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PubMedDate not supplied

[Being a nurse in a transcultural context].

This is a descriptive and exploratory study developed according to a qualitative approach, aiming at discovering how male nurses are seen by the family and other professionals regarding their profession. Also, it has observed their technical vision about this problem. This research was done with male nurses from the Master Degree Course in Public Health Nursing at the Federal University of Paraíba. The population of this study was composed of six male nurses from which four agreed in taking part in this research. The data were collected through a questionnaire with open questions, based on the Leininger Transcultural Theory. The results showed that a great shock and cultural impositions among the male nurses, who have suffered a great variety of misconceptions and stigmatized assumptions from different social actors.

Attitude to Health↗
PubMedDate not supplied

[HIV/AIDS-related stigma and discrimination: the case of health care providers in México].

OBJECTIVE: To analyze the social construction of stigma and discrimination processes associated with HIV/AIDS and people living with HIV/AIDS (PLHA), based on the perceptions of health care providers in three states of the Mexican Republic. MATERIAL AND METHODS: Qualitative and quantitative description. Observation at nine institutions; in-depth interviews (14) and surveys (373) directed to providers of health services. RESULTS: Seventy-five percent of providers reported having received training related to HIV/AIDS; however, notions persist as to patients being hopeless; discrimination due to the idea of risk groups; the immediate identification of living with the virus, having the syndrome and death; and specific lack of knowledge of forms of transmission. Twenty-three percent would not buy food from a PLHA and 16% think they should be banned from public services. With respect to confidentiality: 89% believe it should be maintained and 38% think that employers and administrators have the right to know about their employees' condition. Isolation, notes in clinical histories pointing to HIV, obligatory testing and delays in surgeries for PLHA were constant practices. The perception that men who have sexual relations with men and sexual workers decide their sexual practices marks the division between innocent victims and guilty ones, which determines the stigmatization and discrimination processes in health services. CONCLUSIONS: The design of strategies to decrease stigma and discrimination associated with HIV/AIDS demands the inclusion of an ethical debate about human rights and a structural focus regarding social conditions that go beyond the notion of risk behaviors.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Reactional states in multibacillary Hansen disease patients during multidrug therapy.

It is well known that reactions are commonplace occurrences during the course of leprosy disease. Stigmatization may even be attributable to reactions which are also responsible for the worsening of neural lesions. A cohort of 162 newly-diagnosed baciloscopically positive patients from the Leprosy Care Outpatient Clinic of the Oswaldo Cruz Foundation (FIOCRUZ) was selected for this study. While 46% of the multibacillary (MB) patients submitted to the 24 fixed-dose multidrug therapy (MDT) regimen suffered reactions during treatment, it was found that all MBs were susceptible and that constant attention and care were required at all times. Fourteen per cent were classified as BB, 52% as BL, and 33% as LL. None of the variables under study, such as, sex, age, clinical form, length of illness, length of dermatological lesions, baciloscopic index (BI), or degree of disability proved to be associate with reaction among the patients studied. Reversal Reaction (RR) occurred in 45%, and Erythema Nodosum Leprosum (ENL) occurred in 55%. Among BB patients who developed reactions (15 patients), 93% presented RR; while among the LL patients who developed reactions (34 patients), 91% presented ENL. Likewise, ENL was very frequent among those with disseminate lesions, while RR was most often observed in patients with segmentary lesions. RR was also most likely to occur during the initial months of treatment. It was demonstrated that the recurrence rate of ENL was significantly higher than that of RR. Neither grade of disability nor BI was shown to be associated with RR and ENL reaction. However, the RR rate was significantly higher among patients showing BI < 3, while ENL predominated among those patients with BI > 3.

Adolescent↗
PubMed1997

[Risks and benefits of genetic screening: the sickle cell trait as a model in a Brazilian population group]

Population screening of asymptomatic heterozygotes for genetic guidance purposes is a very controversial procedure due to the risk of labeling, discrimination, stigmatization, loss of self-esteem, and invasion of privacy. Effects of genetic counseling supplied to blood donors with the sickle cell trait (AS heterozygotes) were investigated. Ninety-two AS donors were invited by letter to a free, individual orientation session; 66 of them (72%) accepted the invitation. Some 50% of the individuals brought their wives and children for examination, thus allowing identification of several at-risk couples (13%) and children with sickle cell anemia (5%). Six months afterwards 43 AS donors (65%) were reevaluated, whereby it was observed that the information had been well assimilated. The theoretical risks of genetic screening did not appear to be cause for concern in most of the cases examined. However, signs of stigma, labeling, discrimination, loss of self-esteem, and invasion of privacy were evidenced in a few cases.

Journal Article↗
PubMedDate not supplied

["Knowing about AIDS" and sexual precautions among low-income women from the southern area of Buenos Aires. Notes for defining prevention policies].

