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At least 1,657 records · Page 92Linked to original sources
PubMed2003

Triple jeopardy: targeting older men of color who have sex with men.

This article presents selected findings from a needs assessment conducted for a community-based organization in Chicago that targeted black and Latino men 50 years and older who have sex with men (MSM). A convenience sample of 110 self-identified minority MSM was recruited through agency sources and administered a 73-question survey. Most men surveyed (>90%) reported sex with other men, with 20% reporting unprotected receptive anal sex and most reporting drug use in conjunction with sex. The data showed varying sexual self-identification, with 45% identified as either bisexual or mostly or completely straight and a substantial proportion (36%) reporting sexual activity with women. A large percentage disclosed being relatively secretive about their same-sex behaviors to others, however, and ranked homosexual-related and HIV-related stigma high. Most men (74%) perceived themselves to be at minimal risk for contracting HIV infection, and 50% ranked their level of worry about contracting HIV infection as low. Noteworthy among the findings were the linked variables of age and race, revealing that older minority MSM may be at elevated risk because they are sexually active, often have multiple partners, and include drug use as part of their sexual episodes. Race and age also may play an important role in determining patterns of sexual identity formation, whether older minority MSM disclose same-sex practices to others or perceive gay-related or HIV-related stigmatization. Implications of these data for interventions targeting older minority MSM suggest the need for culturally sensitive and specific dissemination of basic HIV prevention information and promotion of HIV testing.

Acquired Immunodeficiency Syndrome↗
PubMed2003

HIV lipodystrophy: risk factors, pathogenesis, diagnosis and management.

HIV lipodystrophy is a heterogeneous syndrome, which has yet to be objectively defined, comprising peripheral lipoatrophy, central fat accumulation and lipomata, along with hyperlipidaemia, insulin resistance and lactic acidaemia. Both nucleoside analogues and protease inhibitors are involved, but there are also host factors that probably place some patients at greater risk. The pathogenesis is increasingly understood, with evidence of interference of several regulatory proteins such as sterol regulatory enhancer binding protein-1, the proteasome, mitochondrial DNA polymerase gamma and GLUT-4. Along with the issues of cosmesis and stigmatization, a principal clinical concern that arises with lipodystrophy is a possible increased risk of accelerated atherosclerosis. A variety of therapeutic interventions, designed to limit these risks, are under evaluation, but none is conclusively shown to be of value.

HIV-Associated Lipodystrophy Syndrome↗
PubMed2002

The effect of epilepsy on emotional state in Hamilton and Beck questionnaire studies.

Patients with epilepsy present higher rate of psychological and psychiatric problems and emotional disturbances are estimated as the most frequent ones with prevalence of depression about tree times higher than it was observed in general population. In the presented study the occurrence of depressive symptoms was compared in a total of 60 adult patients with newly recognized and chronic epilepsy during remission of illness as well as pharmacoresistant. 21-items Hamilton Depressive Scale and Beck Depressive Inventory were applied once in each testified patient, consecutively by a physician or a patient himself during interictal period. Our study has found a higher level of depressive signs in newly diagnosed than in chronic patients during remission of illness but also in patients with an active process. The scoring rates both on HDRS and BDI were respectively characteristic of moderate or mild intensity of depressive disturbances. This comparison allows us to make a suggestion that diagnosis of epilepsy with its well-known stigmatization and limitations of different life activities may act as a stressing factor that enhances anxiety and depressive reactions in early phase of illness.

Adult↗
PubMed1992

[Familial supravalvular aortic stenosis].

By means of two dimensional echocardiography supravalvular aortic stenosis was diagnosed in two siblings and their cousin. Autosomal dominant transmission with incomplete penetrance or even non-penetrance is assumed to be involved. Somatic stigmatization, typical for Williams' syndrome, failed to be present in the affected children. The reported family provides further evidence that familial supravalvular aortic stenosis and Williams' syndrome are two distinct clinical entities. (Tab. 1, Fig. 3, Ref. 23.)

