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PubMed2001

Factors associated with condom use in Kenya: a test of the health belief model.

This study examined specific cultural beliefs and knowledge about HIV as well as tested components of the Health Belief Model in relation to condom use in Kisumu, Kenya. Interviews were conducted with 223 participants at six governmental and private clinics. Although 75% had engaged in intercourse during the preceding month, fewer than 20% had used a condom. For both men and women, perceived barriers was the only component of the Health Belief Model significantly associated with condom use, with greater perceived barriers being associated with lower frequency of condom use (p < .05). Additionally, individuals with more education and HIV/AIDS knowledge were less likely to endorse stigmatizing beliefs toward HIV/AIDS (p < .001), whereas people who believe that HIV originated in the United States were more likely to endorse these stigmatizing beliefs (p <.002). Nearly everyone (97%) reported that AIDS is the disease that scares them most, suggesting that educational efforts have successfully communicated the severity of this disease. Future intervention efforts must now focus more extensively on addressing stigmatizing beliefs and providing education to overcome barriers to condom use.

Adolescent↗
PubMed2004

Nectar robbery by bees Xylocopa virginica and Apis mellifera contributes to the pollination of rabbiteye blueberry.

Honey bees, Apis mellifera L., probe for nectar from robbery slits previously made by male carpenter bees, Xylocopa virginica (L.), at the flowers of rabbiteye blueberry, Vaccinium ashei Reade. This relationship between primary nectar robbers (carpenter bees) and secondary nectar thieves (honey bees) is poorly understood but seemingly unfavorable for V. ashei pollination. We designed two studies to measure the impact of nectar robbers on V. ashei pollination. First, counting the amount of pollen on stigmas (stigmatic pollen loading) showed that nectar robbers delivered fewer blueberry tetrads per stigma after single floral visits than did our benchmark pollinator, the southeastern blueberry bee, Habropoda laboriosa (F.), a recognized effective pollinator of blueberries. Increasing numbers of floral visits by carpenter bee and honey bee robbers yielded larger stigmatic loads. As few as three robbery visits were equivalent to one legitimate visit by a pollen-collecting H. laboriosa female. More than three robbery visits per flower slightly depressed stigmatic pollen loads. In our second study, a survey of 10 commercial blueberry farms demonstrated that corolla slitting by carpenter bees (i.e., robbery) has no appreciable affect on overall V. ashei fruit set. Our observations demonstrate male carpenter bees are benign or even potentially beneficial floral visitors of V ashei. Their robbery of blueberry flowers in the southeast may attract more honey bee pollinators to the crop.

Animals↗
PubMed2005

Tobacco control, stigma, and public health: rethinking the relations.

The AIDS epidemic has borne witness to the terrible burdens imposed by stigmatization and to the way in which marginalization could subvert the goals of HIV prevention. Out of that experience, and propelled by the linkage of public health and human rights, came the commonplace assertion that stigmatization was a retrograde force.Yet, strikingly, the antitobacco movement has fostered a social transformation that involves the stigmatization of smokers. Does this transformation represent a troubling outcome of efforts to limit tobacco use and its associated morbidity and mortality; an ineffective, counterproductive, and moralizing approach that leads to a dead end; or a signal of public health achievement? If the latter is the case, are there unacknowledged costs?

HIV Infections↗
PubMed1998

Evaluation of a sustained 7-year health education campaign on leprosy in Rufiji District, Tanzania.

