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PubMed1991

Use of a fast protein electrophoretic purification procedure for N-terminal sequence analysis to identify S-locus related proteins in stigmas of Brassica oleracea.

In the cruciferous plant Brassica oleracea L. (cabbage), the S-locus specific glycoproteins (SLSGs) isolated only in stigmas are considered to play an important role in the normal prevention of self-fertilization. Recent molecular data have shown that the gene encoding these glycoproteins (the SLG gene) belonged to a multigenic family consisting of about 10 homologous copies among which another member is expressed, the S-locus related gene (SLR1gene). Our aim was to determine whether the SLR1-gene proteins were expressed in the stigmatic tissues. We first identified the putative SLSGs or SLR1-proteins by Con A-peroxidase detection of glycoproteins separated after isoelectric focusing in polyacrylamide gels. We describe a fast purification procedure for the glycoproteins of interest, based on analytical isoelectric focusing, electrophoresis, and electroblotting of proteins onto polyvinylidene difluoride membranes. Blotted proteins were sequenced for N-terminal amino acid determination. By comparison of the N-terminal sequences of the purified proteins with the peptide sequence predicted from the SLR1-cDNA, we demonstrate the expression of SLR1-like proteins in stigmas of B. oleracea.

Amino Acid Sequence↗
PubMed2004

Emotional reactions of lay persons to someone with Alzheimer's disease.

BACKGROUND: Information about the nature of public reactions to people with Alzheimer's disease (AD) can help reduce stigmatization associated with the disease. OBJECTIVE: The aim of this study was to examine emotional reactions to persons with AD, and its correlates. METHODS: A total of 150 Jewish Israeli adults (mean age=59.9) were interviewed face-to-face regarding their emotional reactions to people with AD using a vignette methodology. RESULTS: Only a third of the participants gave the correct label. The person described in the vignette elicited more positive than negative emotions. Gender and perceived threat were the most important factors associated with emotional reactions. CONCLUSIONS: Findings suggest the need to expand the efforts to increase the recognition of AD by lay persons, and to address the negative emotions of several risk groups, such as male adults and those with greater concern about developing the disease.

Affect↗
PubMed2006

Lay perceptions regarding the competence of persons with Alzheimer's disease.

OBJECTIVE: The aim of the present study was to assess lay persons' perceptions about the competence of a person with AD and its relationship to social distance. METHODS: Face-to-face interviews were conducted with a total of 206 Jewish Israeli adults (mean age = 59.7) using an experimental vignette methodology, varying in the severity of the disease. Participants were requested to rate the competence of the person described in the vignette in the areas of driving, health-decision making, financial decisions, and the performance of instrumental activities of daily living. RESULTS: Results of the study showed that lay persons are able to make a distinction between different types of competence, and that their perceptions about competence affect greatly their behavioral discrimination toward a person with AD. CONCLUSIONS: Findings of this study stress the importance of clarifying the concept of competence among the lay public, in order to reduce the stigmatization of persons with Alzheimer's disease.

Activities of Daily Living↗
PubMed2007

Family physicians' perceptions and predictors regarding the competence of a person with Alzheimer's disease.

OBJECTIVE: The aim of the present study was to assess family physicians' perceptions about the competence of a person with AD. METHODS: Telephone interviews were conducted with a representative sample of 395 family physicians using an experimental vignette methodology, varying in the severity of the disease. Participants were requested to rate the competence of the person described in the vignette in the areas of driving, health-decision making, financial decisions, and the performance of instrumental activities of daily living. RESULTS: Results of the study showed that family physicians perceived the person described in the vignette to be highly incompetent in items involving safety issues. Only a small variety of factors were associated with these perceptions. The main factors were the severity of the disease as reflected in the vignette, participants' perceptions regarding the dangerousness and responsibility of the person with AD, and the percentage of patients aged 65 + with cognitive deterioration in the physician's practice. CONCLUSION: The assessment of competence in persons with AD is a subtle and complex process. Future research is urgently needed to further explore the factors affecting the process, such as stigmatic views.

