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PubMed2004

Research issues in genetic testing of adolescents for obesity.

Obesity is often established in adolescence, and advances are being made in identifying its genetic underpinnings. We examine issues related to the eventual likelihood of genetic tests for obesity targeted to adolescents: family involvement; comprehension of the test's meaning; how knowledge of genetic status may affect psychological adaptation; minors' ability to control events; parental/child autonomy; ability to make informed medical decisions; self-esteem; unclear distinctions between early/late onset for this condition; and social stigmatization. The public health arena will be important in educating families about possible future genetic tests for obesity.

Adolescent↗
PubMedDate not supplied

Approaches to the treatment of depression.

Depression has a biological basis and patients should not be stigmatized by societal misperceptions. Depression is a recurrent disease that often requires long-term therapy. Combining antidepressant medications with cognitive behavior therapy or psychotherapy is the optimal approach. New antidepressants with improved potency and tolerability are under development.

Antidepressive Agents↗
PubMed2006

A comparative study of consumer participation in mental health pharmacy education.

BACKGROUND: People with mental illness have been recognized as key stakeholders in the development of mental health education. However, few studies have evaluated the impact of people with mental illness as participants in education programs for students studying to become health professionals. OBJECTIVE: To assess the impact of education provided by mental health consumer-educators on the attitudes of pharmacy students toward people with mental illness. METHODS: The study used a 2 group, nonrandomized, clustered, comparative design, with 4 tutorial classes allocated to receive standard pharmacist-led instruction (comparison group), and 5 tutorial classes to receive standard pharmacist-led instruction plus additional input from mental health consumer-educators (intervention group). All pharmacy students (N = 229) enrolled in the third year of a 4 year pharmacy degree program were invited to participate. Consumer-educators receiving ongoing treatment for illnesses including schizophrenia, bipolar disorder, and major depression participated in small-group work, case-study discussions, and role plays with pharmacy students in the intervention group. Pharmacy students' attitudes were assessed using a 39 item survey instrument derived from previously published instruments evaluating social distance, attribution, provision of pharmaceutical services, and stigmatization of people with schizophrenia and severe depression. RESULTS: Paired baseline and follow-up responses were obtained from 117 students in the intervention group and 94 students in the comparison group. Students who received the consumer intervention had decreased social distance scores (F(1209) = 5.30; p = 0.02). Students in the intervention group more strongly disagreed with 26 of 27 nonsocial distance statements that demonstrated a negative attitude toward people with mental illness (F(1209) = 13.58; p < 0.001) and more strongly agreed with all 4 nonsocial distance statements that demonstrated a positive attitude (F(1209) = 7.56; p = 0.014). CONCLUSIONS: Consumer participation in mental health education for pharmacy students improves students' attitudes toward people with mental illness.

Attitude of Health Personnel↗
PubMed2000

Social categorizations, social comparisons and stigma: presentations of self in people with learning difficulties.

Self-categorization theory stresses the importance of the context in which the meta-contrast principle is proposed to operate. This study is concerned with how 'the pool of psychologically relevant stimuli' (Turner, Hogg, Oakes, Reicher & Wetherell, 1987, p. 47) comprising the context is determined. Data from interviews with 33 people with learning difficulties were used to show how a positive sense of self might be constructed by members of a stigmatized social category through the social worlds that they describe, and therefore the social comparisons and categorizations that are made possible. Participants made downward comparisons which focused on people with learning difficulties who were less able or who displayed challenging behaviour, and with people who did not have learning difficulties but who, according to the participants, behaved badly, such as beggars, drunks and thieves. By selection of dimensions and comparison others, a positive sense of self and a particular set of social categorizations were presented. It is suggested that when using self-categorization theory to study real-world social categories, more attention needs to be paid to the involvement of the perceiver in determining which stimuli are psychologically relevant since this is a crucial determinant of category salience.

Adolescent↗
PubMed2000

Context effects of facial appearance on attitudes toward mentally handicapped persons.

The influence of facial appearance on social attitudes was examined by exposing participants to the faces of three target persons with or without deviant facial features, posing happy, angry or sad facial expressions, or a mixture of these expressions. When they displayed negative emotional expressions, facially deviant targets were judged more negatively than non-deviant targets. Irrespective of emotional expression and level of personal experience, participants expressed more negative attitudes toward mentally handicapped persons in general after exposure to deviant faces than after exposure to non-deviant faces, or in the absence of exposure. However, correlational analyses suggested that only at low levels of personal experience were attitudes influenced by previously formed impressions of deviant exemplars. Results are discussed in terms of the motivational relevance of physical features in stigmatization, and context and exemplar effects in stereotyping and attitude measurement. Practical implications are also discussed.

