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PubMed1996

The CF carrier status is not associated with a diminished self-concept or increased anxiety: results of psychometric testing after at least 1 year.

To evaluate whether the CF carrier status has any lasting effect on anxiety and on self-concept at least 1 year after the disclosure of the test result, an in-depth interview and additional psychological tests were administered in a group of adults who participated in a previous study which suggested a slight stigmatizing effect of the CF carrier status. Besides carrier status, the role of a second factor-degree of relationship-was investigated. Analysis of Variance (MANOVA or ANOVA) revealed no effect on state and trait anxiety (STAI) and almost no effect on the six subscales of the Tennessee Self-Concept Scale. The absence of a lasting negative effect of the CF carrier status on anxiety and self-concept is a very important finding. Nevertheless, an intriguing significant interaction effect was found: the group of sibs carrying the CF gene felt less integrated in the family than the group of non-carrier sibs. This effect of carrier status was not found in the more distant relatives. It is important to pay sufficient attention to this problem during genetic counseling when brothers or sisters of a CF patient receive a test result.

Adolescent↗
PubMedDate not supplied

The policy and ethical implications of genetic research on attention deficit hyperactivity disorder.

OBJECTIVE: To review the policy and ethical implications of recent research on the molecular genetics of attention deficit hyperactivity disorder (ADHD). METHOD: MEDLINE and psycINFO database searches were used to identify studies on the genetics of ADHD. The implications of replicated candidate genes are discussed. RESULTS: The findings for most genes have been inconsistent but several studies have implicated the genes in the dopaminergic pathway in the aetiology of ADHD. CONCLUSIONS: The current evidence on the genetics of ADHD is insufficient to justify genetic screening tests but it will provide important clues as to the aetiology of ADHD. Genetic information on susceptibility to ADHD has the potential to be abused and to stigmatize individuals. Researchers and clinicians need to be mindful of these issues in interpreting and disseminating the results of genetic studies of ADHD.

Attention Deficit Disorder with Hyperactivity↗
PubMed1994

Nursing the postmodern body: a touching case.

Using touch as a medium for exploring the ways in which it is constructed by nurses, the body is here characterized by a plethora of competing and co-existing terms: disobedient, obedient, mirroring, stigmatized, sinful, post-mortem, sanitized, angelic, desexualized, dangerous, dominant, dominating, deceitful, submissive, disciplined, postmodern and communicative. We have tried to be provocative by juxtaposing contradictory messages and evoking conflicting emotions, and we hope that the reader will not assume that we believe everything we write, or that everything may be taken only at face value. There are as many messages and meanings in the paper as each reader thinks there are.

Attitude to Health↗
PubMed2004

Attitudes of psychiatrists toward patients with schizophrenia.

A questionnaire was distributed to psychiatrists to investigate their attitudes toward patients with schizophrenia. A total of 42.7% of 60 respondents never informed patients of the diagnosis of schizophrenia and 40.7% informed on a case-by-case basis. The reason that psychiatrists gave for avoiding informing the patients/family members of the diagnosis was the idea that they would not understand the meaning (32.6%) and that they would drop-out from treatment (28.3%). A total of 88.4% of respondents thought the term 'schizophrenia' was used in a pejorative manner in public. The findings revealed that stigmatizing attitudes of society are also shared by some psychiatrists.

Adult↗
PubMed2006

Effects of an antistigma program on medical students' attitudes towards people with schizophrenia.

People with schizophrenia are amongst the most stigmatized of those with mental illnesses. The purpose of this study was to examine whether an antistigma program which consists of education, contact, and viewing a film that depicts an individual with schizophrenia, can change attitudes towards people with schizophrenia. The antistigma program was carried out with first-year medical students (n=25). Students' attitudes towards people with schizophrenia were assessed before and after the program. In parallel, a control group of first-year medical students were questioned (n=35). Assessment was repeated after 1 month. Favorable attitudinal changes were observed in terms of 'belief about the etiology of schizophrenia', 'social distance to people with schizophrenia', and 'care and management of people with schizophrenia'. In contrast, no significant change was observed in the control group. Attitude changes tended to decrease at the 1-month follow up. These results suggest that attitudes towards schizophrenia could be changed favorably with this program. To sustain changed attitudes towards people with schizophrenia, antistigma programs should be offered on a regular basis.

