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PubMed2000

Attitudes toward homosexuality: an overview.

In the last decade it has become clear that impairment of the psychological well-being of homosexuals has its origin in a society that discriminates and stigmatizes homosexuality. The article provides some basic information on homosexuality and continues with an overview of current knowledge on attitudes toward homosexuality. It gives special attention to the situation of homosexuality in Israel. Limited knowledge on the situation in Israel suggests that although there is an increase in tolerance toward homosexuality, it is not universally accepted and prejudice is common.

Attitude↗
PubMedDate not supplied

[Social views of mental diseases--results of research].

Social reactions for mental diseases are very complex, because contacts between healthy people and the ill ones are limited in our society. People are afraid of all symptoms of mental disability and they think that such people should be isolated in closed institutions. The majority of examined people (79%) think that mentally disabled should be cured. People of different age and level of education state such opinions with the same frequency. At the same time, the majority of examined people (88%), admit that the knowledge about mentally disabled in our society is insufficient. This conviction grows simultaneously with the level of education of respondents. The social idea of factors, which start or condition the formation of mental diseases is very schematic. This idea consists of four main elements i.e.: genetic conditions (heredity of disease), bad conditions of life, everyday stress and low psychical immunity. Although the declaration of openness, the majority of respondents represent low tolerance to problems of mentally disabled and their opinions stigmatize ill people.

Adult↗
PubMed2001

Health-related quality of life among persons with epilepsy--Texas, 1998.

Epilepsy is a central nervous system disorder characterized by unprovoked, recurrent seizures that may affect physical, mental, or behavioral functioning. In 1995, approximately 2.3 million persons residing in the United States had epilepsy. Approximately 181,000 new cases of epilepsy are diagnosed each year, with annual estimated costs of $12.5 billion in medical care and lost productivity. Because epilepsy has a substantial impact on health (e.g., physical and psychosocial difficulties, side effects of anticonvulsant therapy, lifestyle restrictions, and perceived stigmatization), self-reported physical and mental health-related quality of life (HRQOL) measures are useful in gauging the impact of epilepsy on persons with the disorder. Persons with chronic health disorders are at risk for impaired HRQOL. Few studies have examined the HRQOL of persons with epilepsy, and none has used a representative sample of adults residing in the United States. This report examines data from the 1998 Texas Behavioral Risk Factor Surveillance System (BRFSS) that included a question about epilepsy; findings indicate that persons with epilepsy reported substantially worse HRQOL than persons without epilepsy. Community-based interventions such as the Sepulveda Epilepsy Education Program that address medication self-management, psychosocial self-management, and other education interventions can improve the quality of life for persons with epilepsy.

Epilepsy↗
PubMed2001

Susceptibility markers in colorectal cancer.

Many susceptibility factors contribute to an individual's risk of developing colorectal cancer. Family history of colorectal cancer (particularly with early age of onset), maleness and increasing age are all factors associated with increasing risk. About three quarters of colorectal cancers are thought to be due to somatic mutations, and both high- and low-penetrance predisposing genes contribute to the remaining quarter of cases. Many of the highly penetrant dominant genes are known, but others remain to be identified. Describing the contribution of individual genes is likely to be very complex, as some modify the impact of other genes and other environmental factors rather than incurring a direct, easily attributable effect. The two dominant predisposing syndromes are familial adenomatous polyposis and Lynch syndrome, the first due to a mutant tumour-suppressor gene APC, and the second due to mutations in a number of genes responsible for mismatch repair in DNA at cell division. Establishing genetic susceptibility for colorectal cancer will soon be possible, and could save lives by allowing targetting of screening and the encouragement of preventive behaviours. However, there will always be a risk of making healthy people "sick" through the identification of predisposing genes, and there are many potential ways by which a gene carrier may be stigmatized by society, insurance companies and employers.

Aged↗
PubMed2000

Illness experience and coping with gynecological cancer among northeast Thai female patients.

This quantitative and qualitative study describes the illness experience and the coping mechanisms of cervical cancer patients. Interviews were performed with 208 cervical cancer patients to determine their health seeking behavior and illness beliefs. Most began their treatment at local health services and district hospitals, and sought treatment in up to four different places before coming to the University Hospital. Most of the respondents were not sure about the cause of cervical cancer, and waited to see their symptoms before seeking treatment. Most perceived their condition as at an early stage. The qualitative research consisted of interviews with 79 selected patients and identified stigmatization from family and community members, problems with sexuality, and varied belief in meaning and causation of the disease. Many of the problems faced were coped with because of support from husbands, family and the community. It is recommended that better recording of patient data would allow a better follow-up service, and improved information for relatives would help them to understand the patient's problems, with both of these contributing to a better recovery environment for patients.

