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PubMed2004

Teachers' knowledge, beliefs and attitudes concerning schizophrenia- a cross-cultural approach in Japan and Taiwan.

BACKGROUND: Mental health literacy of the general public is essential for the effective promotion of society's mental health. However, there has been no investigation of the general public's mental health literacy with Japanese and Taiwanese socio-cultural backgrounds. METHODS: A total of 129 Japanese and 150 Taiwanese elementary school teachers were surveyed about knowledge, beliefs and attitudes concerning schizophrenia by means of a questionnaire with a vignette describing a case of the disease. Identification of the case, cause of the disease, coping behavior for the case, and perception of stigmatizing and supporting attitudes by parents and neighbors of the case were investigated. RESULTS: As a common finding with the studies in Western countries, only small percentages of the Japanese and Taiwanese respondents were able to make a correct identification. A further common finding was the emphasis on psychosocial factors as a cause of schizophrenia, as was the rejection of psychotropic medication, although future study is required to determine to what extent the respondents know about therapeutic procedures utilized by psychiatrists. Significantly stronger stigma perception was shown in the Japanese respondents than in the Taiwanese, which may be attributable to the high institutionalization rate in Japan. CONCLUSIONS: Japanese and Taiwanese teachers' knowledge, beliefs and attitudes regarding schizophrenia were similar to those found in the general public in Western societies. Although the present study is limited in sampling and the components of the mental health literacy investigated, several working hypotheses have been extracted from it to be tested in future investigations on the Japanese and Taiwanese and other Asian general public's mental health literacy.

Adaptation, Psychological↗
PubMed2006

Does stigma concerning mental disorders differ through medical education? A survey among medical students in Istanbul.

BACKGROUND: Stigma and discrimination toward mentally disabled persons might exist within the medical environment and may form a barrier for patients to receive appropriate care. The aim of this study is to determine the attitudes of medical students toward mentally disabled people and to understand the impact of schooling on attitude difference by evaluating second and sixth year medical students. METHOD: The study was carried out among 452 students from the all the three public medical schools located in Istanbul, Turkey. Attitudes were assessed through a Likert scale by presenting vignettes for depression and schizophrenia. RESULTS: In both men and women, the scores of last year students for depression and schizophrenia scales were better compared with those of the second graders, and the differences were statistically significant (p<0.05). However, the proportion of students who did not perceive schizophrenia as "temporary" and "curable" and the perceived likelihood of dangerousness for schizophrenia were higher among the last year students compared with the second graders. CONCLUSION: As a result of this study, it was determined that last year students had improved attitudes toward the mentally ill; however, they still had striking stigmatizing opinions and judgments. The improvement in the attitude score between the second and the sixth graders is considered a result of the students' contact and interaction with persons having mental disorders throughout their medical education. The challenge is to maintain a social environment that aims to reduce the distance between the patient and the medical staff through introducing a holistic approach in medical schools.

Adult↗
PubMed2006

Stigma and discrimination towards people with schizophrenia and their family members. A qualitative study with focus groups.

BACKGROUND: There is a scarcity of data regarding the actual stigma and discrimination experienced by schizophrenic patients and their relatives. Those experiences can vary significantly depending on the specific social group involved. We have explored such phenomena in our culture with a qualitative technique. METHODS: We developed a qualitative study with focus groups of clinically stable schizophrenic outpatients (N = 18) and relatives (N = 26). Three groups were performed in each sample. RESULTS: Six categories of stigma and discrimination experiences were extracted from the patients' data: Mental illness vs. Lack of will, Prejudice related to dangerousness, Over-protection-infantilization, Daily social discrimination, Discrimination in health care, Descendants, Avoidance-social isolation. Data from relatives were divided into three sets: discrimination towards the patients witnessed by relatives, discrimination suffered by the relatives themselves and discrimination exerted by the relatives on the patients. CONCLUSIONS: Patients and relatives describe a great variety of stigma and discrimination experiences in all areas of life, including health care. Isolation and avoidance are common reactions to those experiences. Publicizing these stigma and discrimination experiences could help to reduce stigmatizing attitudes in society and result in healthier reactions from patients, favoring a better course of the illness.

Adult↗
PubMed1998

Understanding causal paths between mental illness and violence.

