidado e alteridade na convivência escolar: uma alternativa para a lei do talião

Durante las últimas décadas, la convivencia, la conflictividad y las violencias en el ámbito escolar son problemáticas socialmente relevantes que se han instalado en las agendas públicas de la gran mayoría de los países de la región latinoamericana. En un plano normativo, se han extendido los derechos de los niños y los jóvenes, población que históricamente ha ocupado un lugar subalterno. Lo cierto es que, junto con las leyes, resulta necesario generar las condiciones para el cambio cultural mediante la edificación de una pedagogía que libere las emociones en un sentido emancipador. Por este motivo, es imperioso realizar un viraje desde la pedagogía del castigo a otra que posibilite el autocontrol de las emociones a partir del respeto hacia el otro en la convivencia social. Por tal razón, este artículo tiene como objetivo reflexionar sobre aquellas expresiones de xenofobia y racismo, en las dinámicas sociales de estigmatización que caracterizan la época actual y que se observan en las prácticas educativas. Se entiende a la violencia como constructora de subjetividad, como modo de dolor social que reporta un daño. Así, la reparación es un acto educativo que habilita experiencias escolares menos traumáticas y deja como legado de transmisión una actitud ética para con el otro.

Cohabitation, conflict and violence in schools are socially relevant issues that have been posed in public agendas of most Latin American countries during the recent decades. On a normative level, the rights of those individuals who have been historically placed in a subordinate position, such as children and youngsters, have been extended. However, alongside laws, it is necessary to generate the conditions for cultural change; which helps to build a pedagogy to release emotions in an emancipatory sense. It is imperative to make a turn from the pedagogy of punishment to another one that enables the self-control of emotions on the basis of respect towards others in a social coexistence. This text explores the expressions of xenophobia and racism, in the socio-dynamics of stigmatization which characterize the current times we live in and which are observed in educational practices. We understand violence as a builder of subjectivity, as a mode of social pain that reports damages. Thus, repairing is an educational act that enables less traumatic school experiences and leaves as a legacy of transmission an ethical attitude towards the other.

Durante as últimas décadas, a convivência, o conflito e as violências no âmbito escolar são problemáticas socialmente relevantes que estão instaladas nas agendas públicas da grande maioria dos países da região latino-americana. Num plano normativo, têm sido estendidos os direitos das crianças e jovens, população que historicamente tem ocupado um lugar subalterno. A verdade é que, junto com as leis, é necessário gerar as condições para a mudança cultural mediante a edificação de uma pedagogia que libere as emoções num sentido emancipador. Por este motivo, é imperioso fazer uma viragem desde a pedagogia do castigo para outra que possibilite o autocontrole das emoções a partir do respeito pelo outro na convivência social. Este artigo tem como objetivo reflexionar sobre aquelas expressões de xenofobia e racismo nas dinâmicas sociais de estigmatização que caracteriza a época atual e que são observadas nas práticas educativas. A violência é entendida como construtora de subjetividade, como um modo de dor social que reporta um dano. Assim, a reparação é um ato educativo que habilita experiências escolares menos traumáticas e deixa como legado de transmissão uma atitude ética com o outro.

Public health services and their relationship with rapid HIV test utilization and access for key populations in Morelos, Mexico / La organización de los servicios de salud y su relación con la utilización y acceso a las pruebas rápidas para la detección del VIH en las poblaciones clave en Morelos, México

Objective. In 2009, 4 749 rapid HIV tests were run in Morelos, Mexico, despite lacking evidence on their results. This article seeks to analyze how public health organization relates to utility of rapid HIV test among healthcare users. Materials and methods. Joint study: comparison of differences in applied test and positive results for each group with the Bonferroni statistical tool, observational study in 34 health subsystems, and 11 interviews with public healthcare users. Results. Each subsystem processes influenced the use and usefulness of screening; for instance, primary care centers test only pregnant women and exclude men who have sex with men (MSM). That group shows significant differences (p<0.007) in the HIV-positive test with respect to other groups. Conclusions. Despite the availability of rapid detection tests and epidemiological evidence, the way public health services are organized impedes an efficient diagnosis in the group with higher risk, namely MSM. The distribution of rapid HIV tests was guided by stigmatization.

Objetivo. En 2009, 4 749 pruebas rápidas de detección de VIH fueron aplicadas en Morelos, México, sin evidencias de resultados. Se hace necesario analizar la distribución de estas pruebas y las consecuencias que la organización de los servicios de salud tuvo para el diagnóstico del VIH en las poblaciones clave. Material y métodos. Estudio mixto: comparación de diferencias en pruebas aplicadas y casos diagnosticados en grupos mediante la técnica de Bonferroni, observaciones en 34 subsistemas de salud y 11 entrevistas a usuarios. Resultados. Los procesos de cada subsistema incidieron en la utilización y utilidad del tamizaje: se focalizó en mujeres embarazadas y se excluyó a grupos en mayor riesgo (p<0.007) en hombres que tienen sexo con otros hombres (HSH). Conclusiones. A pesar de la disponibilidad de las pruebas y de información epidemiológica, la organización de los servicios impidió una mayor captación de HSH. La estigmatización influyó en las formas de distribuirlas.