Adaptation, Psychological↗
PubMed2003

The treatment of epilepsy in developing countries: where do we go from here?

Epilepsy is the most common serious neurological disorder and is one of the world's most prevalent noncommunicable diseases. As the understanding of its physical and social burden has increased it has moved higher up the world health agenda. Over four-fifths of the 50 million people with epilepsy are thought to be in developing countries; much of this condition results from preventable causes. Around 90% of people with epilepsy in developing countries are not receiving appropriate treatment. Consequently, people with epilepsy continue to be stigmatized and have a lower quality of life than people with other chronic illnesses. However, bridging the treatment gap and reducing the burden of epilepsy is not straightforward and faces many constraints. Cultural attitudes, a lack of prioritization, poor health system infrastructure, and inadequate supplies of antiepileptic drugs all conspire to hinder appropriate treatment. Nevertheless, there have been successful attempts to provide treatment, which have shown the importance of community-based approaches and also indicate that provision for sustained intervention over the long term is necessary in any treatment programme. Approaches being adopted in the demonstration projects of the Global Campaign Against Epilepsy--implemented by the International League Against Epilepsy, the International Bureau for Epilepsy, and the World Health Organization--may provide further advances. Much remains to be done but it is hoped that current efforts will lead to better treatment of people with epilepsy in developing countries.

Anticonvulsants↗
PubMed2001

Do Ashkenazi Jews have a higher than expected cancer burden? Implications for cancer control prioritization efforts.

BACKGROUND: Recent genetic susceptibility findings in Jews of Eastern European descent, commonly called Ashkenazi Jews, have led to concerns that they may be stigmatized as being more cancer prone than other groups. OBJECTIVE: To examine the hypothesis that site-specific or all-cancer incidence and mortality rates are higher than expected in Ashkenazi Jews worldwide when compared with referent populations. METHODS: A MEDLINE search was performed using keywords "Jews," "cancer," "incidence" and "mortality" to identify studies directly relevant to the primary study question. RESULTS: Little evidence suggested that all-cancer incidence or mortality is higher in Ashkenazi Jews than in North American non-Hispanic whites. Ashkenazi Jewish men appear to have relatively low cancer rates, which may be due to lower tobacco use. Colorectal cancer was shown to disproportionately overburden Ashkenazi Jews, who may also be at increased risk for ovarian, pancreatic and stomach cancer, and non-Hodgkin's lymphoma. Little evidence was found supporting an elevated risk of breast cancer in Ashkenazi Jewish women. Rates of lung, cervical, penile and prostate cancers appear low in this population. Rate disparities were generally attributed to lifestyle differences, particularly diet and tobacco use, rather than to genetic predisposition. CONCLUSIONS: Ashkenazi Jews do not appear to have a higher total cancer burden than comparable North American populations. Any cancer rate differentials in this group are more likely to be related to lifestyle and dietary factors than to genetics. However, colorectal cancer rates in Ashkenazi Jews may be the highest of any ethnic group in the world and cancer controllers should consider this when developing future screening, diagnostic and policy strategies.

Humans↗
PubMed2001

Nutritional factors on longevity and quality of life in Japan.

The relationship of nutrient intakes to life expectancies in Japan since the Second World War has demonstrated that sufficient intakes of animal protein and fat are crucial for attaining longevity. In the community dwelling elderly, the higher the serum albumin was, the longer the further life expectancy in the elderly. Serum total cholesterol showed a U-shape relationship to further life expectancies in the elderly. Low serum cholesterol was deleterious for higher levels of functional capacity. Low serum cholesterol and low serum alpha-tochopherol accelerated depressive status in the community dwelling elderly. For reducing malnutrition and for improving nutritional status in undernourished elders, we carried out intervention trials. Instructions on how to prepare ideal daily meals were useful in functionally independent elders because a certain group of Japanese elderly has been stigmatized for eating meat. In frail elders provided with daily meals in a nursing home, a digestive enzyme drug was helpful for enhancing serum albumin levels.

Aged↗
PubMed2001

[Female genital mutilation meets Swedish health care. Female genital mutilation is one of many forms of discrimination of women in the world].