Adolescent↗
PubMed2006

Psychosocial impact among the public of the severe acute respiratory syndrome epidemic in Taiwan.

During the 2003 outbreak, severe acute respiratory syndrome (SARS) spread to more than 30 countries. Not only did it cause severe health problems but it also imposed a great psychological impact on the public. SARS emerged in Taiwan during April 2003. This study investigates the psychosocial impact and the associated factors of depression of the SARS epidemic in Taiwan when the epidemic had just been controlled. A total of 1552 respondents were recruited in the study by random selection from the telephone book. Demographic data, SARS experience, self-perceived health state, neighborhood relationships, and depression were surveyed by telephone interviewing. Respondents were grouped as 'impacted group' and 'non-impacted group' according to whether they or their friends and family had been quarantined, or suspected of being infected. The psychosocial impact and associated factors were compared between the two groups. The 'impacted group' had higher depressive levels, poorer neighborhood relationships, poorer self-perceived health, and a higher economic impact than the 'non-impacted group'. The poorer self-perceived health and economic impact factors were associated with depression. The neighborhood relationship factor was negatively associated with depression for the 'impacted group', but not for the 'non-impacted group'. The 'impacted group' had experienced greater psychosocial impact possibly due to the SARS impact, the economic downturn, poor self-perceived health conditions, and decreased social support systems. An appropriate mental health intervention to improve the self-perceived health condition, to provide instrumental and psychological support for the 'impacted group', and to decrease the stigmatization and discrimination from the public could have buffered the psychological impact from this epidemic disaster.

Adolescent↗
PubMed2006

Prejudice expectations moderate preconscious attention to cues that are threatening to social identity.

Two studies examined whether chronic and situational expectations about being stigmatized predict attention toward cues that are threatening to social identity. In Study 1, women's chronic expectations about experiencing sexism were positively associated with their attention toward subliminal cues threatening to their social identity. In Study 2, women were vigilant toward subliminal cues threatening to their social identity when the experimental situation conveyed that their gender was devalued, but not when the experimental situation promoted value and respect for their gender. Women were vigilant toward consciously presented cues threatening to their social identity regardless of the attitudes the experimental context conveyed toward their group. These studies have important theoretical and practical implications for understanding the psychological experience of possessing a devalued social identity.

Adolescent↗
PubMed2005

Public policy and mental illnesses: Jimmy Carter's Presidential Commission on Mental Health.

President Jimmy Carter's Presidential Commission on Mental Health was intended to recommend policies to overcome obvious deficiencies in the mental health system. Bureaucratic rivalries within and between governments; tensions and rivalries within the mental health professions; identity and interest group politics; the difficulties of distinguishing the respective etiological roles of such elements as poverty, racism, stigmatization, and unemployment; and an illusory faith in prevention all influenced the commission's deliberations and subsequent enactment of the short-lived Mental Health Systems Act. The commission's work led to the formulation of the influential National Plan for the Chronically Mentally Ill, but a system of care and treatment for persons with serious mental illnesses was never created.

Deinstitutionalization↗
PubMed2004

The enigma of Lenin's (1870-1924) malady.

The health of heads of states is not always handled in the same way as an incapacitating disability in ordinary professionals. Instead of suspension of responsibilities, the health status of political leaders is concealed, especially when the illness is perceived as stigmatizing, such as organic mental impairment or sexual disorder. The objective of the present paper is to analyse the malady of Lenin (1870-1924) in the light of relevant and new medical information. It is hoped that this will accentuate the need for transparency when the health of a statesman is concerned.

Autopsy↗
PubMed2006

Analysis of late stage flower development in Primula vulgaris reveals novel differences in cell morphology and temporal aspects of floral heteromorphy.

Heterostyly in Primula is characterized by the development of long-styled pin and short-styled thrum flowers, with anthers midway down the corolla tube in pin flowers, and at its mouth in thrum flowers. Other differences include pollen size and stigmatic papillae length. Several linked genes at the S locus control these differences. In this study we have analyzed pin and thrum flowers through the temporal development of heteromorphy.These studies indicate that the S locus linked genes that orchestrate heteromorphic flower development act in coordination, but with different temporal and spatial dynamics. Style length is differentiated by longer style cells in pin than thrum. However, our studies on cell shape and size within the corolla tube show that a different mechanism mediates the dissimilar elevation of anthers between pin and thrum types. These studies have also revealed that upper corolla tube cells in thrum flowers are wider than those in pin flowers. This results in a larger corolla tube mouth in thrum flowers and represents a new and previously undocumented heteromorphic variation between pin and thrum flowers.