The stigma associated with mental illness is a major concern for patients, families, and providers of health services. One reason for the stigmatization of the mentally ill is the public perception that they are violent and dangerous. Although, traditionally, mental health advocates have argued against this public belief, a recent body of research evidence suggests that patients who suffer from serious mental conditions are more prone to violent behaviour than persons who are not mentally ill. It is a point of contention, however, whether the relationship between mental illness and violence is only one of association, or one of causality; that mental illness causes violence. A proven causal association between mental illness and violence will have major consequences for the mentally ill and major implications for caregivers, communities, and legislators. This paper outlines the key methodological barriers precluding casual inferences at this time. The authors suggest that a casual inference about mental illness and violence may yet be hasty. Because a premature statement advocating a causal relationship between mental illness and violence could increase stigma and have devastating effects on the mentally ill the authors urge researchers to consider the damage that may be produced as a result of poorly substantiated causal inferences.

Causality↗
PubMed2001

Social inequality in the utilization of in- and outpatient treatment of non-psychotic/non-organic disorders: a study with health insurance data.

BACKGROUND: This study deals with the utilization of in- and outpatient care due to non-psychotic/non-organic disorders (ICD-9 300-307: neuroses, personality disorders, sexual disturbances, alcohol and substance dependencies, drug abuse and functional disorders). Specifically, it examines whether social gradients to the detriment of individuals from lower social positions appear. This is dealt with both in terms of in- and outpatient treatment. Secondly, it examines whether the likelihood of being treated as an inpatient rather than an outpatient differs between occupational status positions. Finally, the study considers whether the hospital department a given patient is most likely to be assigned to differs between occupational status positions. METHOD: Analyses were performed with records from a statutory health insurance in West Germany. The database consists of 124,917 men and women between 20 and 60 years of age. We included only subjects with employment periods, as otherwise outpatient treatment could not be assessed completely. The data had been recorded between 1987 and 1996. In total, 9129 persons had one of the above mentioned diagnoses, 6115 of them received outpatient treatment and 3014 were inpatients only. RESULTS: The relative risk (RR) for outpatient diagnoses was RR=4.41 for the male unskilled/semi-skilled insured in comparison with men in the highest occupational position, the equivalent RR for women was 2.1. The respective results for inpatient treatment were RR=7.3 for men and RR=2.3 for women. In men, the relative risks were considerably reduced after cases with alcohol- and substance-related diagnoses had been excluded. For the assignment to in- and outpatient treatment, no consistent differences between individuals with different occupational positions emerged. Once diagnosed, higher-status individuals had the longest treatment periods as in- and outpatients. Only a small proportion of diagnosed subjects received medical care in psychiatric wards; this held especially for the group with higher occupational positions. CONCLUSIONS: Social inequalities in the treatment of psychogenic disorders emerged for outpatients as well as for inpatients. Inpatients tended to avoid treatment in psychiatric departments, and it can be concluded that individuals holding higher positions may be more successful in their attempts to avoid stigmatization.

Adult↗
PubMed2005

[Polytraumatized burn injury victims].

Most polytraumatized burn injury persons aged 30-40 years who have suffered a burn or a burn-like injury are stigmatized by serious functional deficits, temporary loss of their social independence, injury-associated psychological reactions of different levels, and unusual reversible deficits in their higher cortical functions. The result is a prolonged stage of acute treatment and rehabilitation as well as very often the lifelong need for highly specialized care by physicians and other medical professionals. Accordingly, the deficits in any individual case are high and in spite of the low case rate (approximately 300-400 cases/ year) these accidents have a high impact on society as a whole, resulting in a significant financial burden for the social security system, insurance funds, and pension funds.

Adolescent↗
PubMed2006

Clozapine-induced sialorrhea: pathophysiology and management strategies.

RATIONALE: Clozapine is an atypical antipsychotic agent with proven efficacy in refractory schizophrenia, but its widespread use is limited by adverse effects such as agranulocytosis, seizures, sedation, weight gain, and sialorrhea. Clozapine-induced sialorrhea (CIS) is bothersome and has socially stigmatizing adverse effects, which result in poor treatment compliance. The pathophysiology of this condition is poorly understood and the treatment options available are based mostly on case reports and open-label studies. OBJECTIVE: To review the available studies on CIS. METHOD: All relevant studies available through PUBMED search supplemented with manual search were undertaken. RESULT: The clinical features, complications, assessment, pathophysiology, and management of CIS are discussed. CONCLUSION: Although the studies evaluating the therapeutic options has limitations and no drug has been found to be superior, judicious use of pharmacological agents along with behavioral methods will reduce this troublesome side effect and enhance compliance.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

Psychosocial impact of cosmetic rhinoplasty.

