Transitioning Adolescents Living With Hiv/aids To Adult-oriented Health Care: An Emerging Challenge

Objective: To review the literature on transition from pediatric to adult-oriented health care and discuss this issue in the specific context of chronic conditions. Sources: MEDLINE and LILACS were searched for relevant English and French-language articles published between 1990 and 2010. Summary of the findings: The transition of adolescents with chronic diseases from pediatric care to adult-oriented services has been a growing concern among pediatric specialties. In recent years, young people living with HIV/AIDS have begun to reach adulthood, giving rise to several challenges. The studies reviewed herein discuss such relevant topics as: the difference between transfer, an isolated event, and transition, a gradual process; the transition models used in different services; the importance of transitioning in a planned and individualized manner; the need for comprehensive interaction between pediatric and adult-oriented care teams; the importance of joint participation of adolescents, their families, and health professionals in the process; barriers to and factors that promote successful transitions; and the special needs of adolescents with HIV/AIDS in this important period of life. Conclusions: Several authors agree that transitioning adolescents to adult-oriented health care should be a gradual process not determined by age alone. It requires a plan established with ample dialogue among adolescents, their families, and pediatric and adult care teams. However, there is little evidence to support any specific model of health care transition. This should prompt researchers to conduct more prospective studies on the theme, especially in more vulnerable groups such as adolescents living with HIV/AIDS. 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Integrated Work Of Psychiatry In Ambulatory Internal Medicine: Relation Of An Experience [estagio Integrado De Residencia Psiquiatrica Em Ambulatorio De Clinica Medica. Relato De Uma Experiencia]

[No abstract available]32210911

Women's Feelings In The Face Of Fetal Loss: A Review [sentimientos Presentes En Las Mujeres Frente A La Pérdida Fetal: Una Revisión]

The interest about the subject came from a qualitative field research joined to dissertation of master degree in development together with Pos-Graduation Program in Tocogynecology of the Medical Sciences College of the University of Campinas (UNICAMP). The articles were obtained through a bibliographic survey which was realized in the Medline, PsyInfo and SciELO, using the following keywords "fetal loss", "stillbirth", "grief", "meanings", "qualitative research". Chapters of book of consecrated authors in this area were also considered. The articles found in the database, in consonance with the consecrated authors in the field, present us that the women experiences who suffered a fetal loss evidence complex feelings, because these feelings bring out conflicts related to feminine identity, woman role in the society, death and its taboo. The importance of the health team to realize the emotional dynamics of women who have lived the loss experience is also evidenced.143485490Andajani-Suthahjo, S., Manderson, L., Stillbirth, neonatal death and reproductive rights in Indonesia (2004) Reproductive Health Matters, 12 (24), pp. 181-188Bartilotti, M.R.M.B., (1998) Obstetrícia e Ginecologia: Urgências Psicológicas, , Em: Angerami-Camon (org), V. A. Urgências psicológicas no Hospital. São Paulo: PioneiraCapitulo, K.L., Perinatal Grief online (2004) MCN AmJ Matern Child Nurs, 29 (5), pp. 305-311Defey, D., Diaz, J.R.L., Niñez, M., Terra, C., (1992) Duelo por un niño que muere antes de nacer: vivencias de los padres del equipo de salud, , 2 ed. Montevideo: CLAPFretts, R.C., Etiology and prevetions of stillbirth (2005) American Journal of Obstetrics and Gynecology, 193, pp. 1923-1935Hsu, M.T., Tseng, Y.F., Banks, J.M., Kuo, L.L., Transforming loss:Taiwanese womeń s adaptation to stillbirth (2002) J Adv Nurs, 40 (4), pp. 387-395Hsu, M.T., Tseng, Y.F., Banks, J.M., Kuo, L.L., Interpretations of stillbirth (2004) J Adv Nurs, 47 (4), pp. 408-416Kennell, J.H., Klaus, M.H.T., Atendimento aos pais de um natimorto ou de um bebê que morre (1992) Pais/bebês: a formação do apego, , Klaus, M.H.T., Kennell, J.H. Porto Alegre:Artes MédicasMaldonado, M.T., (1982) Maternidade e paternidade: preparação com técnicas de grupo, , São Paulo Rio de Janeiro: AtheneuMariani Neto C, Aquino, M.M.A., Óbito Fetal (2000) Obstetrícia Básica, , Neme, B. 2 ed. São Paulo: SarvierQuayle, J., (1997) Óbito Fetal e Anomalias Fetais: repercussões emocionais maternas, , Em Zugaib, M., Tedesco, J. J. & Quayle, J. Obstetrícia Psicossomática. São Paulo: AtheneuSantos, A.L.D., Rosenburg, C.P., Buralli, K.O., Histórias de perdas fetais contada por mulheres:estudo de análise qualitativa (2004) Rev. Saúde Pública, 38 (2), pp. 268-276St John, A., Cooke, M., Goopy, S., Shrouds of silence: three women's stories of prenatal loss (2006) Aust J Adv Nurs, 23 (3), pp. 8-12Soifer, R., (1992) Psicologia da Gravidez, Parto e Puerpério, , Porto Alegre:Artes MédicasTrulson, O., Radestad, I., The silent child-mothers before, during and after stillbirth (2004) Birth, 31 (3), pp. 189-195Videla, M., Grieco, A., (1993) Parir y nacer en el hospital, , 1 ed. Buenos Aires: Nueva Viso