Cell Shape↗
PubMed2004

Ill health is powerlessness: a phenomenological study about worthlessness, limitations and suffering.

The aim of the study was to create an understanding of the different dimensions of subjective ill health through discovering the essence of ill health, based on the individual experience. A philosophical, phenomenological method has been employed, and in-depth interviews were conducted with 25 individuals. The findings showed that the essence of ill health is powerlessness, which is made by a self-image of worthlessness, a sense of being imprisoned in one's life situation, and emotional suffering. The individual views her/himself as worthless, based on societal norms, attitudes and human models. Incapability and a sense of worthlessness cause the individual to distrust her/himself and others. She/he is imprisoned in her/his own life situation due to limited choices and ability. Such a situation gives rise to apathy. Destructive feelings of alienation, anguish, shame and guilt take over, and the individual's autonomy and existence are threatened. Stigmatization results from suffering and a sense of worthlessness. The informants compensated for their vulnerability by means of human support, intimacy with others, a society adapted to disability, living in the present and awareness.

Activities of Daily Living↗
PubMed2005

Compensation of aniseikonia in astigmatic pseudophakic eyes.

PURPOSE: A recently published manuscript addressed the problem of compensating for aniseikonia between pseudophakic astigmatic eyes using a least-squares calculation scheme. The purpose of this paper is to revisit this topic with the specific aim of providing explicit formulae for the determination of the intra-ocular lens required to produce a specified transverse image size at the plane of the retina and the characteristics of the contact or spectacle lens required to realize some desired refractive outcome. METHODS: The 4 x 4 ray transference is central to the development of all formulae presented in this paper. Specifically, the formula for the determination of the power of the intra-ocular lens required to achieve some transverse image size at the retina is derived directly from the disjugacy of the pseudophakic eye. RESULTS: The formula is applicable to both stigmatic and astigmatic systems without restriction. A detailed numerical example for an unusual eye is provided. CONCLUSION: A formula for the determination of the intra-ocular lens required to produce any given transverse image size at the retina is derived. This approach does not require the application of the Moore-Penrose pseudo-inverse and one is able to work rather with the properties of the optical system directly without further modification.

Algorithms↗
PubMed2004

Highly purified 1000-cSt silicone oil for treatment of human immunodeficiency virus-associated facial lipoatrophy: an open pilot trial.

BACKGROUND: Among human immunodeficiency virus-infected individuals, facial lipoatrophy has become epidemic. Those affected are stigmatized, leading to psychological distress, social and career impediments, and impaired compliance to human immunodeficiency virus medications. Temporary treatment options are limited by excessive cost, necessity of frequent treatments, and lack of a natural look or feel beneath the skin. Affected patients require more persistent, affordable, safe, and effective treatment options. OBJECTIVE: The objective was to evaluate the safety and efficacy of highly purified 1000-cSt silicone oil injected by microdroplet serial puncture technique for the treatment of human immunodeficiency virus-associated lipoatrophy. METHODS: Data on 77 patients with a complete correction were analyzed to determine the number of treatments, amount of silicone, and time required to reach complete correction, relative to initial severity. RESULTS: The volume of silicone, number of treatments, and time required to reach a complete correction were directly related to initial severity of lipoatrophy (p < 0.0001). Supple, even facial contours were routinely restored, with all patients tolerating treatments well. No adverse events were noted. CONCLUSION: In this pilot trial, we have demonstrated that highly purified 1000-cSt silicone oil is a safe and effective treatment option for human immunodeficiency virus facial lipoatrophy. Longer-term safety and efficacy in human immunodeficiency virus patients remain to be proven.

Adult↗
PubMed2005

Use of hyaluronic acid for soft tissue augmentation of HIV-associated facial lipodystrophy.