Activities of Daily Living↗
PubMedDate not supplied

Cost-benefit analysis of a national screening programme for cystic fibrosis in an Israeli population.

The recently acquired ability to identify 97% of CF carriers in an Israeli Ashkenazi population, prompts an evaluation of a nationwide screening programme. In 1993, the programme would first screen and counsel 9,261 parents, then 396 spouses of carrier parents and finally screen 16.5 fetuses where both parents are carriers. Assuming 92% of screened parents choose abortion of fetus screened positive, 2.33 cases of CF will be prevented in 1993 at a direct cost of $781,000. The $326,000 direct costs of preventing a CF case, exceed the lifetime excess direct costs per case of $297,000. However, benefits of screening also accrue to subsequent pregnancies, resulting in a direct benefit ($14.45 million) to cost ($10.39 million) ratio of 1.39/1 for the period 1993-2032. When benefits and costs resulting from mortality changes, work absences and transport costs are included, the benefit ($15.95 million) to cost ($13.88 million) ratio falls to 1.15/1. Benefit-cost ratios are lower for other ethnic groups in Israel, due to lower carrier rates and lower mutation detection abilities. A CF screening programme will increase the freedom of individuals choice, but should be carried out carefully in order to minimize stigmatization and even discrimination against CF carriers.

Abortion, Eugenic↗
PubMed2004

Screening in liver disease: report of an AASLD clinical workshop.

This report summarizes an AASLD Clinical Workshop that was presented at Digestive Diseases Week 2003 on screening in liver diseases. As newer diagnostic tests become available, many liver diseases and complications of liver disease can be detected at an early asymptomatic stage. In many cases, early detection can lead to earlier treatment and an improved outcome. However, screening for liver diseases in asymptomatic persons has the potential for adverse consequences, including discrimination and stigmatization. The cost of screening programs is significant, and access to screening tests varies in different countries. Future screening programs require careful planning and implementation to balance the benefits, risks, and cost-effectiveness. This review outlines the concepts of screening and their application to a broad range of liver diseases.

Cost-Benefit Analysis↗
PubMed2001

Abortion history and breast cancer risk: results from the Shanghai Breast Cancer Study.

Studies of the association between induced abortion and breast cancer risk have been inconsistent, perhaps due to underreporting of abortions. Induced abortion is a well-accepted family planning procedure in China, and women who have several induced abortions do not feel stigmatized. The authors used data from a population-based case-control study of breast cancer among women age 25-64 conducted between 1996 and 1998 in urban Shanghai to assess whether a history of and the number of induced abortions were related to breast cancer risk. In-person interviews were completed with 1,459 incident breast cancer cases ascertained through a population-based cancer registry, and 1,556 controls randomly selected from the general population in Shanghai (with respective response rates of 91% and 90%). After adjusting for confounding, there was no relation between ever having had an induced abortion and breast cancer (odds ratio [OR] = 0.9, 95% confidence interval [CI] 0.7-1.2). Women who had 3 or more induced abortions were not at increased risk of premenopausal breast cancer (OR = 0.9, 95% CI 0.6-1.4) or postmenopausal breast cancer (OR = 1.3, 95% CI 0.8-2.3). These results suggest that a history of several induced abortions has little influence on breast cancer risk in Chinese women.

Abortion, Induced↗
PubMed1995

Screening for breast cancer in pre-menopausal women. Who should decide?