The psychosocial impact of cosmetic rhinoplasty in Scandinavia is poorly investigated. Therefore a study was undertaken utilizing a mailed audit covering self-percepted experiences before, during, and after surgery. A total of 67 of 80 patients responded to the questionnaire (84%), on average 18 months after surgery. The mean age was 31 years (range, 16-63 years) and the M/F ratio was 20/44 among the 64 patients analyzed, half of whom were of foreign extraction. The self-report disclosed that a majority of the patients had been preoccupied with their noses since puberty and that the mental awareness of nasal stigmatization was given mainly by the mirror (58%), not by others. Despite the early exclusion of patients with possible body dysmorphic disorder, almost one-fourth had a severe complex, and one-third felt socially inhibited by their noses and avoided being looked at from certain angles. Surgery was not a significant problem even though it was performed under local anesthesia and i.v. sedation. The great majority (91%) were satisfied with the result and 89% would recommend the procedure to others. More than 60% felt more self-confident and perceived life as being easier. To conclude, successful rhinoplasty may change preoccupied patients' lives, because the majority simply stopped thinking about their noses.

Adolescent↗
PubMed1998

[Cataract surgery at the Berlin Virchow clinic. Overview of the last 16 years].

PURPOSE: The aim was to compare the different techniques of cataract surgery regarding early postoperative astigmatism and visual acuity. PATIENTS AND METHODS: The data of three groups of patients (100 eyes) were analyzed retrospectively (1980-1982; 1987-1990; 1991-1993). Three different techniques of cataract surgery were used. Included in the prospective study were the data for 285 eyes, which underwent phacoemulsification, self-sealing incision and controlled induction of astigmatism. RESULTS: In the time period retrospectively investigated, we found that because of the advancements in operation methods, there was a reduction in the amount of surgically induced astigmatism. From 1980 to 1995 there was a clear increase in the number of patients with early low-grade postoperative astigmatism < 1 D (1980-1982: 6%, 1987-1990: 19%, 1991-1993: 64%, 1994-1995: 84%). There was an improvement in postoperative vision (with correction > 0.5) of 16% in 1980-1982 to 45% from 1987 to 1990, 58% from 1991 to 1993, and to 76% in 1994-1995. CONCLUSIONS: Surgical induced a stigmatism, which was considered to be a sign of unwanted increased postoperative astigmatism, was reduced from 1980 to 1993. Through controlled induction of astigmatism it was possible to compensate for preoperative astigmatism in the prospective group. Improved surgical techniques led to improvements in early postoperative visual acuity.

Astigmatism↗
PubMed2001

[Keratography (corneal tattooing) in corneal leukoma].

BACKGROUND: Since antiquity attempts have been made to minimize disfigurement and stigmatization of patients with leukoma. Keratography is a relatively new method for imprinting color pigments into the corneal stroma with an entomological needle. MATERIALS AND METHODS: Keratography was performed in 20 patients at the University Eye Hospital, Munich, between November 1997 and September 1999. Patients had either a leukoma that did not tolerate prothesis or had another cloudy corneal disease. The operation was carried out in our outpatient clinic under local anesthesia. RESULTS: There was a single operation in three patients, two operations in nine, three operations in six, and four operations in two. Postoperatively 33% of patients complained of pain. No postoperative bacterial keratitis or perforation occurred. CONCLUSION: All patients were highly satisfied. The long-term stability of color pigments must still be evaluated.

Adolescent↗
PubMed2006

Dual location of a family of proteinase inhibitors within the stigmas of Nicotiana alata.