About 27,000 women from countries in which female genital mutilation (FGM) is a common practice are presently living in Sweden. This means that FGM is a phenomenon that directly affects the Swedish health care system. Knowledge and understanding of the background, meaning and consequences of FGM are a prerequisite for effective prevention, proper clinical handling and supportive reception of the women. To avoid a stigmatizing reception it is also important to understand the situation of genitally mutilated women, and to become aware of the identity crisis many of them experience when they come to Sweden and lose their identity as "normal" women. It is essential to remember that female genital mutilation is one of many forms of discrimination affecting girls and women around the world. This discrimination knows no national or cultural borders and varies in expression and extent. In order to offer optimal care and reception of women who have been socialized into a gender role that is often seen as completely different from the gender role that Swedish society is said to embrace, it is of the utmost importance to first take a critical look beneath the veil of alleged gender equality of Swedish women.

Circumcision, Female↗
PubMed2001

[Modern psychiatric service and criteria for the estimation of its activity].

During the last decade the efforts of psychiatrists and managers of psychiatric service were directed to solving the problem of modern system of psychiatric care and its quality. In Russia the problem has to be solved under conditions of both social instability and economic crisis. The paper presents the data concerning investigation of the problem in terms of epidemiological, social, economic, ethical-juridical and organization criteria. The author concluded that the significant criteria for efficiency of the psychiatric service activity may be the following: satisfaction of the patients with this service; quality of their life; the degree of social integration; the level of their stigmatization in the society; the data about consequences of mental diseases for the family and the society; scientific-founded standards of medical-diagnostic and medical social aid. Social support and care of mentally ill patients and members of their families are essential in modern psychiatry.

Commitment of Persons with Psychiatric Disorders↗
PubMed2001

Benefits and barriers associated with participation in food programs in three low-income Ontario communities.

Our objective was to identify the benefits and barriers associated with participation in food programs. We did a content analysis of focus groups with parents (n=21), teachers (n=10), project staff (n=21), and children (n=17) in three low-income Ontario communities. The key benefits identified by the three adult groups were hunger alleviation and social contact opportunities for both parents and children. Parents also benefited from volunteering with and/or participating in food programs because neighbourhood support networks developed. Teachers reported that children who attended breakfast programs became more attentive in school. The food programs also provided an opportunity for nutrition education. Offering food as part of all community programs (not just those designed to increase food availability) encouraged participation and increased attendance. Children thought that attending food programs kept them healthy, and helped them work harder in school. Parents' pride was the main barrier to participation in programs; however, parents who were actively involved in program delivery did not feel stigmatized accepting food. To encourage participation, nutrition professionals should collaborate with local residents to develop and implement community-based food programs.

Adolescent↗
PubMedDate not supplied

[Ratio between suicides and attempted suicides in the area of the Bjelovar-Bilogora District].

The aim of this paper was to point out the differences between groups of suicide attempters and suicides in prewar period in the Bjelovar-Bilogora county. The data about suicide attempt in patients were assembled from the Psychiatry Department of Bjelovar General Hospital in 1988-1990 period. The data about committed suicides in 1988-1998 period were assembled from Bjelovar-Bilogora police administration. That enabled the analyses of suicides realisation in a suicide attempters group. Sex rate differences were explained by differences in sex roles. Proportional relation between suicide and age and reverse proportional relation between suicide attempts and age was due to biological and psychosocial characteristics of the young and the old. Relation between self-destructive behaviour and appeal in suicidal behaviour was emphasized. Male suicide attempters were more often under the influence of alcohol which reflected alcoholism in general population. In suicide attempts men chose severe means more often than women. More frequent diagnosis of personal disorder in male suicide attempt group was explained by three factors: 1. Higher frequency of antisocial personal disorder in male population; 2. Psychiatrist tendency to avoid stigmatization of patients with personal disorder diagnosis, which has negative connotation of old concept of psychopathy; and 3. Psychiatrist tendency to use this diagnosis only for more serious forms of disruptive behaviour, such as antisocial personal disorder. Three characteristics were pointed out: 1. Low social sensitivity for suicidal behaviour; 2. Failure to instruct individuals to seek psychiatrist help; and 3. Individual hesitation to seek that help. This emphasized the need for the development of non-hospital psychiatry service, as well as the organization of continual psychiatric monitoring of regional epidemiological suicide data.

Adult↗
PubMed1998

An exile in my own country: the confinement of leprosy patients at the United States National Leprosarium.

Leprosy is a disease which has long been stigmatized and persons afflicted with it have frequently been segregated from the rest of society. This paper focuses on the evolution of policies concerning the confinement of patients at the national leprosarium operated by the United States Public Health Service (PHS) at Carville, Louisiana. After a brief review of the origins of the Lousiana Leper Home, which eventually became the national leprosarium, the paper traces changing attitudes and policies at Carville from 1921, when the PHS took control of the facility, to the 1950s.

