Caregiving and Experiences of Health, Illness and Coping in the Context of Paediatric and Adolescent HIV and Poverty

The contextual challenges in the context of HIV negatively impact the social ecology of the families. The consequences of this are that it adversely impacts the psychosocial functioning of caregivers and health and well‐being of the children. The findings showed that caregiving is performed, not only in the context of maternal HIV infection, but also in the context of inadequate material and financial resources and single‐head households where women assume the primary caregiving role. Caregiving is also complicated by the issue of maternal death and abandonment, where relatives (i.e. mainly grandparents) assume the role of the primary caregivers of children infected with HIV. On the other hand, emerging studies that started to focus on enhancing resilience in children whose caregiver is HIV positive holds promise to the fact that adequate interventions can have long‐lasting benefits on the developmental and psychological trajectory of HIV‐positive children and their HIV‐positive caregivers. Consequently, the link between poverty and HIV/AIDS has been established, and its impact on perinatal, infancy and early‐childhood development outcomes is clearly documented

The Association of Home Environment and Caregiver Factors With Neurocognitive Function in Pre-school- and School-Aged Perinatally Acquired HIV-Positive Children on cART in South Africa

Background: Children with perinatally acquired HIV in low resource settings are at risk for neurocognitive impairments not only due to the direct effects of HIV on the brain and in utero ART exposure but also due to factors associated with their environment. Thus, the aim of this study was to examine the association between home environment and caregiver factors and the neurocognitive function of pre-school- and-school-aged HIV-positive South African children from low resource rural communities.Materials and Methods: The Wechsler Preschool and Primary Scale of Intelligence-III was administered to assess the neurocognitive functioning of 152 purposively sampled perinatally acquired HIV-positive children on cART, aged 3 years to 7 years 6 months (mean age 63.13 months). The primary caregivers (n = 152) completed the Home Screening Questionnaire to assess the quality of the home-environment of the children.Results :The results showed that unfavorable environment, caregiver type, and quality of stimulation in the home were negatively associated with the neurocognitive development of perinatally HIV-positive children on cART. Most of the HIV-positive children (n = 95) were under the care of an extended relative. Older HIV-positive boys, reared by biological mothers, who also lived in suboptimal and poor quality home-environments had poorer neurocognitive function when compared to HIV-positive children reared by non-biological (extended relatives) caregivers, [F(2,149) = 14.42, p < 0.001].Conclusion: The child's early home environment is associated with general neurocognitive development, which highlights the need for early psychosocial interventions that can promote better cognitive outcomes among children living with HIV

The relationship between psychosocial factors and poor neurocognitive and socio-emotional development in children perinatally infected with HIV in South Africa.

