Reproductive health and lifestyle factors associated with health-related quality of life among perinatally HIV-infected adolescents in Uganda

Background With increased survival of perinatally HIV - infected adolescents due to antiretroviral therapy (ART), the focus of HIV care has shifted to health-related quality of life (HRQoL) as a measure of disease progression, effects of ART co-morbidity and prognosis. We assessed factors associated with better HRQoL in perinatally HIV -infected adolescents in Uganda by determining the associations between sexual and reproductive health (SRH) or lifestyle experiences on HRQoL. Methods In a cross-sectional study, data on SRH, lifestyle experiences, socio demographic factors, communication with parents on sexuality and satisfaction of SRH services in ART clinics were collected from 614 HIV perinatally infected adolescents aged 10–19 using an interviewer-administered survey questionnaire. HRQoL data were collected using the Medical Outcomes Study HIV Health Survey instrument (MOS-HIV). Factors associated with better HRQoL were analysed using multiple logistic regression. Results The mean age was 16.2 ± 2.1 years, 362 (58.8 %) were females and 210 (34.2 %) were sexually active. Adolescents on ART were twice likely to present with better physical health (AOR = 2.07, 95 % CI: 1.24–3.46) and four times more likely to present with better mental health (AOR = 3.9, 95 % CI: 2.22–6.92) than those who were not on ART. There were no statistically significant associations between SRH (ever had sex, ever been pregnant, condom use, contraceptive use) or life style factors and physical health or mental health. Those with secondary or tertiary education were more likely to present with a better mental health (AOR = 5.3, 95 % CI: 1.86–15.41) compared those who had attained primary or no education. Participants who desired to have a child in future more likely (AOR 1.7, 95 % CI: 1.05–3.00) to present with a better mental health. Lack of communication with guardians on sexuality (AOR = 0.6, 95 % CI: 0.40–0.89), or dissatisfaction with SRH services (AOR 0.34, 95 % CI: 0.18–0.62) were associated with poorer mental health. Conclusion Among perinatally HIV-infected adolescents in Uganda, being on ART was associated with better physical and mental health while lack of communication with guardians on sexuality or dissatisfaction with SRH services was associated with poor mental health. Adolescents with pregnancy intentions were more likely to have a better mental health

Il chiodo fisso.

Ossessioni e compulsioni costituiscono fenomeni comuni ed estremamente diffusi. Talvolta hanno carattere doloroso, straziante, inaccettabile sia per chi personalmente ne soffre, sia per chi indirettamente ne è a contatto. Questo libro si rivolge a tutti coloro che affrontano in maniera esasperata le piccole irrazionalità della vita. In realtà essi soffrono terribilmente senza riuscire a trovare un rimedio e soprattutto senza capirne il perché

Predicting burnout among HIV/AIDS and oncology health care workers

Psychological stress and coping strategies in staff working with AIDS and with cancer patients were assessed using self-report methods. The Maslach Burnout Inventory (MBI), Coping Orientations to Problems Experiences (COPE), State-Trait Anxiety Inventory (STAI) and Depression Questionnaire (DQ) were completed by staff from 20 hospitals of North-Center Italy, including 268 doctors and nurses working with people with AIDS and 260 doctors and nurses working in oncology. Few significant differences were found between two units on the MBI, COPE subscale and depression/anxiety. When a Bonferroni corrected p level of p < 0.0025 was used, the difference on Emotional Exhaustion (EE) subscale of MBI still remained statistically significant, indicating greater exhaustion in the oncology staff. The regression analysis suggested that the negative aspects of burnout were predicted primary by professional status (being a doctor), type of unit (oncology), depression and the use of the humor as a coping strategy. In contrast personal accomplishment was better predicted by positive coping strategies (i.e. planning, restraint coping, non-denial) and low level of anxiety

Il \uabSaving Inventory-Revised (SI-R)\ubb: Contributo alla verifica della struttura trifattoriale nella popolazione generale italiana