Adolescent↗
PubMed2002

Are essentialist beliefs associated with prejudice?

Gordon Allport (1954) proposed that belief in group essences is one aspect of the prejudiced personality, alongside a rigid, dichotomous and ambiguity-intolerant cognitive style. We examined whether essentialist beliefs-beliefs that a social category has a fixed, inherent, identity-defining nature-are indeed associated in this fashion with prejudice towards black people, women and gay men. Allport's claim, which is mirrored by many contemporary social theorists, received partial support but had to be qualified in important respects. Essence-related beliefs were associated strongly with anti-gay attitudes but only weakly with sexism and racism, and they did not reflect a cognitive style that was consistent across stigmatized categories. When associations with prejudice were obtained, only a few specific beliefs were involved, and some anti-essentialist beliefs were associated with anti-gay attitudes. Nevertheless, the powerful association that essence-related beliefs had with anti-gay attitudes was independent of established prejudice-related traits, indicating that they have a significant role to play in the psychology of prejudice.

Adult↗
PubMed2002

Attitudes and intentions of homeless people towards service provision in South Wales.

The theory of planned behaviour (TPB: Ajzen, 1988, 1991) was used as a framework to investigate homeless people's participation in outreach service programmes. In total, 104 homeless people from South Wales were interviewed using a schedule based on the TPB. Congruent with previous research on the TPB, attitude was the dominant predictor of behavioural intentions, and intention and perceived behavioural control were predictive of behaviour. Contrary to predictions, subjective norms also exerted a direct effect on behaviour. The discussion focuses on two issues: first, the utility of social cognition models in explaining the relationship between demographic variables and behaviour in homelessness research; second, the direct effects of norms on behaviour and the extent to which work on social groups might usefully extend research on models such as the TPB to aid understanding of behaviour amongst stigmatized populations.

Adolescent↗
PubMed2004

Shame as a social phenomenon: a critical analysis of the concept of dispositional shame.

An increased clinical interest in shame has been reflected in the growing number of research studies in this area. However, clinically orientated empirical investigation has mostly been restricted to the investigation of individual differences in dispositional shame. This study reviews recent work on dispositional shame but then argues that the primacy of this construct has been problematic in a number of ways. Most importantly, the notion of shame as a context-free intrapsychic variable has distracted clinical researchers from investigating the management and repair of experiences of shame and shameful identities and has made the social constitution of shame less visible. Several suggestions are made for alternative ways in which susceptibility to shame could be conceptualized, which consider how shame might arise in certain contexts and as a product of particular social encounters. For example, persistent difficulties with shame may relate to the salience of stigmatizing discourses within a particular social context, the roles or subject positions available to an individual, the establishment of a repertoire of context-relevant shame avoidance strategies and the personal meaning of shamefulness.

Attitude↗
PubMed1997

On what basis hope? Modern progress and postmodern possibilities.

Modern and postmodern versions of hope as they apply to services for persons labeled as having mental retardation were examined. Proponents of modernism construct hope as relying on an ever-improving science to accurately comprehend mental retardation and other disabilities and the effectiveness of professional interventions. This myth of scientific progress is traced in various forms through American intellectual history to the development of special education as interventionist social science. Advocates of postmodernism cast doubt upon the grand narrative of modernism and critique modern social science as perpetuating stigmatized "mentally retarded" identities through the exercise of power. A rhetorical analysis of the current controversy over facilitated communication demonstrates the utilization of the language of modern science for its power effects in special education discourse.

Attitude to Health↗
PubMed2004

Structural violence and racial disparity in HIV transmission.

Among women of color in the United States, infection with the human immunodeficiency virus (HIV) is rising. Most of the research on this topic, however, has focused on individual-level risk factors, which do not fully explain racial or ethnic differences in infection rates. This article uses structural violence as a conceptual framework to examine ecological-level risk factors leading to disparate rates of heterosexually transmitted HIV among women of color in Syracuse, New York. Three ecological pathways to disproportionate infection are discussed: community rates of infection, concurrent partnerships, and increased vulnerability. The discussion of the pathways considers the following macro-level risk factors: disproportionate incarceration rates of African American men, residential segregation, gang turf, constraints on access to sexually transmitted disease services, an African American sex ratio in which women outnumber men, social norms stigmatizing homosexuality, and commercial sales of douching products. The authors argue that health care providers and policy analysts must address ecological-level risk factors for HIV transmission in underserved communities.