Aortic Valve Stenosis↗
PubMedDate not supplied

Anal incontinence: evaluation and biofeedback therapy.

Incontinence is a very stigmatizing symptom in our society. About 1% of the adult population is affected by fecal incontinence. In the evaluation anorectal manometry and defecography play a major role. Therapy often is still disappointing. In recent years simple retaining or biofeedback therapy have been reported to improve about 70% of incontinent patients. Within one year we treated 19 patients. Success was achieved in 69%. Biofeedback training, therefore, should be attempted prior to considering surgery.

Biofeedback, Psychology↗
PubMed1958

Medico-legal aspects of traumatic epilepsy.

The medico-legal problems of cranial injuries require a broad assessment of many factors, not always related to the nervous system, and a nicety of judgment in correctly evaluating the role of each factor in relation to all of them. Seizures in the period immediately after trauma are not necessarily precursors of later development of epileptic attacks. If such seizures do occur, it can be said in general, from statistical data, that the sooner they occur after injury the less the likelihood of disabling attacks later. It would seem a reasonable medical probability that if a patient has no neurological symptoms or deficit, has a normal electroencephalogram and has gone two years after injury without evidence of seizures, he will not have epilepsy. Putting a label of "post-traumatic epilepsy" on a patient, unless he is known to have had authentic seizures, may stigmatize him without warrant and lead to unjust settlement of litigation or to unreasonable compensation awards. In doubtful cases, perhaps an equitable solution of compensation for damage would be to award an insurance policy providing suitable payments if disabling seizures should develop later as a sequel of cranial injury.

Bone and Bones↗
PubMed1977

Physical stigma and academic performance as factors affecting children's first impressions of handicapped peers.

The effects of four variables on attitudes toward children were studied: the sex and social status of the rater and the physical appearance and academic competence of the target child being rated. The results indicated that competent and physically nonstigmatized children were rated more favorably than incompetent and physically stigmatized children. The data also revealed that girls had a significantly more positive stereotype than did boys of a competent male target child but that boys were more willing to be in physical proximity to the male target child as measured by a social-distance scale. Finally, the results indicated that popular children rated the attractive and competent target child less favorably than children who were not so popular. However, the popular children rated the attractive and incompetent target child more favorably than the less popular children did. The findings were discussed in terms of the salience of physical labels (i.e., stigma) on attitudes toward children.

Achievement↗
PubMed1992

The introduction of cystic fibrosis carrier screening into clinical practice: policy considerations.

Routine prenatal testing for cystic fibrosis (CF) should be halted until the detection rate reaches 95 percent. Pilot studies are needed in order to evaluate the feasibility of meeting education, consent, and counseling requirements in order to facilitate informed reproductive decisions by clients and to minimize the potential for confusion, stigmatization, and discrimination. Primary care physicians may not be trained adequately to provide appropriate information, and prenatal visits may not be an ideal setting. The public's interest in carrier testing, prenatal testing, and pregnancy termination is uncertain because CF patients have an increasing median survival, variable disability, and normal intelligence. Even with a goal that limits testing for the purpose of informed reproductive decision making, the considerable cost of screening per case prevented must be considered before it becomes public policy. Until these issues have been clarified, the duty of primary care physicians is to inform patients of the test's availability and to refer interested patients to qualified genetic counselors rather than to provide the test themselves.

Attitude to Health↗
PubMed1992

Confidentiality of human immunodeficiency virus status on autopsy reports. Council on Ethical and Judicial Affairs, American Medical Association.

The medical profession has long recognized the need to maintain the confidentiality of a patient's medical condition, particularly when stigmatizing conditions, like human immunodeficiency virus infections, are involved. The obligation to maintain confidentiality continues after the death of the patient. At the same time, there may be public health concerns that justify limited disclosure of a deceased person's human immunodeficiency virus status. This report provides guidelines that balance the need for confidentiality with public health concerns when a deceased person infected with the human immunodeficiency virus undergoes an autopsy.