To assess the impact of a 7-year intensive health education campaign about leprosy delivered by workers of the Kindwitwi Leprosy Trust to schoolchildren and general public in Rufiji District. Knowledge, attitude and beliefs towards leprosy were measured in Rufiji and compared to neighbouring Kisarawe District as control. Lessons learned from this analysis may be useful for the planning and evaluating of health education campaigns. Interview of schoolchildren, general public, community leaders, traditional healers and medical staff in both districts. A stratified randomized sampling scheme was used, with stratification for urban and rural settings. A representative sample of schoolchildren, general public, community leaders, traditional healers and medical staff in Rufiji District and in the control area of Kisarawe District was interviewed. The interviews were partly structured and partly open. The results of the interviews were analysed in the context of epidemiological leprosy data from 1985 till 1995, and demographic data of both districts. Data entry and statistical analysis was done using FileMaker Pro, Stata and Excel computer packages. We did not observe positive effects of the health education campaign on the indicators regarding early diagnosis of leprosy with less disability. Leprosy case detection was declining in both districts. We found that the campaign had a favourable impact on the knowledge and the attitude of schoolchildren in Rufiji District. We could demonstrate a relationship between increased knowledge of leprosy and a positive, less stigmatizing attitude. Knowledge of leprosy was better in Rufiji as compared to Kisarawe, but only among schoolchildren. We found indications that low level of education, rural residence, older age, female gender and Moslem religion were associated with stigmatizing attitudes and beliefs towards leprosy. Knowledge about leprosy reactions among medical staff interviewed was not optimal. The exact outcome of the sustained campaign in Rufiji District was difficult to assess because no comparison could be made with the situation prior to the campaign. However, the health education campaign was associated with increased knowledge and diminished tendency to stigmatize leprosy among schoolchildren. Health education campaigns have to be sustained and have to cover a broad sector of the society in order to induce behavioural changes in the community. The focus of health education should be rural communities and schools, and pay special attention to women, religious leaders and traditional healers. Awareness of diagnosis and treatment of leprosy reactions among medical staff should be improved.

Adolescent↗
PubMed2000

Stigma reduction through group counselling of persons affected by leprosy--a pilot study.

Stigmatization of persons with leprosy causes the emotional harm of social, economic and spiritual deprivation. Individual counselling has benefits in addressing these psychosocial problems but is a slow process and effects few people at any one time. Our experience of group counselling of stigmatized persons achieved the following: addressing common issues to more than one person at a time, encouraging the unity of sufferers, developing compassion for others, understanding the common effects of stigmatization, and beginning to overcome its harmful effects.

Adaptation, Psychological↗
PubMed1999

Public awareness of the effectiveness of psychiatric treatment may reduce stigma.

UNLABELLED: Stigmatization is of importance in mental disorders. It is widely believed that one of the most important factors in stigmatization is considering the patients as dangerous. This study aims at analyzing the impact of knowledge regarding the chances of treating mental illness. MATERIALS AND METHODS: 700 final year university students filled out the Dangerousness Scale and gave their opinions on whether mental illnesses are treatable. RESULTS: The results showed that the subjects who think that the chance of treatment for mental diseases does not exist find mentally ill people more dangerous than the subjects who declare the opposite. On the basis of this finding, it can be suggested that drawing public attention to the therapeutic advances in psychiatry may lead to a decrease in stigmatization.

Adolescent↗
PubMed2000

HIV-related knowledge and stigma--United States, 2000.

An essential component of efforts to prevent new human immunodeficiency virus (HIV) infections in the United States is the use of voluntary HIV counseling and testing by persons at risk for HIV, especially members of underserved populations (1). To increase the number of persons at risk for HIV who receive voluntary HIV counseling and testing services, barriers to these services must be identified and removed. The stigmatization of persons infected with HIV and the groups most affected by HIV, including men who have sex with men and illicit drug users, is a barrier to testing (2,3). Measuring public attitudes and knowledge about HIV transmission to determine the prevalence and the correlates of stigmatizing attitudes is important for guiding efforts to remove barriers to HIV prevention. This report describes the results of a national public opinion survey conducted through the Internet to measure indicators of HIV-related stigma and knowledge of HIV transmission. The findings indicate that most persons do not have stigmatizing views.

Adult↗
PubMed2001

Sexual abuse: a comparison between resilient victims and drug-addicted victims.

The goal of this study was to determine which variables distinguish resilient victims from drug-addicted victims, who were sexually abused during their childhood--in addition, to measure the contribution of these variables to the level of distress experienced by the victims. There were two groups of 20 women interviewed. The resilient group showed no clinically significant symptoms of mental distress, and the addicted group were undergoing treatment for drug dependency. They all completed a semi-structured interview and a questionnaire regarding the type and severity of their sexual abuse, mental health status, self-esteem, locus of control, support and cognitive factors from Finkelhor's model. Both of these groups were equally and severely abused. Resilient and addicted women both received a moderate level of support. These women also reported the same sense of betrayal and powerlessness. Furthermore, both groups believe, to a large degree, that they now control what happens to them (internal locus of control). There were three distinguishing variables among the two groups, they were stigmatization, self-blame, and hazard for the locus of control. In comparison, resilient women had less self-blame for having been abused and they also felt less stigmatized than addicted women. In fact, stigmatization and self-blame account for 65% of the TSC-40 variance. These results suggest that cognitive strategies, particularly those that are linked to the interpretation of the event, may have some importance in the recovery.