Reproductive and storage tissues of many plants produce large amounts of serine proteinase inhibitors (PIs). The ornamental tobacco, Nicotiana alata, produces a series of 6 kDa chymotrypsin and trypsin inhibitors that accumulate to up to 30% of soluble protein in the stigma. These inhibitors are derived by proteolytic processing of two closely related multidomain precursor proteins. Using immunogold electron microscopy, we find that the stigmatic PIs accumulate in both the central vacuole and in the extracellular mucilage. Labelling with antibodies specific for the C-terminal vacuolar targeting peptide (VTS) of each precursor confirms earlier biochemical data showing that the VTS is removed during passage through the secretory pathway. We have isolated and characterised the extracellular population of PIs, which are largely identical to PIs isolated from whole stigmas and are functional inhibitors of serine proteases. Subcellular fractionation of immature stigmas reveals that a sub-population of the PI precursor protein is proteolytically processed within the endoplasmic reticulum. This proteolysis results in the removal of the vacuolar sorting information, causing secretion of this PI population. We propose a novel mechanism whereby a single gene product may be simultaneously trafficked to two separate compartments mediated by proteolysis early in the secretory pathway.

Chymotrypsin↗
PubMed2001

Evidence for orthologous S-locus-related I genes in several genera of Brassicaceae.

In the Brassica genus, self-incompatibility (SI) is considered to be controlled by the combined action of several highly polymorphic genes located at the S-locus. These genes, including the S-Locus Gene (SLG), and the S-Receptor Kinase (SRK) are all members of the complex multigenic S-family. The S-Locus Related I gene (SLR1) is a member of the S-family, but is not involved in SI control since it is not linked to the S-locus and is essentially monomorphic. Here we confirm or demonstrate the occurrence of SLR1 as highly diverged but not very polymorphic genes in several genera of the Brassicaceae family (Arahidopsis, Brassica, Hirschfeldia, Raphanus, Sinapis). They show similar expression patterns with respect to location (stigmatic papillae), developmental stage (before and during anthesis) and transcript size (1.6 kb). In addition, they are assumed to be involved in the same biological function (late pollen adhesion). These features suggest that the pollen adhesion function might have evolved towards self-pollen recognition through duplication of SLR1 and recruitment of a protein kinase gene.

Arabidopsis↗
PubMed2002

Why do fig wasps actively pollinate monoecious figs?

Active pollination, although rare, has been documented in a few pollination mutualisms. Such behaviour can only evolve if it benefits the pollinator in some way. The wasps that pollinate Ficus inflorescences can be active or passive pollinators. They lay their eggs in fig flowers, so that a proportion of flowers will host a wasp larva instead of a seed. We show in an actively pollinated monoecious fig that lack of pollination does not induce fig abortion or affect wasp offspring size but results in smaller numbers of offspring. Hence, conversely to other active pollination systems, seed formation is not obligatory to sustain developing pollinator larvae; however there is a direct fitness cost to active pollinators not to pollinate. We then compared the locations of eggs and fertilised flowers of three actively pollinated Ficus species and one passively pollinated species. We found that more flowers containing wasp eggs were fertilised in the actively pollinated species relative to those of the passively pollinated one. These results along with comparison with similar studies on dioecious figs, support the hypothesis that active pollination has evolved in fig wasps to ensure that more flowers containing wasp eggs are fertilised as this may increase the chances of successful gall development. The stigmatic platform characterising actively pollinated figs is probably an adaptation to increase pollen dispersion within the fig.

Animals↗
PubMed2004

Generous-like flowers: nectar production in two epiphytic bromeliads and a meta-analysis of removal effects.

Animal-pollinated angiosperm plants that respond positively to nectar removal by replenishment invest energy that can entail a reproductive cost. We investigated whether or not nectar removal stimulates replenishment in two hummingbird-pollinated bromeliad species. Nectar replenishment rates were also assessed by removing nectar from manually pollinated flowers because pollination events might be used as signals to save energy by preventing allocation to post-pollination nectar production. Then we synthesized the current understanding of nectar removal effects by reviewing existing published studies with a meta-analysis. The magnitude and significance of estimated nectar removal effects and factors associated with variation in size and direction of nectar removal effects were elucidated with the meta-analysis. We found that both Tillandsia species strongly respond to repeated nectar removal by producing >3 times additional nectar. Nectar secretion patterns were not altered by pollination (stigmatic pollen deposition) and we found no evidence of nectar reabsorption. Although the effect size varied widely across systems and/or environmental conditions, the meta-analysis showed that nectar removal had overall a positive effect on nectar replenishment (mainly among species inhabiting wet tropical habitats such as Tillandsia), and a negative effect on the secretion of additional sugar, suggesting that those plants are resource limited and conservative in the secretion of additional sugar.

Adaptation, Physiological↗
PubMed2006

Detection and release of allergenic proteins in Parietaria judaica pollen grains.

