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1.
The course of HIV/AIDS in children has been transformed from an acute to a chronic one with the advent of Anti-Retroviral Therapy. The aim of this study was to determine the prevalence and pattern of psychiatric morbidity in HIV-infected children and adolescents between 6 and 18 years of age and the relationship between their socio-demographic factors, immune suppression and psychiatric morbidity. The study was conducted at a paediatric HIV clinic in Nairobi, between February and April 2010. One hundred and sixty-two HIV-infected children and adolescents aged between 6 and 18 years and their guardians were interviewed. Seventy-nine (48.8%) of the study participants were found to have psychiatric morbidity. The most prevalent Diagnostic Statistical Manual, 4th Edition TR psychiatric disorders were: Major depression (17.8%), Social phobia (12.8%), Oppositional Defiant Disorder (12.1%) and Attention Deficit Hyperactivity Disorder (12.1%). Twenty-five per cent of the study participants had more than one psychiatric disorder. The prevalence of psychiatric morbidity in HIV-infected children is higher than that found in children in the general population. There is therefore a need to integrate psychiatric services into the routine care of HIV-infected children. 相似文献
2.
Knowledge of the variant vascular anatomy of the subhepatic region is important for hepatobiliary surgeons in limiting operative complications due to unexpected bleeding. The pattern of arterial blood supply of 102 gallbladders was studied by gross dissection. The cystic artery originated from the right hepatic artery in 92.2% of cases. The rest were aberrant and originated from the proper hepatic artery. Accessory arteries were observed to originate from proper hepatic artery (n = 5), left hepatic artery (n = 2), and right hepatic artery (n = 1). Most of the arteries approached the gallbladder in relation to the common hepatic duct (anterior 45.1%, posterior, 46.1%). The other vessels passed anterior to common bile duct (2.9%), posterior to common bile duct (3.9%), or were given off in Calot's triangle. Cystic arteries in this data set show wide variations in terms of relationship to the duct systems. In about one tenth of patients, an accessory cystic artery may need to be ligated or clipped during cholecystectomy. 相似文献
3.
Ngugi CW Boga H Muigai AW Wanzala P Mbithi JN 《Health care for women international》2012,33(7):595-613
In this study, 50 in-depth interviews were carried out with women from the general population in Thika, Kenya. We explored awareness, attitudes, and behavior toward cervical cancer and screening measures among the women. The concept of the health belief model (HBM) was used to develop the topics for the in-depth interviews. Our findings highlight the lack of awareness of cervical cancer and the benefits of early detection measures as critical barriers that affect women's participation in screening programs. We provide a basis for designing programs that will be acceptable and accessible to a larger population, resulting in a reduced cervical cancer burden. 相似文献
4.
Wangari Waweru-Siika Meredith Edwards Clement Lilian Lukoko Simon Nadel Philip M. Rosoff Violet Naanyu 《Global public health》2017,12(5):589-600
The concept of brain death (BD), defined as irreversible loss of function of the brain including the brainstem, is accepted in the medical literature and in legislative policy worldwide. However, in most of Sub-Saharan Africa (SSA) there are no legal guidelines regarding BD. Hypothetical scenarios based on our collective experience are presented which underscore the consequences of the absence of BD policies in resource-limited countries (RLCs). Barriers to the development of BD laws exist in an RLC such as Kenya. Cultural, ethnic, and religious diversity creates a complex perspective about death challenging the development of uniform guidelines for BD. The history of the medical legal process in the USA provides a potential way forward. Uniform guidelines for legislation at the state level included special consideration for ethnic or religious preferences in specific states. In SSA, medical and social consensus on the definition of BD is a prerequisite for the development BD legislation. Legislative policy will (1) limit prolonged and futile interventions; (2) mitigate the suffering of families; (3) standardise clinical practice; and (4) facilitate better allocation of scarce critical care resources in RLCs. There is a clear-cut need for these policies, and previous successful policies can serve to guide these efforts. 相似文献
5.
Roula Kteily-Hawa Nisha Andany Ying Wang Carmen H. Logie Wangari Tharao Tracey Conway 《HIV clinical trials》2019,20(2):35-47
Objective: This study assessed and compared physical and mental health components of quality of life (QoL) for older and younger women living with HIV (WLWH).Method: Using survey data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study, demographic, well-being, and physical and mental health-related QoL (HR-QoL) variables were compared between older (≥50 years) and younger (<50 years) WLWH. As the only significantly different QoL component, bivariate analyses and linear regression were used to assess factors associated with physical HR-QoL of older women.Results: The sample frame comprised 1,422 women (28.0% older women). Younger WLWH’s mean age was 37.8 years (SD = 7.4) compared to older WLWH (55.8 years, SD = 5.3). Compared to younger WLWH, older WLWH had poorer physical HR-QoL (40.0 vs. 50.7; p?0.001) but similar mental HR-QoL (42.7 vs. 42.1; p?>?0.001). Older WLWH had lower social support (p?0.001) with no significant differences in depressive symptoms or resilience. Resilience was associated with improved physical HR-QOL. Food insecurity, poorer mental HR-QoL and depressive symptoms were associated with poorer physical health.Discussion: Compared to younger WLWH, older WLWH had poorer physical HR-QoL, which was associated with resilience, food insecurity and mental health factors, highlighting the complex interactions of health-related social-ecological factors impacting aging WLWH. 相似文献
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7.
