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Item Psychosomatic Medicine: An International Guide for the Primary Care Setting(Springer Nature, 2019) Fritzsche, Kurt; McDaniel, Susan H.; Wirsching, MichaelThe book is divided into a general part and a part with specific clinical manifestations. The general part addresses topics that are relevant to all clinical manifestations such as the interaction between mind and body, doctor–patient relationship, doctor– patient communication, the family interview, and the Balint group. The second part addresses specific clinical manifestations that are most frequently encountered in primary care, including depressive disorders, anxiety disorders, somatoform disorders, posttraumatic stress disorder, alcohol dependency, and psychosomatics of life threatening diseases such as cancer and coronary heart disease. Each chapter is divided into diagnostics, treatment, and pitfalls. In each chapter, typical case studies are used to demonstrate the diagnostic and therapeutic steps. As a result, the book has a high practical relevance, and can also be used directly as a course book in training in Psychosomatic Basic Care.Item Adolescent Sexual and Reproductive Health in Uganda: Results from the 2004 National Survey of Adolescents(Alan Guttmacher Institute., 2006) Neema, Stella; Ahmed, Fatima H.; Kibombo, Richard; Bankole, AkinrinolaAdolescents in Sub-Saharan Africa face many hurdles,including balancing the expectations of the traditional,often conservative, norms against the increasing exposure, through the mass media, to modern ideals. The sexual and reproductive health of adolescents is one area in which this struggle is often apparent, and many young people engage in sexual activities with little or no knowledge about how to protect themselves against the risks of infection and unwanted pregnancy. An estimated 6.9 percent of women and 2.2 percent of men aged 15–24 in the region were living with HIV at the end of 2004. Furthermore, about one in 10 young women have had a premarital birth by age 20. In Uganda, evidence from the AIDS Information Centre shows that, among 15–24-year-olds who were first-time testers, HIV seroprevalence was 3% among men and 10% among women in 2002. Furthermore, in 2000–2001, 39% of recent births to Ugandan adolescents were either mistimed or unwanted.Item From access to adherence: the challenges of antiretroviral treatment(World Health Organization, 2006) Hardon, Anita; Davey, Sheila; Gerrits, Trudie; Hodgkin, Catherine; Irunde, Henry; Kgatlwane, Joyce; Kinsman, John; Nakiyemba, Alice; Laing, RichardSince the launch of WHO’s ʹ3 by 5ʹ initiative in 2003, many countries in sub‐Saharan Africa have established national antiretroviral treatment (ART) programmes. Although the WHO target of providing access to ART for 3 million people by 2005 was not achieved, by end‐2005 an estimated 1.3 million people in low‐ and middle‐income countries had access to treatment (about 20% of those estimated to be in need) (WHO and UNAIDS, 2006). By mid‐2005, the WHO target had already been overtaken by an even more ambitious aim. In July 2005, the G8 group of industrialized countries committed to the goal of achieving ʹas close as possible to universal access to treatment for all those who need it by 2010.ʹ (UNAIDS, 2006, G8 Gleneagles Summit, 2005). Nonetheless, the challenges in the region remain great. Health systems are weak, and the target orientation of ART programmes risks an emphasis on initiating people on ART at the expense of ensuring effective use of medicines. As discussed in Chapter 2, extremely high levels of adherence (at least 95%) are needed to ensure positive treatment outcomes and prevent the development of drug‐resistance (Paterson et al., 2000). Up till now, only limited operational research has been carried out to identify adherence problems in resource‐poor settings and to strengthen adherence support (Jaffar et al., 2005; Bennet, Boerma and Brugha, 2006; Kent et al., 2003; Akileswaran et al., 2005; Farmer et al., 2001). Previous studies on adherence to ART in Africa have provided quantitative estimates of adherence and data on clinical outcomes, mainly from experimental settings (Ivers, Kendrick and Doucette, 2005; Coetzee et al., 2004; Orrell et al., 2003; Koenig, Léandre and Farmer, 2004; Gill et al., 2005). A recent review of six of these studies reported that 68%‐99% of patients took at least 95% of their medicines. The authors, Ivers et al., conclude that adherence levels in Africa are high, i.e. comparable to those in industrialized settings. However, Gill and