AIDS-Related Complex↗
PubMed1992

[Psychosocial consequences of screening programs in children].

Owing to improved possibilities of early diagnosis, there has been increasing interest in screening children, particularly newborns. However, in the event of false-positive results or certain hereditary risk factors there is a danger of adverse psychosocial consequences, especially negative stigmatization (both of children and their families). Accordingly, except where neonatal screening may be essential for medical reasons, such screening programmes should preferably be scheduled for a later stage in life when the parents are less prone to anxiety about anything that might be interpreted as a threat to the well-being of their offspring.

Anxiety↗
PubMed1992

Older women. Sexually transmitted diseases and acquired immunodeficiency syndrome.

Increasingly, American women aged 50 and over are afflicted with sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS). In order to meet the US Public Health Services' Health Objective for the Year 2000, health care workers must address the issues that impact on the older woman's ability to protect herself and others from these highly stigmatized diseases. Nurses must be aware of the potential for STDs and AIDS in this population and appropriately refer individuals for screening and follow-up care. Older women must be empowered economically, legally, and politically so they can assume an assertive role in their own health promotion. Cultural and societal barriers need to be overcome to change stereotypic attitudes about older women's sexuality. Only then can access to health information, health care, and research be assured.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Medical workers and AIDS: the attitude to the problem].

A questionnaire was spread among Kiev physicians with the purpose of evaluating their level of information concerning the AIDS problem. An interrelation of level of knowledge and character of relation to the HIV infection was found. It was established that the idea of air-drop ways of HIV transmission is widely spread among the medical personnel with a tendency to stigmatization of the infected, underestimation of the AIDS problem significance. The authors emphasize the requirement of state-backed program on system of professional training of medical personnel in the AIDS problem.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Prostitution--a sequela of sexual abuse].

AIDS has consolidated the isolated state of prostitutes and stigmatized them as HIV carriers. Due to the threat of AIDS, the Berlin senate has worked out a programme for prostitutes. For the programme to succeed, knowledge of the causes of prostitution is a prerequisite, such as sexual abuse during childhood and adolescence. The sexually abused who have gone without psychological help are prone to prostitution. The work and its evaluation by a psychologist is presented to help counselling Services on Venereal Diseases in their work.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Role of systemic consultation in the psychiatric diagnosis].

Basing on the example of one patient and her family, the advantages and disadvantages of a systemic consultation are presented. The patient was hospitalised due to schizophrenia. In the given example the psychiatrist was an observer of the consultation conducted by a therapist from the ward. A systemic consultation allowed a "multiple-picture" to be obtained: the family members and the patient presented their own understanding of the situation, their "stories" This new and multi-perspective description, showing the patient's symptoms functionality caused diagnostic uncertainty in the psychiatrist--how far is the diagnosis of schizophrenia a justifiable one. The possibility to empthasize with the existential, psychological and family problems of the patient caused a scepticism in the psychiatrist, towards the stigmatizing diagnosis. The authors stress the danger arising in the systemic consultation, which broadens and deepens the knowledge on the patient's situation. According to the authors, the systemic consultation is necessary to understand the social context of the patient and to formulate a complex treatment plan. At the same time however, the multiple layered perspective (which contains the psychological, social and existential domains of the patient) should not over-shadow the psychopathological domain. For the therapeutic team, the consideration of the given levels of systemic reality description remains a challenge.

Adult↗
PubMed2002

Epilepsy: an overview.

According to Epilepsy Canada (2001), one to two per cent of Canadians have epilepsy and 75 to 80 per cent of these people develop it before the age of 18. Despite the fact that many famous and successful people throughout history have had epilepsy, misunderstanding and prejudice about this common neurological disorder remain prevalent. In our experience, some people diagnosed with epilepsy do not tell others about their medical condition because of their fear of being stigmatized and shunned.

Adult↗
PubMed1992

Being a family. The experience of raising a child with a disability or chronic illness.