BACKGROUND: Lipodystrophy syndrome is a devastating complication of antiretroviral therapy in individuals with human immunodeficiency virus (HIV). The appearance of the associated facial lipoatrophy can be demoralizing and stigmatizing for the affected individuals to a point at which it may compromise their compliance with antiretroviral medication. OBJECTIVE: We describe the use of hyaluronic acid as an intradermal filler for correction of this disfiguring problem. METHODS: We treated five patients with grade 2 to 3 facial lipoatrophy. Each patient received approximately 5 to 6 cc in total of hyaluronic acid in the malar area via intradermal injection. RESULTS: There were no adverse events. We found that this technique provided a good cosmetic result with high patient satisfaction. At 6-month follow-up, sustained longevity was observed. CONCLUSIONS: We propose the use of hyaluronic acid for HIV-associated facial lipoatrophy as an efficacious and safe, but temporary, option for this problem until a more cost-effective option is available.

Adult↗
PubMed1995

Staying connected: the core of facilitating health care for homeless persons.

A grounded theory study explored the ways nurses and others in nurse-managed shelter clinics facilitate health care for homeless persons. Analysis of in-depth interview and participant observation data yielded a core category, "staying connected," that represents the essence of what the staff do to facilitate care for homeless persons. The three most important aspects of "staying connected" are the links that nurses establish with the homeless patient, the connections nurses establish in the form of networks with other providers, and facilitation of the homeless person's connections with the health care system. The nurses' descriptions of "staying connected" demonstrate the barriers to facilitating health care and the breakdowns that occur while trying to facilitate care for homeless persons. The barriers include lack of health insurance, insensitivity of health care providers towards homeless persons, stigmatization, cultural barriers, and communication breakdowns. Homeless persons are socially, economically, and politically vulnerable in the American health care system. Nurses have a powerful influence, both macro- and micro-socially, in facilitation of care for this population.

Adult↗
PubMed1997

Resources, stigma, and patterns of disclosure in rural women with HIV infection.

A growing number of cases of HIV infection are being diagnosed in rural communities especially among women. Although HIV-specific education and care delivery programs have been focused on rural areas in recent years, limited data are available on the impact of such initiatives on the lives of women with HIV infection. The purpose of this study was to examine characteristics of women with HIV disease living in rural communities. The study used a cross-sectional sample of rural women in Georgia. Data analysis indicated that although a majority of the women reported adequate resources, there was a group of women for whom resources for basic needs were not always adequate. Additionally, women with HIV who had not progressed to AIDS had greater difficulty in obtaining a number of resources. Almost half of the women felt stigmatized due to having HIV. Yet, a high percentage of these women had disclosed their HIV status to health care workers, sexual partners, and family. Study results provide insight into the needs of HIV-infected rural women from their perspective. This information can be important to nurses working in public health and community settings as they face the challenge of developing effective health care services for this population.

Adolescent↗
PubMed1998

Meeting the needs of women living with HIV.

HIV research, treatment, and support programs in North America have been based on the premise that HIV is a gay man's disease. HIV also affects women. The purposes of this study were to: (1) examine the feelings, concerns, and needs of HIV infected women in a mid-sized Canadian city; and (2) determine whether a community agency for HIV positive persons was adequately supporting women. With informed consent, HIV positive women attending the community agency or a regional medical care facility were interviewed using qualitative research methods to elicit their lived experience. Eight women were interviewed (20% of the women who are HIV positive in this center). Four areas of concern were identified: (1) the impact of diagnosis on women and their children; (2) need for supports specific to HIV positive women; (3) differences in needs and supports available to men and women; and (4) lack of comfort with, or knowledge about, currently available facilities. These results are consistent with previously reported research. HIV positive women who are neither drug-users nor promiscuous feel stigmatized and less supported than HIV positive males. Recommendations for practice included: formulation of self-help groups for women, a more female friendly atmosphere, presence of female staff and other HIV positive women to support these women, and improved inter-agency cooperation. Many recommendations have been implemented and exceeded. The community agency now includes a child's play area, the hiring of a female social worker, and the establishment of an off-site support group for HIV positive women.

Canada↗
PubMedDate not supplied

Epilepsy in adolescence: implications for the development of personality.

Sixteen adolescent children with onset of epilepsy between the ages of 1 and 12 years and 16 control children were investigated by interview, self-esteem scales, and the Thematic Apperception Test (TAT). Children with epilepsy had a significantly larger discrepancy between the self-image and the ideal self-image than did the control children. TAT indicated the body and self-image is poorer, the unknown and the risk of acting out more threatening, the sex identity less stable, and the defense not as adaptive as the control group. Persons suffering from epilepsy are often stigmatized. One explanation could be the influence of epilepsy on the development during adolescence of the basic trust of their bodies and of themselves.

Adolescent↗