The recent UICC meeting on breast cancer screening in pre-menopausal women showed that experts disagree: some would recommend that screening begin at age 40, others would postpone it until after age 50 (Eckhardt et al., 1994). There is full consensus that screening at ages 40 to 49 may detect a substantial fraction of breast-cancer cases before their clinical manifestation, but the trials carried out have not indicated a significant reduction in subsequent mortality. As stated in the report of the UICC meeting, "this issue is too large for it to remain only the concern of experts." In our opinion, women should be provided with full information to enable them to decide themselves what is better for them. This means that the available scientific evidence both on benefits and on risks should be made quantitatively explicit. As recently reviewed by Hurley and Kaldor (1992), potential benefits include saved lives, increased use of conservative therapies, and reassurance of women without pre-clinical cancer; risks include radiation-induced breast cancer, unnecessary investigations for false positives, useless early diagnosis and treatment, diagnosis and treatment of lesions not requiring treatment (over-diagnosis), false reassurance, and psychological and social morbidity such as anxiety and the stigmatization of women with positive diagnosis.

Adult↗
PubMed2006

Dynamic-SIMS imaging and quantification of inorganic ions in frozen-hydrated plant samples.

We present here SIMS images of the distribution of inorganic cations (Na, K, Mg and Ca) in frozen-hydrated samples of three plant species, ivy, camomile, and flax. The samples were cryofixed using fast plunge-freezing. Stigmatic images were obtained, at 100 K, under dynamic SIMS conditions by fast atom bombarding (FAB). Even though the images obtained with the frozen-hydrated plant samples are still not of upper quality, they show that the method used to prepare these samples preserves existing ionic gradients between the outer and the inner part of the cells, between adjacent cells, including cells with the same type of differentiation, and between tissues. We also describe the quantification of the relative proportions of the ions in the vacuoles of flax. The reasonable accuracy achieved for quantification of the vacuole ion ratios permitted to show (i) that radial gradients of ion ratios in hypocotyls change when the plant is becoming older and (ii) that large differences may exist between adjacent cortical cells of the same type. The role of these substantial differences in vacuole ion balance ratios is a largely unexplored issue in plant physiology.

Cations↗
PubMed2005

Disparities in mental health treatment following the World Trade Center Disaster: implications for mental health care and health services research.

To assess disparities in mental health treatment in New York City (NYC) after the World Trade Center Disaster (WTCD) reported previously related to care access, we conducted analyses among a cross-sectional survey of adults who had posttraumatic stress disorder (PTSD) or major depression (N = 473) one year after the event. The dependent variables examined were use of mental health services, in general, and use of mental health services related to the WTCD. Similar dependent variables were developed for medication usage. Although a number of bivariate results were statistically significant for postdisaster mental health visits, in a multivariate logistic regression model, only WTCD exposure remained significant. For service utilization related to the WTCD, the multivariate results indicated that African Americans were less likely to have had these visits compared to Whites, while those with a regular doctor, who had greater exposure to WTCD events, and those who had a perievent panic attack were more likely to have had such visits. In terms of medication use, multivariate results suggested that African Americans were less likely to use postdisaster medications, whereas persons 45 + years old and those with a regular doctor, were more likely to use them. For WTCD-related medication use, multivariate models indicated that African Americans were less likely to use medications, relative to Whites, while those between 45 and 64 years old, those with a regular doctor, those exposed to more WTCD events, and those who had a perievent panic attack, were more likely to have taken medications related to the disaster. The primary reason respondents gave for not seeking treatment (55% of subsample) was that they did not believe that they had a problem (73%). Other reasons were that they wanted to solve the problem on their own (5%), had problems accessing services (6%), had financial problems (4%), or had a fear of treatment (4%). Despite the availability of free mental health services offered in a supportive and potentially less stigmatizing environment post disaster, there still appeared to be barriers to receiving postdisaster services among those presumably in need of care.

Health Services Needs and Demand↗
PubMed2003

Young- versus older-onset Parkinson's disease: impact of disease and psychosocial consequences.