Adaptation, Psychological↗
PubMed2003

Attitudes of medical staff towards the psychiatric label "schizophrenic patient" tested by an anti-stigma questionnaire.

The aim of this research was to investigate the opinions and attitudes of medical staff towards schizophrenic patients. The research included three groups of examinees, 200 physicians of various specialties, 200 nurses and technicians working in Zagreb city hospitals, and 200 3rd and 4th year students of the School of Medicine in Zagreb. Previously validated anti-stigma questionnaire was used, consisting of 25 questions divided into three thematic groups, structured and adapted to the specific requirements of this study. The results were mutually compared and statistically analyzed by applying the chi 2-test. Significant difference (p < 0.01) between the answers of physicians and those of medical students was found in questions 2, 4, 5, 6, 11, 13, 15, 16, 18, 22, 23, 25, and between physicians and nurses/technicians in answers to questions 4, 15, 22, 23. Significant difference (p < 0.01) between the answers given by nurses/technicians and medical students was found in questions 10, 13, 22, 23. The results point to the existence of prejudices and stigmatizing attitudes in all three investigated groups. The most frequent reasons for stigmatizing attitude of students are based on fear and insufficient knowledge about mental patients and schizophrenia as a disease, while there are a high percentage of positive answers to the questions on rehabilitation and resocialization. The nurses/technicians also show a high degree of mistrust towards schizophrenic patients and mostly answer with "I don't know", thus presenting insufficiently formed attitudes about the mentioned problems. The physicians in their answers confirm fear, mistrust and stigmatizing attitudes towards schizophrenic patients found in general population in Croatia. The consequences of such attitudes are the low quality of life of schizophrenic patients, and slow, often incomplete, resocialization.

Adult↗
PubMed1995

Sexual orientation in adolescents who commit suicide.

It has been suggested that there is a strong relationship between suicidal behavior and homosexuality in adolescence. It has been further suggested that it is due to the stigmatization and feelings of isolation that are experienced by many gay adolescents. Much of the literature that has given support to these hypotheses has been conducted on uncontrolled nonrepresentative samples and its generalizability is open to question. An opportunity to examine the relationship in an unselected sample arose in a case control, psychological autopsy study of 120 of 170 consecutive suicides under age 20 and 147 community age, sex, and ethnic matched controls living in the Greater New York City area. Homosexuality was defined as having had homosexual experiences or having declared a homosexual orientation. Three teenagers and no controls met these criteria. The difference was not significant. The circumstances of death were examined and are described. In no instance did suicide directly follow an episode of stigmatization. All three suicides had evidence of significant psychiatric disorder before death. In spite of opportunities for biased reporting, it is concluded that this study finds no evidence that suicide is a common characteristic of gay youth, or that when suicide does occur among gay teenagers, that it is a direct consequence of stigmatization or lack of support.

Adolescent↗
PubMed2001

Consent to the use of stored DNA for genetics research: a survey of attitudes in the Jewish population.

The use of anonymized stored tissue is a routine practice in genetic research. Investigators who utilize stored samples are neither required nor able to obtain informed consent before each use. Many genetic studies, however, are conducted on specific ethnic populations (e.g., Ashkenazi Jews). The results in these cases, although individually anonymous, are not anonymous with respect to the ethnicity of the participants. This lack of group anonymity has led to concern about the possibility of stigmatization and discrimination based on the results of the genetic research. In the present study we surveyed Jewish individuals about their attitudes regarding the practice of using stored DNA samples for genetic research. Specifically, we were interested in whether attitudes about informed consent and willingness to participate in genetics research using stored DNA would depend on the circumstances in which the material was collected (i.e., clinical setting vs. research setting) and the characteristics of the disease or trait under investigation. Overall, most respondents reported that written informed consent should be required and that they would be willing to provide such consent. Participants were most willing to provide consent, however, when the sample had been collected in a research rather than clinical setting. Further, participants were more likely to endorse the need for obtaining consent when the sample was collected in a clinical setting. Finally, participants were significantly less willing to participate in research that examined stereotypical or potentially stigmatizing traits as opposed to research that examined medical or mental illnesses.