Rapid diffusion of allergenic proteins in isotonic media has been demonstrated for different pollen grains. Upon contact with stigmatic secretion or with the mucosa of sensitive individuals, pollen grains absorb water and release soluble low-molecular-weight proteins, these proteins enter in the secretory pathway in order to arrive at the cell surface. In this study we located allergenic proteins in mature and hydrated-activated pollen grains of Parietaria judaica L. (Urticaceae) and studied the diffusion of these proteins during the first 20 min of the hydration and activation processes. A combination of transmission electron microscopy and immunocytochemical methods was used to locate these proteins in mature pollen and in pollen grains after different periods of hydration and activation processes. Activated proteins reacting with antibodies in human serum from allergic patients were found in the cytoplasm, wall, and exudates from the pollen grains. The allergenic component of these pollen grains changes according to the pollen state; the presence of these proteins in the exine, the cytoplasm, and especially in the intine and in the material exuded from the pollen grains, is significant in the hydrated-activated studied times, whereas this presence is not significant in mature pollen grains. The rapid activation and release of allergenic proteins of P. judaica pollen appears to be the main cause of the allergenic activity of these pollen grains.

Allergens↗
PubMed2005

The scientific foundation for understanding attention-deficit/hyperactivity disorder as a valid psychiatric disorder.

Continued questioning of the validity of a diagnosis of attention-deficit/hyperactivity disorder (ADHD) has created uncertainties about its management in the minds of many clinicians and the public. Inaccurate beliefs about the validity of ADHD hinder the clinical care of many ADHD patients and lead to confusion about the need to seek out or accept treatment. Critics describe ADHD as a diagnosis used to label difficult children who are not ill but whose behavior is at the extreme end of normal. They further contend that, far from having a biological basis, ADHD results from poor parenting and ineffective teaching practices. Such attitudes do much to further stigmatize patients and their families and increase the burden of this debilitating condition. This review attempts to address these challenges by presenting evidence to show that ADHD meets the criteria for a valid psychiatric diagnosis. Not only does it cause specific disabling symptoms that frequently persist into adulthood, but many studies show it has a biological basis and a characteristic response to treatment. Such data support the idea that ADHD is a valid diagnostic category.

Attention Deficit Disorder with Hyperactivity↗
PubMed2000

Isolation and characterization of a class I SLG gene from Chinese cabbage (Brassica campestris).

In Brassica species, self-incompatibility in the recognition reaction between self and non-self pollens is determined by two genes, SLG and SRK, at the S locus. We have cloned and characterized a genomic DNA fragment containing a complete open reading frame of the SLG gene from Chinese cabbage. The genomic clone, named BcSLG2, was found to possess the region that shares a homology of 77% in amino acid identity with the SLG46 gene of Brassica campestris. Northern blot analysis revealed that the BcSLG2 gene expression is restricted to the pistil of Chinese cabbage flower. In situ hybridization showed that in the pistil, the gene is expressed predominantly in the stigmatic tissue. Much lower expression in the tapetum was also detectable at an immature stage of the flower development. Southern blot hybridization with the BcSLG2 DNA probe showed polymorphism in the SLG gene organization of the Chinese cabbage plants. These results will provide valuable information in understanding the S gene complex of the Chinese cabbage plants.

Amino Acid Sequence↗
PubMed2006

Condom use and its correlates among female sex workers in Hanoi, Vietnam.

Knowledge of female sex workers' (FSW) condom use behaviors in Vietnam is important for predicting the epidemic and designing interventions. Four hundred FSWs in Hanoi were studied in 2002. Consistent condom use in the past month was higher with irregular clients (62%), less with regular clients (41%), and lowest with "love mates" (5%). Reasons for not using condoms were partner objection, condom unavailability, and belief of partner's disease-free status. Twenty-seven percent reported not always having a condom available. Thirty-five percent reported increasing condom use in the previous 6 months. Reluctance to ask clients to use condoms and condom unavailability were independently associated with inconsistent condom use with both irregular and regular clients. Older age was also associated with inconsistent condom use with irregular clients. Condom promotion should focus on FSWs and their partners. Negative attitudes toward FSWs and condom promotion need to be changed to reduce stigmatization of FSWs and to make condom use a norm in the society.

Acquired Immunodeficiency Syndrome↗