The effect of Parkinson's disease (PD) on young patients' lives is likely to differ from that in older patients. For this study, 75 patients with onset of PD before the age of 50 and 66 patients with later onset completed a booklet of questionnaires on demographic and clinical variables, quality of life, and psychosocial factors. Apart from a higher rate of treatment-related dyskinesias in the younger onset group, the two groups did not differ in self-reported disease severity or disability. A higher percentage of young-onset patients was unemployed due to disability or had retired early. Quality of life as measured on the PDQ-39 was significantly worse in young-onset patients than in older-onset patients. Young-onset patients also had worse scores on the stigma and marital satisfaction scales, and were depressed more frequently. Differences between the two groups in their most commonly employed coping strategies and in terms of their satisfaction with emotional support did not reach significance. We conclude that young-onset patients more frequently experience loss of employment, disruption of family life, greater perceived stigmatization, and depression than do older-onset patients with PD. In addition to more severe treatment-related motor complications, social and psychosocial factors may contribute to greater impairment of quality of life in young patients with PD.

Activities of Daily Living↗
PubMed2001

Perceived stigma in Spasmodic Torticollis.

Little is known about the "stigmatizing" effects of Spasmodic Torticollis--a condition that produces physical disfigurement. This is important in understanding the social dimensions of this disorder. This study examined the presence, the dimensions, and the degree of perceived stigma in patients with Spasmodic Torticollis. The study was completed in two stages. In the first stage, ten patients were interviewed to identify the effects of their condition on their social interactions. In the second stage, a self-rating measure of stigma and questions about the impact of the condition on the patients' lives were devised. Perceived stigma was defined as avoidance of others, avoidance by others, self-consciousness, feeling unattractive, feeling apologetic, and feeling different from others. The questionnaires were sent to one hundred patients. The majority of the patients perceived "some" or "severe" stigma. Stigma was found to affect the patients' social, private, and working lives. It is suggested that stigma in Spasmodic Torticollis needs to be considered as a parameter relevant to the clinical management of these patients.

Aged↗
PubMed2007

Lessons learned in the implementation of an innovative consultation and liaison service for children of cancer patients in various hospital settings.

OBJECTIVE: To evaluate the process of implementing a family-oriented consultation and liaison service in various hospital-based settings, with special regard to problems and obstacles encountered. METHOD: Qualitative content analysis using categorization and sequential, phenomenological analysis of descriptive progress notes during the implementation period. The team members of the liaison service were defined as participant observers. Interpretations of the material were derived in previously defined, sequential steps in team discussions. RESULTS: Despite a consistent concept behind the new service, the degree to which it was able to be integrated into different medical settings varied to a remarkable degree. Obstacles encountered were often linked to a lack of consideration being given to divergent concepts of care. It was necessary to give special attention to providing physicians with practical evidence of the value of the intervention. The new service was most readily utilized by families when physicians personally communicated the referrals as a standard procedure to their patients and when the referrals were not made too quickly after the parent's initial diagnosis. CONCLUSIONS: Hospital-based services for cancer patients with children under the age of 18 should carefully address patients' fears of psychiatric stigmatization. Furthermore, they should include modules for acute crisis intervention. Implications for future implementation activities in this field are discussed.

Adaptation, Psychological↗
PubMed2003

The evolving experience of illness for Chinese women with breast cancer: a qualitative study.

The study of illness meaning in cancer in western communities has usually focused on causal attributions. We report a phenomenological study of 17 Hong Kong Chinese women with breast cancer, interviewed on completion of initial treatment, and describe how the illness experience and hence, meaning evolves for women in the Hong Kong Chinese culture. Themes arising from the identification and treatment of the disease include the difficulty of living in uncertainty and of maintaining and regaining normalcy in a superstitious society. The initial uncertainty of disease detection and the diagnostic process are characterized by shock and disbelief mingled with fear of death. Treatment choice presents women with difficulties arising from more uncertainty over the pressure to make quick decisions and the dilemma of death or mutilation. Following treatment, re-evaluation, re-prioritizing and positive life-re-evaluation occur. Changes in appearance proved problematic for those women who tried to hide their disease to protect themselves against stigmatization and social exclusion. In many ways, these findings parallel studies on western populations, suggesting that a common disease-medical care process is a predominant influence in shaping breast cancer experience. Implications for care are drawn from these data.