This study is part of a line of research on gender and prevention in a research program on the social construction of HIV/AIDS. We present the results of an ethnographic study among low-income women 15-35 years old in the southern area of Buenos Aires. The area has the highest number of HIV/AIDS cases and high poverty levels, extensive social degradation, and urban violence. According to our results, in the interface between "knowing about" and "behaving" there are complex processes involving stigmatized and gender-biased representations of HIV/AIDS as "other people's problem" and social and sexual relations permeated by gender stereotypes and roles. We believe that planning of prevention should be based on the consideration of overall social practices and specifically the characteristics of gender relations, prioritizing relational strategies between women and men and promoting critical reflection on the main nodes organizing daily life and active participation in the production of social relations and practices of reciprocity and equity. The increasingly precarious conditions in social life intensifies poor women's vulnerability and social interaction contexts that relate to the socioeconomic and symbolic role played by women.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Community genetics and hemophilia in a Brazilian population].

Hemophilia is an important hemorrhagic disease in Brazil, affecting about 1 out of every 10,000 males. Patient's self-perception of hemophilia and interaction with the community are relevant to the clinical management of this disease. We investigated several social, psychological, and community aspects of hemophilia in a Brazilian population (Campinas, São Paulo State), interviewing 30 hemophiliac males, a control sample comprised of 73 non-hemophiliac brothers, and 641 individuals from the community. According to our results, more severe social disability in the hemophiliac patient was related to economic factors, mainly unemployment; however, no difference was found in relation to marital status, reproduction, or education. Self-perception of changes in health and lifestyle by individuals with hemophilia showed frequent self-stigmatization, along with depression, anxiety, and insecurity. The community showed a widespread lack of familiarity with hemophilia (49%), viewing people with hemophilia with the kinds of prejudices often observed in relation to people with infectious diseases, like AIDS. The paper concludes by recommending that a community-based program be implemented to improve the social adjustment status of individuals with hemophilia.

Adult↗
PubMed2004

[Audio Computer-Assisted Interview: a new technology in the assessment of sexually transmitted diseases, HIV, and drug use].

Reliable responses are crucial when applying questionnaires on sensitive and stigmatized behaviors. This challenge has motivated researchers to develop new data collection methods. We conducted a systematic literature review on the implementation, effectiveness, reliability, and validity studies of ACASI (Audio Computer-Assisted Interview) in the assessment of drug use and sexual behavior. We reviewed 24 papers, none of which published by Brazilian researchers, and only three of which describing research implemented outside the United States. The studies showed that the computerized method is able to reduce psychological barriers linked to the collection of sensitive health-related information, thereby increasing its reliability. According to the surveys, the ACASI format is a fast and valid assessment method for large samples. ACASI generates databanks that can be easily processed and analyzed.

Attitude to Computers↗
PubMed2006

[Re-signifying pain, overcoming loneliness: childbirth experiences among working-class adolescents in a public maternity hospital in Salvador, Bahia, Brazil].

This article examines childbirth in a public maternity hospital in Salvador, Bahia, Brazil, from the perspective of young and adolescent women, mostly black and working-class. As an anthropological study, it is based on the analysis of birth narratives and hospital ethnography, especially in the obstetric ward. The women describe labor as dominated by fear, loneliness, and pain. These feelings are transformed into love with the birth of the child. Viewing childbirth as a biosocial process, the authors show how the young women construct meanings during the birth; meanwhile, social interactions specific to hospital birth develop, particularly with healthcare professionals. Symbolically, women construct birth as a rite of passage legitimating motherhood, against the institution's effective de-legitimization of sexual reproduction in low-income black mothers and stigmatization of adolescent motherhood.

Adolescent↗
PubMedDate not supplied

[Building the meaning of disease recurrence: experience of women with breast cancer].

Regarding recurrence as a possibility in the lives of women with breast cancer, this work aimed at identifying how they construct the meaning of such possibility from their own existence. The study was based on the conceptions of symbolic interactionism and the content analysis of interviews with 12 mastectomized women was used. The possibility of recurrence was present in the lives of the women under study. It was configured by the uncertainty that they experienced and represented in the thematic units identified in their accounts when they stated to be "living with a stigmatizing disease", "experiencing a negative feeling" and "facing prejudice".

Breast Neoplasms↗
PubMed2005

Popular conceptions of schizophrenia in Cape Verde, Africa.