Doctor-patient Relationship Barriers To Substance Dependents Seeking Treatment [barreiras Na Relação Clínico-paciente Em Dependentes De Substâncias Psicoativas Procurando Tratamento]

Introduction. Knowing the barriers substance dependents come across when seeking treatment has medical and public health implications. The study's aim was to formulate hypothesis on psychological and social and familiar variables forming subjective barriers to early treatment. Methods. A qualitative exploratory study was conducted in an intentional sample (selected through saturation and variety of types) of 13 substance dependents who sought treatment. In-depth open-question semi-structured interviews were conducted and the transcribed data underwent qualitative analysis. Results. The main barriers in doctor-patient relationship were fear of doctors and facilities which are regarded as "sadistic," and the perception of doctor-patient "distancing." Conclusions. Health care professionals should take into consideration the existence of barriers to treatment and should bear this in mind when promoting their services. Issues such as "fear of being abused" and "doctors wouldn't know how to treat me" should be covered in structured questionnaires of further quantitative studies.364439447Balint, M., (1975) O Médico, Seu Paciente E a Doença, , 2 a ed. Rio de Janeiro/São Paulo: AtheneuBardin, L., Análise de conteúdo (1979), 70. , Lisboa: EdiçõesBell, J., Treatment dependence: Preliminary description of yet another syndrome (1992) Br. J. Addict, 87, pp. 1049-1054Bleger, J., (1989) Temas De Psicologia: Entrevista E Grupos, , 4 a ed. São Paulo: Martins FontesCopeland, J.C., A qualitative study of barriers to formal treatment among women who self-managed change in addictive behaviours (1997) J. Subst. Abuse Treat, 14, pp. 183-190Denzin, N.K., Lincoln, Y.S., (1994) Handbook of Qualitative Research, , editors. Thousand Oaks: SageFerri, C., Cocaína: Padrão de consumo e fatores associados à procura de tratamento (1999), [Tese de doutorado]. São Paulo (SP): Universidade Federal de São PauloFontanella, B.J.B., Procura de tratamento por dependentes de substâncias psicoativas: Um estudo clínico-qualitativo (2000), [Tese de doutorado]. Campinas (SP): Universidade Estadual de CampinasFreud, S., (1924) Obras Psicológicas Completas De Sigmund Freud, 19, pp. 195-212. , 2 a ed. Rio de Janeiro: ImagoO problema econômico do masoquismo [Edição Satandard Brasileira]Hingson, R., Mangione, T., Allan, M., Scotch, N., Seeking help for drinking problems: A study in the Boston Metropolitan Area (1982) J. Stud. Alcohol, 43, pp. 273-288Klingemann, H.K., The motivation for change from problem alcohol and heroin use (1991) Br. J. Addict, 86, pp. 727-744Kolck, O.L.V., Tosi, S.M.V.D., Pellegrini, T.F., Auto-imagem em alcoólicos crônicos (1991) Temas, 42, pp. 374-382O'Leary, M.R., Speltz, M.L., Walker, R.D., Influence of reported helplessness on client-clinician relationships in na alcoholism program (1980) Hosp. Community Psychiatry, 31, pp. 783-784Oppenheimer, E., Sheehan, M., Taylor, C., Letting the client speak: Drug misusers and the process of help seeking (1988) Br. J. Addict, 83, pp. 635-647Radó, S., The psychoanalysis of pharmacothymia (drug addiction) (1933) Psychoanal. Q, 2, pp. 1-23Rohrer, G.E., Thomas, M., Yasenchak, A.B., Client perceptions of the ideal addictions counselor (1992) Int. J. Addict, 27, pp. 727-733Rosenfeld, H.A., Os estados psicóticos (1968), pp. 148-165. , Rio de Janeiro: ZaharDa taxonomiaRounsaville, B.J., Kleber, H.D., Untreated opiate addicts: How do they differ from those seeking treatment? (1985) Arch. Gen. Psychiatry, 42, pp. 1072-1077Thom, B., Sex differences in help-seeking for alcohol problems - 1 : The barriers to help-seeking (1986) Br. J. Addict, 81, pp. 777-788Turato, E.R., Introdução à metodologia da pesquisa clínico-qualitativa: Definição e principais características (2000) Rev. Port. Psicossom, 2, pp. 93-108Unis, G., Pons, A.H., Gus, G., Krahe, J.L., Amon, L.C., Carvalho, L.T., Influência do curso médico no aprendizado do alcoolismo (1987) Rev. AMRIGS, 31, pp. 300-30