La disposofobia (hoarding disorder) \ue8 definita dall\u2019acquisizione e dalla conservazione di numerosi oggetti di scarso valore, e da un conseguente ingombro degli spazi abitativi tale da precluderne l\u2019uso. Il pi\uf9 importante strumento di valutazione dei comportamenti di accumulo \ue8 il Saving Inventory-Revised (SI-R), che \ue8 formato da 23 item su scala Likert a 5 punti. L\u2019analisi fattoriale originaria ha identificato 3 scale: Ingombro, Difficolt\ue0 a disfarsi degli oggetti e Acquisizione, e diversi adattamenti in lingua straniera del questionario hanno confermato sia le buone caratteristiche psicometriche sia la struttura trifattoriale osservate nella versione originaria. Il presente studio \ue8 stato condotto con l\u2019obiettivo di verificare le caratteristiche psicometriche della versione italiana del SI-R; inoltre, attraverso l\u2019analisi fattoriale confermativa si \ue8 voluto contribuire alla verifica della struttura trifattoriale su due campioni indipendenti di partecipanti tratti dalla popolazione non clinica. I risultati hanno confermato che la versione italiana del SI-R presenta buone coerenza interna e affidabilit\ue0 test-retest, e un\u2019accettabile intercorrelazione tra le scale. Inoltre, la bont\ue0 del modello a tre fattori \ue8 stata supportata. Si rendono necessari studi futuri volti a valutarne le caratteristiche psicometriche anche in campioni clinici

Presentazione della versione italiana dell'Obsessive Beliefs Questionnaire: struttura fattoriale e analisi di affidabilit\ue0\ua0.

L\u2019Obsessive Beliefs Questionnaire (OBQ) \ue8 un questionario sviluppato dall\u2019Obsessive Compulsive Cognitions Working Group (OCCWG) per valutare i domini cognitivi considerati centrali nella patogenesi e mantenimento del disturbo ossessivo-compulsivo. Scopo del presente studio \ue8 stato quello di esaminare la struttura dell\u2019Obsessive Beliefs Questionnaire nel contesto linguistico e culturale italiano. Il questionario \ue8 stato somministrato, unitamente a Padua Inventory, Beck Depression Inventory e Beck Anxiety Inventory, a 752 soggetti tratti dalla popolazione studentesca. Sono state condotte inizialmente due analisi fattoriali esplorative con richiesta di 6 fattori e 3 fattori secondo la pi\uf9 recente revisione del Working Group. Le analisi confermative LISREL hanno evidenziato una struttura fi nale composta da 46 item suddivisi in 5 sottoscale: Perfezionismo, Responsabilit\ue0 per Danno, Controllo dei Pensieri, Responsabilit\ue0 per Omissione e Importanza dei Pensieri. Le analisi di consistenza interna e stabilit\ue0 temporale supportano in generale buona validit\ue0 e affi dabilit\ue0 dello strumento. I risultati mettono in evidenza una peculiarit\ue0 del concetto di responsabilit\ue0 per danno e per omissione presente, a nostra conoscenza, solo nella realt\ue0 italiana

Burnout syndrome among health workers caring for AIDS patients: predictive variables

Psychological stress and coping strategies in staff working with AIDS patients were assessed using self report methods. Measures: Maslach Burnout Inventory (MBI), Coping Orientations to Problems Experiences (COPE), State-Trait Anxiety Inventory (STAI) and Depression Questionnaire (DQ) were completed by staff from 20 hospitals of North-Center Italy, including 329 doctors and nurses working with people with AIDS. The results suggested important correlations among burnout, coping style, depression and anxiety. Inadequate strategies used as Focusing on and Venting of emotion, Behavioral Disengagement and depression predicted high level of Emotional Exhaustion and Depersonalization, while Personal Accomplishment were predicted by more adequate strategies (Planning, Restrain coping and Seeking social support) and low level of anxiety

Coping and cognitive processing style in HIV-Positive Subjects

Background: People's reactions to traumatic events are mediated by their subjective style of coping. This is of particular importance for HIV+ patients, mainly in the first phases of the disease, This work aimed at examining whether an 'acceptance' style of coping, as opposed to a 'mental disengagement' style, selectively influences the first stages of the processing of neutral, emotional and HIV-related information. Method: Two groups of 11 HIV+ asymptomatic subjects were chosen according to their coping strategies, acceptance or menta I disengagement, as measured by Coping Orientations to the Problems Experienced (COPE). Twenty-two patients completed the Emotional Stroop Task and an incidental memory recognition task containing neutral, emotional and HIV-related stimuli. Results: Analysis of reaction times (RTs) on the Emotional Stroop Task showed that HIV+ subjects have longer RTs for emotional and HIV-related than for neutral words. Instead, no effect was found as regards interaction with style of coping. Conclusion: Results confirmed a processing bias of emotional information, whereas Acceptance and Mental disengagement strategies, as measured by the COPE scales, did not appear to influence information processin