This chapter examined the experiences of families of children with a variety of specialized needs, families who, as pioneers in family-centered, community-based care, are defining the future of services. It also looked at the services that are supposed to support the families in their efforts. On one hand, we have exposed the reader to the tension between traditional approaches to services for children with special needs and the expressed needs of families for coherence and empowerment. On the other hand, the data testify to the development of a new definition of the parent-professional relationship as individual professionals and select service systems around the country strive to work out what it means to support families. When the testimony of these families is carefully read, we are left with an impression of a schizophrenic system of public and private supports for home care for children with severe disabilities and specialized health care needs. The official rhetoric affirms the primacy of the family, and yet the experience of these families is otherwise. Again and again, the families told of benefits managers, case managers, discharge planners, social workers, program administrators, special educators, and the like who implied that parents were out to "milk the system." This attitude was conveyed even in dealing with entitlements and plans to which the parents had long contributed. Families were treated as beneficiaries of benevolent charity for which they should be grateful. Families, already struggling to come to terms with their child's impairment and the care demands associated with it, find themselves stigmatized, impoverished, and degraded. In a society of rugged individualists they are forced to ask for help. That in itself is more than some of the parents can deal with. It should be clear that these parents are not asking for charity. No one here is out to "milk the system." They are simply seeking support to meet some of the extraordinary demands associated with raising their children. As parents, they are not looking for the state to assume their responsibilities. Rather, they seek supports that will enable them to devote their energies to being parents. Their testimony suggests the need for states to recognize support for the family as an entitlement that affirms that the family. They base this call on the fact that support for families is the most cost effective service the state can provide.(ABSTRACT TRUNCATED AT 400 WORDS)

Child↗
PubMed2004

[Current pharmacotherapy of schizophrenia].

Second generation antipsychotics have become the standard of modern pharmacotherapy of schizophrenia. Amisulprid, clozapine, olanzapine, quetiapine, risperidone, sertindol, ziprasidone are the second generation antipsychotics registered in Hungary. They are more efficacious and their side effects are less stigmatizing than those of the first generation of antipsychotic drugs. Their use is limited by the availability of different formulations, by the lack of experience of some physicians, however the main limitation is the economic barrier.

Amisulpride↗
PubMed2003

[Meteorologic conditions and esophageal varices rupture].

BACKGROUND: While meteorologic conditions are thought to be related to the incidence of certain cardiac and cerebrovascular events, very little information is available concerning the onset of variceal bleeding. We undertook this study to determine whether there is any correlation between esophageal variceal hemorrhage and several meteorologic and astronomic parameters. METHODS: Sixty-seven episodes of bleeding from ruptured esophageal varices observed in 52 patients from southern Tunisia during a 7-Year period were studied retrospectively. All patients underwent endoscopic examination within 24 hours of admission. The date of the event (variceal rupture) was considered--if no stigmates of active bleeding were found at endoscopy--as the day of occurrence of the hematemesis and the day preceding melena. Meteorologic readings (11 parameters) plus moon-cycle, circadian and seasonal distribution of the 67 days of variceal bleeding in comparison with a control period of days randomly selected among 134 days without rupture. RESULTS: No relationship was found between variceal bleeding and mean atmospheric pressure, daily hours of sunshine, nebulosity, direction and velocity of wind and mean humidity. On the contrary, a significant correlation was observed with the mean temperature (18 degrees C vs 21.16 degrees C; p=0003), rainfall (p<0.01) and stormy weather (p=0.008), the latter being the only parameter retained as an independent factor at multivariate analysis: OR=13.37 (95% CI=1.5-118.5). Furthermore, a negative correlation was found with full moon but only at univariate analysis (p=0.04). The seasonal distribution of variceal bleeding episodes showed the highest percentage during winter with a significant variation at multivariate analysis: OR=3.2 (95% IC=1.6-6.54). Occurrence of variceal bleeding also showed a circadian variation with the higher prevalence night between 6 and 0 PM (p<0.001).

Adult↗