colleagues (2005) and Laurent et al., 2002) stress that there is no room for complacency, noting that adherence rates tend to deteriorate over time.Item Handbook on Counselling and Psychosocial Care for Children and Adolescents Living with and Affected by HIV in Africa(African Network for the Care of Children Affected by HIV/AIDS – ANECCA, 2013) Nasaba, Rosemary; Tindyebwa, Denis; Musiime, Victor; Iriso, Robert; Ingabire, Resty; Nansera, Denis; Etima-Kizito, Monica; Kasule, Joseylee; Duffy, MaliaIn 2013, the Joint United Nations Programme on HIV/AIDS (UNAIDS) proposed the ambitious “fasttrack” goals to end the global HIV epidemic by 2030, including reducing new HIV infections among children and adolescents from 500,000 annually to 200,000 annually (2014). Donor- and countrydriven investments have dramatically strengthened the HIV response around the world. Despite these major commitments and advances, HIV incidence is on the rise in young people; and in Africa, AIDS remains a leading cause of death in adolescents. The proportion of HIV-positive children and adolescents receiving HIV services, including ART, has also continued to lag well behind that of adults. Evidence of this gap from the World Health Organization (WHO) shows that 52% of children compared to 59% of adults were on ART in 2017 (2018). Controlling the epidemic, within countries and globally, must include preventing, testing for, and treating HIV in children and adolescents, including addressing psychosocial issues experienced by these populations to enhance their ability to manage the disease and live positively. To improve access to HIV services, several African countries have decentralised HIV care to primary health facilities. However, health care providers (HCPs) in many primary care settings do not have access to up-to-date clinical resources to build their knowledge so they can provide comprehensive HIV care for children and adolescents. HIV care for children and adolescents is complex, and requires not only addressing their medical needs, but also caring for their psychological wellbeing— to keep them healthy, retain them in care, and enable them to live positively. HCPs often have limited skills to counsel and provide psychosocial support (PSS) to children and adolescents living with HIV. While there have been specific in-service training courses designed to address this challenge, high staff turnover reduces their impact. The Handbook on Counselling and Psychosocial Care for Children and Adolescents Living with and Affected by HIV in Africa seeks to address this gap and serves as a comprehensive reference to provide HCPs with practical information to provide effective counselling and PSS for children and adolescents living with and affected by HIV.Item Handbook on Pædiatric AIDS in Africa by the African Network for the Care of Children Affected by AIDS(African Network for the Care of Children Affected by AIDS (ANECCA)., 2004) Tindyebwa, Denis; Kayita, Janet; Musoke, Philippa; Eley, Brian; Nduati, Ruth; Coovadia, Hoosen; Bobart, Raziya; Mbori-Ngacha, Dorothy; Kieffer, Mary PatHIV/AIDS is a major cause of infant and childhood mortality and morbidity in Africa. In children under five years of age, HIV/AIDS now accounts for 7.7% of mortality worldwide. AIDS already accounts for a rise of more than 19% in infant mortality and a 36% rise in underfive mortality. Together with factors such as declining immunisation, HIV/AIDS is threatening recent gains in infant and child survival and health. Yet, for the most part, HIV infection in children is preventable. In industrialised countries in North America and Europe, paediatric HIV infection has largely been controlled. In these settings, HIV testing as part of routine antenatal care, combinations of antiretroviral (ARV) drug regimens, elective caesarean section, and complete avoidance of breast-feeding have translated into mother-to-child transmission (MTCT) rates of less than 2%. In Africa, on the other hand, high rates of maternal HIV infection, high birth rates, lack of access to currently available and feasible interventions, and the widespread practice of prolonged breast-feeding translate into a high burden of paediatric HIV disease. The transmission risk for a child born to an HIV-infected mother in an African setting without interventions for prevention of mother-to-child transmission (PMTCT) is about 30–40%. The other 60–70% of children, although not HIV-infected, still have a 2- to 5-fold risk of mortality as a direct consequence of the mother’s HIV disease, when compared to children born to uninfected mothers.