Custodial Care↗
PubMedDate not supplied

Strengthening the roles of existing structures by breaking down barriers and building up bridges: intensifying HIV/AIDS awareness, outreach, and intervention in Uganda.

A major repercussion of the HIV/AIDS epidemic is the challenge of caring for the children who have been dramatically affected by watching their parents fall sick, become incapacitated, lose their jobs, become stigmatized, and die. The biopsychosocial impact on these children is compelling. The Eaglets Child Welfare Project is working to identify community-based problem-solving strategies to address the needs of children orphaned by HIV/AIDS. This article describes the impact of the epidemic, the project's methodology, and lessons learned to assist in bringing down barriers and building bridges.

Adolescent↗
PubMed2001

[Characteristics of mental status of patients with neurocirculatory dystonia].

AIM: To specify forms of severity of mental disorders in neurocirculatory asthenia (NCA) for more precise differentiation between NCA as a nosological entity and syndrome. MATERIAL AND METHODS: The examination including specially-designed interview, ECG, echo-CG, orthostatic and hyperventilation tests, bicycle exercise, consultation of the psychiatrist, psychological tests covered 80 NCA patients (31 men, 49 women, mean age 29.2 +/- 9.08 years). RESULTS: NCA is characterized by the absence of a clear link with psychoemotional stress, seasonal disease aggravations, weakness, dizziness, negative results of orthostatic and hyperventilation tests. Among NCA criteria, dominating are "additional signs". Patients with anxio-fobic, panic, anxio-depressive neurotic disorders are characterized by strong relations between manifestation, subsequent disease exacerbations with psychogenia; attack-like NCA manifestation, prevalence of "basic signs" among diagnostic criteria (cardialgia, pulse and blood pressure lability, nonspecific alterations of T wave, positive orthostatic and hyperventilation tests). CONCLUSION: NCA presents at least with two variants. In the first variant NCA picture is characterized by hereditary or early acquired vegetative stigmation and secondary neurotic disorders; the second variant presents as a clinically formed illness in which NCA symptoms manifest as a syndrome which is a leading component of a mental disease.

Adult↗
PubMed2001

Nursing directors. Great barrier reach.

A survey of nurse directors showed that only half of those who had applied for chief executive posts had been shortlisted. As many as 70 per cent of respondents said that nurse directors are prevented from becoming chief executives because they are stigmatized. Gender was identified as a barrier by 43 per cent of respondents.

Administrative Personnel↗
PubMed2001

[Floral biology and pollinators of Trichocereus pasacana (Cactaceae) in Parque Nacional Los Cardones, Argentina].

Many columnar cacti are bat pollinated. It has been suggested that this kind of pollination would be more important in tropical than in temperate regions where flowers are open only one night. Thrichocereus pasacana produces big and resistant white flowers. We analyzed flower characteristics, floral cycle, stigmatic receptivity, nectar production, pollen presence and floral visitors in a T. pasacana population at National Park Los Cardones (Salta, Argentina) in November 1997. Flower features were constant between individuals of the population. Flowers start opening at evening and anthesis time is from 18 to 40 hs. The estigma was receptive throughout the floral cycle. Anther dehiscence occurs with flower opening. Nectar production was highest between 18 to 24 hs. Although T. pasacana are open during the night, floral visitors are diurnal. The most frequent was Xylocopa sp. In the study area, nectarivorous bats were not detected. The morphological features of T. pasacana flowers were similar but bigger compared to other columnar cacti. Anthesis time was also longer while nectar production was lower. T. pasacana pollination at National Park Los Cardones is done by bees.

Animals↗
PubMed2001

[HIV in pregnancy].

Since the start of the HIV epidemic, over 36 million people have been infected with the virus worldwide. As the virus is predominantly transmitted through sexual contact, equal numbers of males and females are infected, mainly young people of reproductive age. Hence, there is a growing number of HIV positive children infected during pregnancy, delivery or through breastmilk. Untreated 20-40% of infants born to HIV infected mothers will be infected as well, whereas a combination of antiretroviral medication during pregnancy, elective Caesarean section and bottle feeding can reduce the risk of vertical transmission to below 2%. Although the above mentioned intervention are widely used in the industrialised world, implementation seems difficult in developing countries because of political, financial, logical and societal factors. Screening of pregnant women and identification of HIV positive mothers can result in violence, rejection and stigmatization, and has to be put in the balance of programmes aiming at reducing the number of infected children. Hence, further research in to affordable, feasible and locally acceptable interventions for the reduction of mother-child HIV transmission is a priority. In addition, primary prevention, mainly aiming at behavioural changes of youngsters, remains crucial.

Adult↗