Doctor of Philosophy in Psychology. University of KwaZulu-Natal, Howard College 2015.Background: Survival among perinatally HIV infected children has increased over the last few years in South Africa, mainly due to the availability and accessibility of combination antiretroviral therapy (cARTs). These children, however, remain a vulnerable group with respect to heightened behavioural and socio-emotional problems as well as neurocognitive deficits. The majority of HIV-positive children live in an environment of multiple deprivations; i.e. poverty, parental death or ill health, stress associated with daily living and poor stimulation in the home environment. Early childhood is known to be a sensitive period for brain development, especially in forming neural circuits underlying behaviours and higher cognitive functions. Injury or insult and environmental deprivation (impoverishment, nutritional deficits and lack of nurturance) have the potential to create vulnerability which can negatively impact on the life trajectory of the child. With this in mind, the aim of this study was to investigate the impact of key psychosocial factors, namely, socio-economic status, caregiver depression, quality of home environment and nutritional status, on the neurocognitive and socio-emotional functioning of perinatally acquired HIV-positive children living in semi-rural Eastern Cape, South Africa. Method: A cross-sectional, convergent mixed method design using non-probability sampling was employed. Quantitative data was collected on 152 dyads of perinatally infected HIV positive children on cARTs (mean age = 63.13 months) and their caregivers. The Wechsler Preschool and Primary Scale of Intelligence-III (WPPSI-III) was administered to assess the neurocognitive functioning of the children, while the Strengths and Difficulties Questionnaire (SDQ) (caregiver report version) was administered to assess the children’s socio-emotional function. Anthropometric data was obtained from the HIV-positive children through the WHO-anthro-programme to assess nutritional status. The Home Screening Stimulation Questionnaire (HSQ) was administered to assess the quality of home environment the children were living in. The Beck Depression Inventory, 2nd edition (BDI-II) was used to assess caregiver depression among the 152 (mean age = 45 years) caregivers. Qualitative data was obtained through a series of semi-structured in-depth interviews with a sub-set of 44 caregivers of the HIV-positive children who were conveniently recruited from the quantitative sample. A series of one-way ANOVAs, independent t-tests, chi-square and correlation analyses was performed on the quantitative data. The qualitative data was analysed using interpretive phenomenological analysis. Results: The converging quantitative and qualitative results in this doctoral study provides evidence that various psychosocial factors differentially impact neurocognitive and socioemotional development of perinatally HIV-infected children. Older HIV-positive boys who lived in suboptimal, poor quality homes and who demonstrated stunting, wasting and /or were underweight (indicators of nutritional status) were worse off neurocognitively when compared to younger boys and girls infected with HIV from similar environmental deprivation context. Socio-emotional adjustment was also generally poor, with caregiver depression strongly associated with poor socio-emotional functioning among HIV-positive children. This relationship existed whether or not the child was raised by a biological or nonbiological caregiver and was greater in younger children. The children’s overall psychosocial difficulties mean score was 16.9 (SD = 5.05), with indications of the significant presence of psychological and behavioural symptoms. Hyperactivity problems was reported in 40.1 % (M = 5.27, SD = 1.72) of the children, emotional problems in 29.6 % (M = 4.31, SD = 2.34), conduct problems in 41.4 % (M = 3.13, SD = 2.18) and peer related problems in 51.3 % (M = 3.49, SD = 1.46). The qualitative data indicated, inter alia, that stigma negatively impacts on caregivers’ mental health and deters them from seeking social support. This in turn, exacerbates caregivers’ poor mental health and capacity to adequately meet the needs of their HIVvii positive children, ultimately leading to negative child outcomes. This finding highlights the importance of Bronfenbrenner’s micro- and meso-system variables, such as the importance of quality parent/child interaction, adequate language stimulation through dialogue, and availability of tools within the home and school environment that could act as a buffer against the negative effects of HIV on the infected child’s developing brain. The children’s neurocognitive, psychological and behavioural development is influenced by their ecological context. Conclusion: This is the first study in South Africa investigating the impact of psychosocial factors associated with poor neurocognitive and socio-emotional functioning in perinatally HIV-infected children. The findings highlight that it is not enough to just focus attention on the medical management of paediatric HIV. Despite having access to cART’s, HIV-positive children are vulnerable to developing neurocognitive deficits and socio-emotional and behavioural problems. These problems can impact negatively on their ability to learn and thrive academically, establish pro-social relationships with peers, and importantly, adhere to their treatment regimes. The need for integrative interventions including the identification and treatment of caregiver depression as well as nutritional supplementation, early parenting skills training and psychosocial stimulation to improve overall health and future quality of life of this population is recommended

Effect of gardening physical activity on neuroplasticity and cognitive function

Background: The beneficial effects of gardening as a form of physical activity have garnered growing interest in recent years. This research aimed to evaluate the effect of gardening as a physical activity on promoting neuroplasticity and cognitive functioning in people. Methods: A systematic review was conducted on published articles between January 2010 to December 2022. The systematic search identified 3,470 records based on the PRISMA recommendations, 23 studies were eligible for inclusion in the review. Results: The study revealed the potential benefit of gardening physical activity on brain health. The evidence suggests that engaging in gardening physical activity not only boosts immunity and lowers inflammation but can also increase levels of growth neurotrophic factors like brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and platelet-derived growth factor (PDGF), which are essential for promoting neuroplasticity and improving cognitive function. These results should be interpreted cautiously given the small number of included studies and few randomized controlled trials. Discussion: The study results of gardening physical activity are promising. However, to adequately comprehend the underlying mechanism of the physical activity of gardening on brain health, more well-designed research is still necessary