Adolescent↗
PubMed2004

Hepatitis C virus-infected patients report communication problems with physicians.

We examined the prevalence and nature of perceived problems in the interaction between physicians and patients diagnosed with hepatitis C virus (HCV) infection. This cross-sectional study included 322 outpatients diagnosed with chronic HCV infection and treated at a tertiary referral hospital's hepatology clinic. Patients were asked to provide demographic information and to complete a semistructured interview, the Sickness Impact Profile (SIP) and Hospital Anxiety Depression (HAD) scale. A team of two blinded coders analyzed the interviews. A total of 131 (41%) study patients reported communication difficulties with physicians involved in their care. The main difficulties were the poor communication skills of physicians (91 [28%]), physician incompetence regarding the diagnosis and treatment of HCV infection (74 [23%]), feelings of being misdiagnosed, misled, or abandoned (51 [16%]), or being stigmatized by their physician (29 [9%]). Patients were twice as likely to report difficulties with subspecialists as compared with generalists. Nonresponse with antiviral therapy correlated with perceived physician conflict even after adjusting for treatment in relation to the time of interview, whereas previous or ongoing substance abuse and mode of acquisition did not. In a multivariate model, patients' psychosocial problems were the best predictors of communication difficulties. In conclusion, a substantial number of patients with HCV infection report difficulties when interacting with physicians, which may be due to coexisting emotional or social problems. However, perceived stigmatization by physicians and a sense of abandonment reflect the need for further educational efforts. These should target both specialists and primary care providers to inform them about the psychosocial challenges facing these patients.

Adult↗
PubMedDate not supplied

The limits to patient compliance with directly observed therapy for tuberculosis: a socio-medical study in Pakistan.

Complying with the prescriptions of the directly observed therapy (DOT), one of the components of the Global Tuberculosis Programme of the WHO, is problematic for many patients. The factors leading to patient (non-) compliance with DOT are placed in a structural equation model. The study is based on a survey carried out in one general hospital in the Punjab province of Pakistan, amongst all sputum positive pulmonary TB patients (n = 621) who arrived at the TB unit from September 1997 to October 1998. The tested sequence of manifest variables and latent constructs shows that the social stratification perspective has to be extended by the stigmatization perspective. The advantages of universally applying DOT will increase even further when the latter perspective is involved in the analysis of non-compliance. There is a real danger that the patients reached by selective DOT will be stigmatized even more.

Adult↗
PubMed2005

Toward promoting generative cultures of intentional mentoring within academic settings.

Mentoring promotes ongoing learning of clinical psychologists, regardless of their expertise and experience. Most academic programs, however, do not possess vigorous mentoring cultures in which mentors simultaneously are learners. Academic programs are largely based on "mastery" philosophies that tacitly aim mentoring at less-experienced peers. This orientation can make stigmatizing mentoring opportunities, especially for psychologists from underrepresented populations. Using concepts from experiential learning theory, we articulate interventions to invigorate mentoring cultures and make mentoring less stigmatizing.

Clinical Competence↗
PubMed1993

Promiscuous germination and growth of wildtype pollen from Arabidopsis and related species on the shoot of the Arabidopsis mutant, fiddlehead.

When pollen lands upon the stigmatic surface of a receptive flower, recognition events take place that permit germination, pollen tube growth, and tube penetration into the cell walls of the stigmatic papillae. Previously, we have described a mutant of Arabidopsis thaliana, named fiddlehead (fdh), where noncarpel organs of the shoot fuse late in ontogeny (Lolle et al., 1992). Here we demonstrate that wildtype Arabidopsis pollen grows on noncarpel organs of the fdh mutant. Pollen grains adhere, germinate, and emit pollen tubes when applied to vegetative and nonreproductive floral organs. Some of the emergent pollen tubes penetrate into the cell wall. Although pollen from a number of closely related species responds, tomato, tobacco, and snapdragon pollen does not. In addition, we show that organ fusion is not a prerequisite for pollen growth and that root epidermis does not express this activity. Based on these findings we propose that the fdh mutation identifies an important regulatory gene that controls the expression of an epidermis-specific developmental program normally expressed only during gynoecial ontogeny.