Adaptation, Psychological↗
PubMedDate not supplied

A comparative assessment of psychological and psychosocial characteristics of cancer patients and their caregivers.

We recruited 50 cancer patients and their caregivers with the aim of extending our knowledge of emotional, personality and psychosocial variables, and comparing their reciprocal experience of the disease. The patients and caregivers were administered four of the questionnaires included in the Cognitive Behavioral Assessment 2.0, the Family Strain Questionnaire and the Satisfaction with Life Scale. The patients were characterised by significantly greater emotional disturbances than their caregivers, who were emotionally stable and had a relatively low level of perceived strain despite their high level of hostility and state anxiety. The intra-scale correlations highlighted the fact that the perception of distress depends on neuroticism and the presence of anxiety and depression (which are themselves known to be connected with neuroticism). The everyday life of the caregivers seemed to be characterised by restricted social relationships and interests; a relatively large proportion also declared that they had practical problems related to disease management, economics and some embarrassing and stigmatic aspects of the disease itself.

Activities of Daily Living↗
PubMed1997

An overview of mental health services for the elderly.

Psychiatric distress is substantially prevalent among elderly individuals, particularly in the primary care and institutional settings, where most older persons receive mental health care. Barriers to care from providers include negative attitudes and stigmatization and poor recognition by general health care professionals. When psychiatric disorders are recognized, the intensity and duration of treatment provided is generally below standards for adequacy. Further research can determine the impact of patient, caregiver, and provider factors on treatment provision and on patient adherence to treatment. Assessment of factors influencing the treatment process are needed to ensure that treatments provided in the real world approximate the efficacy established in controlled clinical trials.

Aged↗
PubMed2000

The ILAE/IBE/WHO Global Campaign against Epilepsy: Bringing Epilepsy "Out of the Shadows"

Epilepsy affects at least 100 million people worldwide at some time in their lives, especially in childhood and adolescence. It is a universal problem involving all ages, races, social classes, and nations. Nevertheless, it has been misunderstood, feared, and stigmatized for more than 3000 years. The psychosocial and economic consequences of epilepsy are considerable in developed nations but are even greater in developing nations, where the treatment gap may vary from 60 to 98%. To address the long-standing worldwide neglect of this disease, a campaign titled Epilepsy: Out of the Shadows has been launched by an alliance of three global organizations: the International League against Epilepsy (ILAE), the International Bureau for Epilepsy (IBE), and the World Health Organization (WHO). Global, regional, and national initiatives are currently underway.

Journal Article↗
PubMed1994

The rodent carcinogenicity bioassay produces a similar frequency of tumor increases and decreases: implications for risk assessment.

We examined the overall results of 124 consecutive rodent carcinogenesis assays carried out at the maximum tolerated dose on 37 chemicals reported recently by the Toxicology Program of the United States. In 31 experiments each in male and female F-344 rats and in male and female B6C3F1 mice, tumor increases and decreases occurred in 41 and 46% of the experiments, respectively. In 22 experiments both increases and decreases in tumor incidence were reported. Of the experiments with decreases in tumor incidence, about 70% were associated with lower body weights of the treated animals. However, of the 30 chemicals producing some tumor decreases, 12 showed decreases in some experiments without any association with bodyweight. Ten chemicals that were Salmonella positive produced increases and decreases in tumor incidences and three produced only decreases in tumor incidence. If it is considered that the bioassay provides information relevant to the carcinogenic potential of a chemical, then logically it must also be considered that information about the cancer-preventive potential of a chemical is provided. When a chemical causes increases and decreases in tumors, several questions follow. First, which are more relevant to the health of an exposed individual: tumor increases or tumor decreases? Second, should such a chemical be stigmatized as a "carcinogen," in view of all the legal and economic implications that ensue from such a label? Third, how should one define a carcinogen?

Animals↗