Judith A. MacDonnell Mahdieh Dastjerdi Nimo Bokore Wangari Tharao Nazilla Khanlou Wairimu Njoroge 《International journal of mental health and addiction》2017,15(4):738-752
Racialised immigrant women face many challenges with resettlement with potential impacts on their mental health and well-being. Recent community-based research (CBR) and associated knowledge translation/exchange (KTE) activities with racialised immigrant women in Toronto, Canada, suggest that activism can promote their mental health and well-being. In this paper, the researchers describe community engagement processes in the CBR that included a stakeholder Think Tank with communities, researchers and service providers in settlement and mental health sectors to create an action plan based on the research. Using a feminist post-colonial lens to analyse the Think Tank data yielded research, policy and program strategies aligned with principles such as building on individuals’ and communities’ strengths and foregrounding gender and racialisation in strategies that can enhance racialised immigrant women’s capacities to take action and overcome barriers. Research, policy and program implications for comprehensive strategies that support health equity, thereby promoting their mental health and well-being, are considered. 相似文献
8.
Judith A. MacDonnell Mahdieh Dastjerdi Nazilla Khanlou Nimo Bokore Wangari Tharao 《Health care for women international》2017,38(2):187-204
Although immigrant women bear a disproportionate burden of chronic disease and mental health issues, limited research addresses how to promote their mental wellbeing. The authors first describe grounded theory findings from community-based focus group research with 57 racialized immigrant women in Toronto, Canada that used a critical gender and intersectional lens to explore the links among settlement, wellbeing, and activism. Secondly, a community mobilization strategy is described whereby racialized immigrant women discuss activism as a feature of wellbeing in various language communities while creating meaningful health promotion resources. Implications for creating activism-based initiatives to promote women's wellbeing are discussed. 相似文献
9.
Allison J Carter Sonya Bourgeois Nadia O'Brien Kira Abelsohn Wangari Tharao Saara Greene Shari Margolese Angela Kaida Margarite Sanchez Alexis K Palmer Angela Cescon Alexandra de Pokomandy Mona R Loutfy 《Journal of the International AIDS Society》2013,16(1)
Introduction
The increasing proportion of women living with HIV has evoked calls for tailored services that respond to women''s specific needs. The objective of this investigation was to explore the concept of women-specific HIV/AIDS services to identify and define what key elements underlie this approach to care.Methods
A comprehensive review was conducted using online databases (CSA Social Service Abstracts, OvidSP, Proquest, Psycinfo, PubMed, CINAHL), augmented with a search for grey literature. In total, 84 articles were retrieved and 30 were included for a full review. Of these 30, 15 were specific to HIV/AIDS, 11 for mental health and addictions and four stemmed from other disciplines.Results and discussion
The review demonstrated the absence of a consensual definition of women-specific HIV/AIDS services in the literature. We distilled this concept into its defining features and 12 additional dimensions (1) creating an atmosphere of safety, respect and acceptance; (2) facilitating communication and interaction among peers; (3) involving women in the planning, delivery and evaluation of services; (4) providing self-determination opportunities; (5) providing tailored programming for women; (6) facilitating meaningful access to care through the provision of social and supportive services; (7) facilitating access to women-specific and culturally sensitive information; (8) considering family as the unit of intervention; (9) providing multidisciplinary integration and coordination of a comprehensive array of services; (10) meeting women “where they are”; (11) providing gender-, culture- and HIV-sensitive training to health and social care providers; and (12) conducting gendered HIV/AIDS research.Conclusions
This review highlights that the concept of women-specific HIV/AIDS services is a complex and multidimensional one that has been shaped by diverse theoretical perspectives. Further research is needed to better understand this emerging concept and ultimately assess the effectiveness of women-specific services on HIV-positive women''s health outcomes. 相似文献10.
Caroline Wangari Ngugi Hamadi Boga Anne W. T. Muigai Peter Wanzala John N. Mbithi 《Health care for women international》2013,34(7):595-613
In this study, 50 in-depth interviews were carried out with women from the general population in Thika, Kenya. We explored awareness, attitudes, and behavior toward cervical cancer and screening measures among the women. The concept of the health belief model (HBM) was used to develop the topics for the in-depth interviews. Our findings highlight the lack of awareness of cervical cancer and the benefits of early detection measures as critical barriers that affect women's participation in screening programs. We provide a basis for designing programs that will be acceptable and accessible to a larger population, resulting in a reduced cervical cancer burden. 相似文献