Black or African American↗
PubMed2006

Contested boundaries: psychiatry, disease, and diagnosis.

Since the 19th century, we have come to think of disease in terms of specific entities--entities defined and legitimated in terms of characteristic somatic mechanisms. Since the last third of that century, we have expanded would-be disease categories to include an ever-broader variety of emotional pain, idiosyncrasy, and culturally unsettling behaviors. Psychiatry has been the residuary legatee of these developments, developments that have always been contested at the ever-shifting boundary between disease and deviance, feeling and symptom, the random and the determined, the stigmatized and the value-free. Even in our era of reductionist hopes, psychopharmaceutical practice, and corporate strategies, the legitimacy of many putative disease categories will remain contested. The use of the specific disease entity model will always be a reductionist means to achieve necessarily holistic ends, both in terms of cultural norms and the needs of suffering individuals. Bureaucratic rigidities and stakeholder conflicts structure and intensify such boundary conflicts, as do the interests and activism of an interested lay public.

Criminal Law↗
PubMed2003

Variational analysis of z scan of thick medium with an elliptic Gaussian beam.

By variational approach, we analyze the characteristics of beam propagation through a cubic optical nonlinear medium using a laser beam that has a transverse elliptic Gaussian profile. The analytic solution to the normalized transmittance at the center of the far field as a function of medium position and the beam characteristics is obtained and compared with the numerical simulation, which is realized by a combination of algorithms. We also analyze the peak-valley transmittance difference as a function of medium length, ellipticity, and a stigmatism. The relationship between peak-valley normalized transmittance difference of the z-scan trace and aperture size or the slit width are obtained. Meanwhile, the comparison of z-scan characteristics with an elliptic Gaussian beam with those using a circular symmetric Gaussian beam is made.

Journal Article↗
PubMed2003

Optical design of a spectrometer-monochromator for the extreme-ultraviolet and soft-x-ray emission of high-order harmonics.

A grazing-incidence spectrometer-monochromator for diagnostics and application of the extreme-ultraviolet (EUV) and soft-x-ray high-order harmonics generated by the interaction between a few-optical-cycle laser pulse and a gas jet has been fabricated. We address the necessity of high-resolution spectral and spatial analyses of the high-order harmonics as well as their use as short EUV backlighters in pump-probe experiments. The spectrometer that we present uses a variable-line-spaced flat grating illuminated in the converging light coming from a toroidal mirror. The spectrum is stigmatic, and the focal surface is almost flat in a wide spectral region. The detector is a microchannel plate intensifier with a phosphor screen optically coupled to a CCD camera; it can be moved by means of a linear drive to acquire different portions of the spectrum in the 5-75-nm region. The resolution is almost limited by the pixel size of the detector. We apply the same optical scheme to achieve a constant-deviation-angle monochromator by substituting an exit slit for the detector block: The rotation of the grating gives the spectral scanning. A monochromator for the 5-50 nm spectral region is achieved.

Journal Article↗
PubMed2004

Imaging spectrograph for interstellar shocks: a narrowband imaging payload for the far ultraviolet.

We present an imaging spectrometer developed for narrowband imaging at 1035 A with high (approximately 1-arc sec) spatial resolution over a modest field of view (approximately 5 arc min). The instrument is based on a conventional Gregorian telescope with aberration-corrected holographic rulings on the secondary optic. These aberration-correcting rulings enable stigmatic imaging in diffracted light with a minimum number of optical elements, thereby maintaining a high system efficiency. The capabilities of this instrument allow us to map the distribution of UV-emitting material in the hot (approximately 300,000 K) plasma from shocks in supernova remnants. Although this design is optimized for imaging near 1035 A, the basic concept can be applied to provide narrowband imaging or long-slit imaging spectroscopy at any wavelength. In addition, a larger field of view is possible with a corresponding loss in spatial resolution.

Journal Article↗
PubMed2006

Propagation of hollow Gaussian beams through apertured paraxial optical systems.

On the basis of the generalized Collins formula and the expansion of the hard-aperture function into a finite sum of complex Gaussian functions, an approximate analytical formula for a hollow Gaussian beam propagating through an apertured paraxial stigmatic (ST) ABCD optical system is derived. Some numerical examples are given. Furthermore, by using a tensor method, we derive approximate analytical formulas for a hollow elliptical Gaussian beam propagating through an apertured paraxial general astigmatic ABCD optical system and an apertured paraxial misaligned ST ABCD optical system. Our results provide a convenient way for studying the propagation and transformation of a hollow Gaussian beam and a hollow elliptical Gaussian beam through an apertured general optical system.