Psychosocial Aspects During the First Wave of COVID-19 Infection in South Africa

Background: In South Africa, as in many countries, the nationwide spread of COVID-19 caused a public health emergency that resulted in the government implementing necessary restrictive measures such as the nationwide lockdown as a way of containing the pandemic. Such restrictive measure, while necessary, can disrupt many aspects of people's lives resulting in unprecedented psychosocial distress.Aim: The present study aims to describe the psychosocial health and situational factors associated with the novel coronavirus (COVID-19) in South Africa during the first wave of infection.Methods: This cross-sectional survey, recruited a total of 203 participants through convenience sampling via online platforms—WhatsApp, Facebook, emails, etc.—during COVID-19 lockdown in the country. Through the snowball technique, participants from across South Africa completed the online survey that assessed socio-demographic information, risk perception, history of mental health, COVID-19-related stress, and fears during the lockdown (first wave).Results: The majority of the participants who completed the survey were young, Black African, and female. Participants reported feelings of stress and anxiety (61.2%); stress about finances (39.5%); and feelings of sadness, anger, and/or frustration (31.6%) during the lockdown. Females compared to males were more likely to perceive COVID-19 as a risk to their household, X(20)2 = 45,844, p < 0.001 and community, X(20)2 = 40,047, p = 0.005. COVID-19 differentially impacted the mental health of participants with and without mental health diagnosis, X(4)2 = 16.596, p = 0.002. Participants with a prior mental health diagnosis reported significant extra stress during lockdown (p < 0.05).Conclusion: The findings may be of significance to assist in the development of targeted psychosocial interventions to help people during and after the pandemic

COVIDiSTRESS Global Survey dataset on psychological and behavioural consequences of the COVID-19 outbreak

This N = 173,426 social science dataset was collected through the collaborative COVIDiSTRESS Global Survey - an open science effort to improve understanding of the human experiences of the 2020 COVID-19 pandemic between 30th March and 30th May, 2020. The dataset allows a cross-cultural study of psychological and behavioural responses to the Coronavirus pandemic and associated government measures like cancellation of public functions and stay at home orders implemented in many countries. The dataset contains demographic background variables as well as measures of Asian Disease Problem, perceived stress (PSS-10), availability of social provisions (SPS-10), trust in various authorities, trust in governmental measures to contain the virus (OECD trust), personality traits (BFF-15), information behaviours, agreement with the level of government intervention, and compliance with preventive measures, along with a rich pool of exploratory variables and written experiences. A global consortium from 39 countries and regions worked together to build and translate a survey with variables of shared interests, and recruited participants in 47 languages and dialects. Raw plus cleaned data and dynamic visualizations are available.Measurement(s) psychological measurement center dot anxiety-related behavior trait center dot Stress center dot response to center dot Isolation center dot loneliness measurement center dot Emotional Distress Technology Type(s) Survey Factor Type(s) geographic location center dot language center dot age of participant center dot responses to the Coronavirus pandemic Sample Characteristic - Organism Homo sapiens Sample Characteristic - Location global Machine-accessible metadata file describing the reported data:Peer reviewe

Stress and worry in the 2020 coronavirus pandemic: Relationships to trust and compliance with preventive measures across 48 countries in the COVIDiSTRESS global survey

The COVIDiSTRESS global survey collects data on early human responses to the 2020 COVID-19 pandemic from 173 429 respondents in 48 countries. The open science study was co-designed by an international consortium of researchers to investigate how psychological responses differ across countries and cultures, and how this has impacted behaviour, coping and trust in government efforts to slow the spread of the virus. Starting in March 2020, COVIDiSTRESS leveraged the convenience of unpaid online recruitment to generate public data. The objective of the present analysis is to understand relationships between psychological responses in the early months of global coronavirus restrictions and help understand how different government measures succeed or fail in changing public behaviour. There were variations between and within countries. Although Western Europeans registered as more concerned over COVID-19, more stressed, and having slightly more trust in the governments' efforts, there was no clear geographical pattern in compliance with behavioural measures. Detailed plots illustrating between-countries differences are provided. Using both traditional and Bayesian analyses, we found that individuals who worried about getting sick worked harder to protect themselves and others. However, concern about the coronavirus itself did not account for all of the variances in experienced stress during the early months of COVID-19 restrictions. More alarmingly, such stress was associated with less compliance. Further, those most concerned over the coronavirus trusted in government measures primarily where policies were strict. While concern over a disease is a source of mental distress, other factors including strictness of protective measures, social support and personal lockdown conditions must also be taken into consideration to fully appreciate the psychological impact of COVID-19 and to understand why some people fail to follow behavioural guidelines intended to protect themselves and others from infection. The Stage 1 manuscript associated with this submission received in-principle acceptance (IPA) on 18 May 2020. Following IPA, the accepted Stage 1 version of the manuscript was preregistered on the Open Science Framework at https://osf.io/g2t3b. This preregistration was performed prior to data analysis