INTRODUCTION: It has been well documented that schizophrenia presents a better clinical course in developing countries. Although there are many epidemiological studies showing this association, little research has been conducted to investigate the local representation systems for schizophrenia in these countries. OBJECTIVES: This study focuses on cultural factors of schizophrenia, namely the local representation systems for the disease, as well as what is locally understood as deviant behavior and its acceptability, and mechanisms of social-cultural insertion or exclusion of patients with schizophrenia in Cape Verde, Africa. METHODS: Randomized open interviews were carried out with the relatives of patients under treatment at the mental health out patient service of the Batista de Sousa Hospital (São Vicente Island) between the years 1994 and 1995. Interviews dealt with patients' life histories and disease related to problems, strategies employed by the family to cope with such problems, and comments on the social and family burden. RESULTS: 20 interviews with close relatives of 10 patients were analyzed. The study focused on three main categories explaining schizophrenia: "tired head" (cabeça cansada), "nervous" (nervoso), and supernatural categories (like "sorcery" or "witchcraft"). The interviewees expressed their opinions, either explicitly or not, on whether their relatives truly had a disease. CONCLUSION: Characteristics of local categories for schizophrenia found in Cape Verde can be regarded as a less stigmatized way of dealing with the disease. It is reasonable to suppose that the understanding of such cultural factors could lead to better outcomes in the treatment for schizophrenia in this country, and also in others, where similar conditions can be identified.

Adolescent↗
PubMed2000

Repairing the cleft lip nasal deformity.

OBJECTIVE: The repair of the cleft lip nose and nasal deformity remains a challenging endeavor for reconstructive surgeons. Psychosocially, this complex, multifaceted deformity significantly stigmatizes the patient. Numerous techniques have been advocated by multiple authors for the treatment and reconstruction of these deformities, usually requiring serial staged reconstructions. METHOD: Described is our technique for early primary repair of the cleft lip nasal deformity. The use of multiple suspension sutures to repair the nasal defect facilitates the repair of even very wide cleft lips. CONCLUSIONS: These maneuvers provide an aesthetic and functional repair of the nasal defect in conjunction with the lip repair. Long-term results have minimized the need for surgical revision.

Cleft Lip↗
PubMed2001

Effect of bumble bee (Hymenoptera: Apidae) pollination intensity on the quality of greenhouse tomatoes.

Laboratory studies were conducted to assess tomato, Lycopersicon esculentum Mill. (Solanaceae), quality in relation to the level of buzz-pollination by bumble bees. Studies were conducted in commercial tomato greenhouses in the Leamington, Ontario, area to categorize bruising of tomato anther cones by bumble bees into five levels of bruising. The number of pollen grains per stigma was determined for each bruising level, and the bruising level was found to be a good predictor of stigmatic pollen load. Experimental flowers were pollinated by bumble bees and assigned to bruising levels based on the degree of anther cone discoloration. Fruit set, tomato weight, minimum diameter, the number of days until ripe, roundness, weight, percentage sugars, and number of seeds were assessed and compared among bruising level. Fruit set in flowers receiving no pollination visits was 30.2%, whereas, 83.3, 84.4, 81.2, and 100% of the flowers set fruit in bruising levels 1, 2, 3, and 4, respectively. Minimum diameter, number of seeds, and tomato weight all increased from no bruising to different levels of bruising. There was no increase in weight or diameter above a bruising level of 1, and no increase in the number of seeds per fruit after a bruising level of 2. We found that pollination of tomato flowers greater than a bruising level of 2 (corresponding to approximately one to two bee visits) did not result in a significant increase in quality.

Animals↗
PubMed2006

HIV/AIDS and other infectious diseases among correctional inmates: transmission, burden, and an appropriate response.

Correctional inmates engage in drug-related and sexual risk behaviors, and the transmission of HIV, hepatitis, and sexually transmitted diseases occurs in correctional facilities. However, there is uncertainty about the extent of transmission, and hyperbolic descriptions of its extent may further stigmatize inmates and elicit punitive responses. Whether infection was acquired within or outside correctional facilities, the prevalence of HIV and other infectious diseases is much higher among inmates than among those in the general community, and the burden of disease among inmates and releasees is disproportionately heavy. A comprehensive response is needed, including voluntary counseling and testing on request that is linked to high-quality treatment, disease prevention education, substance abuse treatment, and discharge planning and transitional programs for releasees.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Temporarily detained: tuberculous alcoholics in Seattle, 1949 through 1960.

Repeatedly noncompliant tuberculosis patients (who are often homeless or substance users) are once again being forcibly detained. Health officials intend that confinement be used only when "less restrictive alternatives" have failed. Past programs of detention can inform current efforts. In 1949, Seattle's Firland Sanatorium established a locked ward. Although initially intended only for active public health threats, the ward was eventually used to maintain order among Firland's alcoholic patients. That is, the staff detained alcoholics--regardless of their infectivity or compliance with medications--for breaking sanatorium rules. In this manner, maintaining institutional order became a legitimate reason for invoking public health powers. Although new detention regulations strive to protect patients' civil liberties, attention must also be paid to the day-to-day implementation of coercive measures. When public health language is used to justify administrative or institutional requirements, disadvantaged patients may be stigmatized.