Arabidopsis↗
PubMed1995

A 7-kDa pollen coating-borne peptide from Brassica napus interacts with S-locus glycoprotein and S-locus-related glycoprotein.

Two S(self-incompatibility)-family glycoproteins have been identified in stigmas of self-compatible (SC) Brassica napus L. by their ability to interact, in vitro, with a peptide fraction from the pollen coating containing a PCP7-like peptide, PCP7 (pollen coat peptide 7[kDa]) being a pollen coat peptide from self-incompatible (SI) Brassica oleracea L. which has been shown to interact with S-locus glycoproteins (SLGs). Electrophoretic purification and N-terminal amino-acid sequencing of these stigmatic glycoproteins confirmed one to be an SLG and the other to be a class 1 S-locus-related glycoprotein (SLR1). This is the first reported isolation of SLG and SLR1 proteins from SC B. napus and the first time that a PCP7-like peptide has been shown to interact with an S-class glycoprotein other than SLG. On the basis of these findings we suggest that an ability to interact with PCP7 or a PCP7-like peptide is a property of SLGs, SLR1s and possibly other S-glycoproteins and may thus provide a novel route to the identification of these glycoproteins in stigmatic extracts. The levels of the SLG in stigmas of SC B. napus were relatively much lower than the levels of the SLR1--the opposite to the situation in SI B. oleracea. This finding is discussed in terms of translational control of SLGs and SLR1, and the possible implications for self-incompatibility in B. oleracea and self-compatibility in B. napus.

Amino Acid Sequence↗
PubMed1976

Two studies of comparative stigma: employer attitudes and practices toward rehabilitated convicts, mental and tuberculosis patients.

Two studies compared the effects of stigmatization on two questionnaire measures of social distance and on offers of employment in retail sales. Employers' questionnaire responses revealed less social distance only with tuberculosis patients, compared to exconvicts, exmental patients or marginally adjusted individuals, all of whom did not differ among themselves. There were no differences in the number or conditions of retail sales job offers obtained by six competent experimenters role playing each of three stigmatizing conditions. The results of the studies are seen as reducing concern over the recent changes in California mental health laws which make involuntary commitment in mental hospitals more difficult and may increase the number of convicts who would otherwise become mental patients. Satisfactory employment, often related to low prisoner and mental patient recidivism rates, may be equally accessible to competent exmental patients and felons.

Attitude↗
PubMed2002

Notes on the pollination biology of Notylia nemorosa (Orchidaceae): do pollinators necessarily promote cross pollination?

The pollination biology of Notylia nemorosa was elucidated from field and ex situ observations. Field observations were carried out in Minas Gerais, southeastern Brazil, where this orchid is pollinated by males of Eulaema nigrita(Euglossini). Plants cultivated in Campinas (São Paulo State, southeastern Brazil) were eventually pollinated by males of Eulaema nigrita and Euglossa melanothricha(Euglossini). In both cases, Euglossini males collect aromatic compounds produced on the surface of the lip, fix the pollinaria on the dorsal surface of the labrum and perform pollination. This species is protandrous. Recently opened flowers present their stigmatic surfaces blocked and thus flowers act only as pollen donors. After 2-3 days the viscidium dries out and pollinaria cannot be removed anymore. Then, a narrow slit opens in the stigmatic cavity, allowing pollen deposition. Experiments performed with cultivated plants suggest that this orchid species is strongly, though not completely self-incompatible. Pollination experiments showed that bees tend to stay several minutes in each inflorescence. This behavior may promote some degree of geitonogamous pollination because flowers in male and female phases coexist in the same inflorescence. The combination of self-incompatibility with this specific pollinator behavior may explain the rarity of fruits in several neotropical reward-offering Orchidaceae.

Animals↗