Stress and worry in the 2020 coronavirus pandemic : relationships to trust and compliance with preventive measures across 48 countries in the COVIDiSTRESS global survey

The COVIDiSTRESS global survey collects data on early human responses to the 2020 COVID-19 pandemic from 173 429 respondents in 48 countries. The open science study was co-designed by an international consortium of researchers to investigate how psychological responses differ across countries and cultures, and how this has impacted behaviour, coping and trust in government efforts to slow the spread of the virus. Starting in March 2020, COVIDiSTRESS leveraged the convenience of unpaid online recruitment to generate public data. The objective of the present analysis is to understand relationships between psychological responses in the early months of global coronavirus restrictions and help understand how different government measures succeed or fail in changing public behaviour. There were variations between and within countries. Although Western Europeans registered as more concerned over COVID-19, more stressed, and having slightly more trust in the governments' efforts, there was no clear geographical pattern in compliance with behavioural measures. Detailed plots illustrating between-countries differences are provided. Using both traditional and Bayesian analyses, we found that individuals who worried about getting sick worked harder to protect themselves and others. However, concern about the coronavirus itself did not account for all of the variances in experienced stress during the early months of COVID-19 restrictions. More alarmingly, such stress was associated with less compliance. Further, those most concerned over the coronavirus trusted in government measures primarily where policies were strict. While concern over a disease is a source of mental distress, other factors including strictness of protective measures, social support and personal lockdown conditions must also be taken into consideration to fully appreciate the psychological impact of COVID-19 and to understand why some people fail to follow behavioural guidelines intended to protect themselves and others from infection. The Stage 1 manuscript associated with this submission received in-principle acceptance (IPA) on 18 May 2020. Following IPA, the accepted Stage 1 version of the manuscript was preregistered on the Open Science Framework at https://osf.io/g2t3b. This preregistration was performed prior to data analysis.Peer reviewe

Stress and worry in the 2020 coronavirus pandemic: relationships to trust and compliance with preventive measures across 48 countries in the COVIDiSTRESS global survey

The COVIDiSTRESS global survey collects data on early human responses to the 2020 COVID-19 pandemic from 173 429 respondents in 48 countries. The open science study was co-designed by an international consortium of researchers to investigate how psychological responses differ across countries and cultures, and how this has impacted behaviour, coping and trust in government efforts to slow the spread of the virus. Starting in March 2020, COVIDiSTRESS leveraged the convenience of unpaid online recruitment to generate public data. The objective of the present analysis is to understand relationships between psychological responses in the early months of global coronavirus restrictions and help understand how different government measures succeed or fail in changing public behaviour. There were variations between and within countries. Although Western Europeans registered as more concerned over COVID-19, more stressed, and having slightly more trust in the governments' efforts, there was no clear geographical pattern in compliance with behavioural measures. Detailed plots illustrating between-countries differences are provided. Using both traditional and Bayesian analyses, we found that individuals who worried about getting sick worked harder to protect themselves and others. However, concern about the coronavirus itself did not account for all of the variances in experienced stress during the early months of COVID-19 restrictions. More alarmingly, such stress was associated with less compliance. Further, those most concerned over the coronavirus trusted in government measures primarily where policies were strict. While concern over a disease is a source of mental distress, other factors including strictness of protective measures, social support and personal lockdown conditions must also be taken into consideration to fully appreciate the psychological impact of COVID-19 and to understand why some people fail to follow behavioural guidelines intended to protect themselves and others from infection. The Stage 1 manuscript associated with this submission received in-principle acceptance (IPA) on 18 May 2020. Following IPA, the accepted Stage 1 version of the manuscript was preregistered on the Open Science Framework at https://osf.io/g2t3b. This preregistration was performed prior to data analysis