Journal Article↗
PubMed2006

Routine HIV testing in Botswana: a population-based study on attitudes, practices, and human rights concerns.

BACKGROUND: The Botswana government recently implemented a policy of routine or "opt-out" HIV testing in response to the high prevalence of HIV infection, estimated at 37% of adults. METHODS AND FINDINGS: We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana to assess knowledge of and attitudes toward routine testing, correlates of HIV testing, and barriers and facilitators to testing, 11 months after the introduction of this policy. Most participants (81%) reported being extremely or very much in favor of routine testing. The majority believed that this policy would decrease barriers to testing (89%), HIV-related stigma (60%), and violence toward women (55%), and would increase access to antiretroviral treatment (93%). At the same time, 43% of participants believed that routine testing would lead people to avoid going to the doctor for fear of testing, and 14% believed that this policy could increase gender-based violence related to testing. The prevalence of self-reported HIV testing was 48%. Adjusted correlates of testing included female gender (AOR = 1.5, 95% CI = 1.1-1.9), higher education (AOR = 2.0, 95% CI = 1.5-2.7), more frequent healthcare visits (AOR = 1.9, 95% CI = 1.3-2.7), perceived access to HIV testing (AOR = 1.6, 95% CI = 1.1-2.5), and inconsistent condom use (AOR = 1.6, 95% CI = 1.2-2.1). Individuals with stigmatizing attitudes toward people living with HIV and AIDS were less likely to have been tested for HIV/AIDS (AOR = 0.7, 95% CI = 0.5-0.9) or to have heard of routine testing (AOR = 0.59, 95% CI = 0.45-0.76). While experiences with voluntary and routine testing overall were positive, 68% felt that they could not refuse the HIV test. Key barriers to testing included fear of learning one's status (49%), lack of perceived HIV risk (43%), and fear of having to change sexual practices with a positive HIV test (33%). CONCLUSIONS: Routine testing appears to be widely supported and may reduce barriers to testing in Botswana. As routine testing is adopted elsewhere, measures should be implemented to assure true informed consent and human rights safeguards, including protection from HIV-related discrimination and protection of women against partner violence related to testing.

AIDS Serodiagnosis↗
PubMed2001

Partnership, sexuality, and sexual disorders in morbidly obese women: consequences of weight loss after gastric banding.

BACKGROUND: A study was performed to determine what consequences surgery for morbid obesity has on sexual attitudes and partnership in obese female patients. METHOD: Semi-structured interviews concerning sociodemographic data, sexuality and relationship were conducted on 82 female patients preoperatively and at least 1 year postoperatively. RESULTS: Physical appearance played the main role in the decision to undergo weight reduction surgery in only 17% of the study patients. Postoperatively, half of the patients were satisfied with their physical appearance 1 year after surgery, the other half not. Preoperatively, 44% of the patients stated that sexuality with their partners was satisfying and the frequency of sexual intercourse was regular. Postoperatively, 63% of the patients stated that they enjoyed sex more, compared with 12% of the patients who enjoyed sex less than before surgery. Postoperatively, 20% of the patients reported that partnership had changed positively, 10% negatively. CONCLUSIONS: The results indicate that many of the sexual problems in obese individuals are the result of an underlying lack of self-esteem, unsatisfactory relationships, or collective stigmatization of obese individuals. Binge eating, often found in morbidly obese patients, seems to be less the result of or compensation for sexual problems but is more likely to stem from other psychosocial or psychological problems.

Adult↗
PubMed2003

Ethical issues raised by genetic testing with oligonucleotide microarrays.

Because genes and alterations within them determine the identity, characteristics, and inheritance of every individual, the application of genetic science to humans has long been surrounded by apprehension, controversy, and real or perceived potential for abuse. Crude eugenics practices of the past now find a theoretical rebirth and transformation through the use of modern molecular genetic technologies for mutation detection, predictive and prenatal diagnosis, and, ultimately, gene replacement. The advent of oligonucleotide microarray analysis, in which hundreds or thousands of genes and mutations can be tested in parallel, offers tremendous promise for more accurate, sensitive, and efficient genetic testing. At the same time, however, this powerful technology dramatically increases the number and scope of ethical concerns accompanying each individual test request. This article considers the evolution and implications of these concerns, from the initial ordering of a microarray test by the physician to such issues as informed consent, privacy, confidentiality, clinical utility, discrimination, stigmatization, ethnic and population impact, and reimbursement.

Confidentiality↗