Alcoholism↗
PubMed2000

New NHLBI clinical guidelines for obesity and overweight: will they promote health?

OBJECTIVES: The purpose of this study was to assess the justification, on the basis of mortality, of the new National Heart, Lung, and Blood Institute (NHLBI) guidelines on obesity and overweight and to discuss the health implications of declaring all adults with a body mass index of 25 through 29 "overweight." METHODS: The relationships between NHLBI body mass index categories and mortality for individuals older than 31 years were analyzed for 6253 Alameda County Study respondents aged 21 through 75 years. Time-dependent proportional hazards models were used to adjust for changes in risk factors and weight during follow-up. RESULTS: Adjusted relative risks of mortality for 4 NHLBI categories compared with the category "normal" indicated that only being underweight or moderately/extremely obese were associated with higher mortality. Specific risk varied significantly by sex. CONCLUSIONS: Our results are consistent with other studies and fail to justify lowering the overweight threshold on the basis of mortality. Current interpretations of the revised guidelines stigmatize too many people as overweight; fail to account for sex, race/ethnicity, age, and other differences; and ignore the serious health risks associated with low weight and efforts to maintain an unrealistically lean body mass.

Adult↗
PubMed2002

HIV-related stigma and knowledge in the United States: prevalence and trends, 1991-1999.

OBJECTIVES: This study assessed the prevalence of AIDS stigma and misinformation about HIV transmission in 1997 and 1999 and examined trends in stigma in the United States during the 1990s. METHODS: Telephone surveys with national probability samples of English-speaking adults were conducted in the period 1996 to 1997 (n = 1309) and in 1998 to 1999 (n = 669). Findings were compared with results from a similar 1991 survey. RESULTS: Overt expressions of stigma declined throughout the 1990s, with support for its most extreme and coercive forms (e.g., quarantine) at very low levels by 1999. However, inaccurate beliefs about the risks posed by casual social contact increased, as did the belief that people with AIDS (PWAs) deserve their illness. In 1999, approximately one third of respondents expressed discomfort and negative feelings toward PWAs. CONCLUSION: Although support for extremely punitive policies toward PWAs has declined, AIDS remains a stigmatized condition in the United States. The persistence of discomfort with PWAs, blame directed at PWAs for their condition, and misapprehensions about casual social contact are cause for continuing concern and should be addressed in HIV prevention and education programs.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Two new species of diplosoma (Ascidiacea: Didemnidae) bearing prokaryotic algae prochloron from Okinawajima (Ryukyu Archipelago, Japan).

Two new species of didemnid ascidians, Diplosoma ooru sp. nov. and Diplosoma simileguwa sp. nov., are described from coral reefs on Okinawajima (Ryukyu Archipelago, Japan). These two species form green colonies, having a symbiotic association with a prokaryotic alga Prochloron sp. The former species was found at the reef edges in the subtidal zone and the latter was found in a shallow reef lagoon. In these species, the colonies are thinner and the zooids are smaller than those of any other Prochloron-bearing Diplosoma species so far described. Moreover, each of the present new species has a unique combination of stigmatic numbers: 5 stigmata in the first and third rows, 6 in the second row, and 4 in the fourth in D. ooru; 4 stigmata in the first and third rows, 5 in the second row, and 3 in the fourth in D. simileguwa. In both of the new species, the retractor muscle emerges from the underside of the thorax. Larval morphology of D. ooru is also described.

Animals↗
PubMed2001

Vitiligo. Pathogenesis and treatment.

Vitiligo is an acquired skin disorder caused by the disappearance of pigment cells from the epidermis that gives rise to well defined white patches which are often symmetrically distributed. The lack of melanin pigment makes the lesional skin more sensitive to sunburn. Vitiligo can be cosmetically disfiguring and it is a stigmatizing condition, leading to serious psychologic problems in daily life. It occurs worldwide in about 0.5% of the population and it occurs as frequently in males as it does in females. The cause is unknown, but might involve genetic factors, autoimmunity, neurologic factors, toxic metabolites, and lack of melanocyte growth factors. Since a causative (gene) treatment is not (yet) available, current modalities are directed towards stopping progression and to achieving repigmentation in order to repair the morphology and functional deficiencies of the depigmented skin areas. Many treatments have been used for some time; however; there are some new developments: narrowband ultraviolet (UV) B (311 nm) therapy, the combination of corticosteroid cream + UVA therapy, and the transplantation of autologous pigment cells in various modalities. In widespread vitiligo, residual pigment can be removed by depigmentation agents. Sunscreens, camouflage products, and good guidance may help the patient cope better with the disease.

Androstadienes↗