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PubMedDate not supplied

[Bioconversion of beta-sitosterol and its complex esters by Rhodococcus actinobacteria].

The ability of pure cultures of Rhodococcus actinobacteria from the Ural specialized collection of alkanotrophic microorganisms (World Federation for Culture Collections accession number 768; http://www.ecology.psu.ru/iegmcol) to convert beta-sitosterol (BSS) and its 3beta-acylated derivatives was studied. Rhodococcus strains with pronounced cholesterol oxidase activity, capable of converting BSS to stigmat-4-ene-3-one in the reaction of cooxidation with n-hexadecane, were selected. The dependence of the activity of cholesterol oxidase of rhodococci on the length of the acyl group in BSS esters was studied. Conditions under which Rhodococcus cells convert BSS to 17beta-hydroxyandrost-4-ene-3-one (testosterone), commonly used in pharmacology, were determined.

Alkanes↗
PubMed2005

The criminalization of HIV transmission in England and Wales: questions of law and policy.

In this article, Matthew Weait and Yusef Azad discuss the current law concerning the criminalization of HIV transmission in England and Wales, and raise some issues about the wider implications of criminalization for those working in the HIV/AIDS sector. The authors look at the way the fault requirement of "recklessness" has been interpreted in the cases. They explore the courts' approach to consent--the defence which those who have appealed against conviction have sought to use. Then the authors raise some questions about the relevance of disclosure and the way the courts have dealt with knowledge about HIV status and the risks associated with unprotected sex. Finally, they discuss the relevance of the nature of the relationship between the accused person and the person to whom HIV has allegedly been transmitted, and touch on the potentially stigmatizing effects that criminalization may have on socio-economically marginalized groups. The authors conclude by discussing some more general policy-related issues.

Criminal Law↗
PubMed2005

Vitiligo.

Vitiligo represents a selective destruction of the melanocytes. It is a relatively common, probably autoimmune disorder that affects people of all backgrounds and both genders. No particular group seems to be preferentially affected. Half of vitiligo patients have an onset before the age of 18 years. In regions where leprosy is endemic, individuals with vitiligo are often stigmatized due to similarities in appearance between the two diseases. We will review this important subject, emphasizing the latest therapeutic advances.

Humans↗
PubMedDate not supplied

Awareness of and attitudes towards HIV among pregnant women at the Antenatal Clinic, Port Moresby General Hospital.

BACKGROUND: The prevalence of HIV (human immunodeficiency virus) among pregnant women in Port Moresby has increased tenfold, from 0.08% in 1994 to 0.8% in 2002. To stop a further epidemic spread as seen in sub-Saharan Africa it is urgent to identify and intervene to reduce risk behaviours. In order to do so it is important to evaluate current awareness of and attitude towards HIV. METHODS: Interviews with 122 pregnant women were conducted at the Antenatal Clinic, Port Moresby General Hospital, Papua New Guinea. We assessed the women's HIV awareness and relate the results to education and socioeconomic factors. RESULTS: 4 out of 122 women did not know about HIV. 97% knew that HIV is spread by sexual contacts, 96% knew about mother-to-child transmission and 69% knew about infection through breastfeeding. However, there were many misconceptions; 36% believed that HIV can be spread by mosquitoes and 17% believed that caring for an AIDS (acquired immune deficiency syndrome) patient is a risk. Among the women with no education or primary school education only, 51% knew for sure that HIV is not spread by caring for an AIDS patient, compared to 86% for the women with higher education. 47% of the women received their first information about HIV through the media. CONCLUSIONS: The AIDS campaigns have been successful in making almost all the women aware of HIV as a sexually transmitted disease. However, the high frequency of misconceptions makes it probable that patients are stigmatized. This is particularly true for the lower educated women. To more effectively fight the HIV epidemic it is important to improve the general level of education of both men and women, to encourage women to be more in charge of their own sexuality and to increase their status in society. It is also important to make men aware of their responsibility to practise safe sex.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Pathogenesis and pharmacologic treatment of obesity: the role of energy regulatory mechanism.

Obesity has become a worldwide public health problem affecting millions of people. This is a chronic, stigmatized, and costly disease, rarely curable and is increasing in prevalence to a point today where we define obesity as an epidemic disease that not only in developed but also on developing countries. The pathogenesis of obesity is largely unknown, especially about energy regulatory mechanism that involved wide area of neuroendocrinology that is very interesting but very complex and makes internists "refuse" to learn. Obesity occurs through a longstanding imbalance between energy intake and energy expenditure, influenced by a complex biologic system that regulates appetite and adiposity. Obesity influences the pathogenesis of hypertension, type 2 diabetes, dyslipidemia, kidney, heart, and cerebrovascular disease. It is very wise for every internist to learn the pathogenesis and treatment of this worldwide diseases. Until now, the available treatments, including drugs, are palliative and are effective only while the treatment is being actively used; and besides so many side effects reported.

Appetite Depressants↗
PubMed2004

Disentangling privacy from property: toward a deeper understanding of genetic privacy.

With the mapping of the human genome, genetic privacy has become a concern to many. People care about genetic privacy because genes play an important role in shaping us--our genetic information is about us, and it is deeply connected to our sense of ourselves. In addition, unwanted disclosure of our genetic information, like a great deal of other personal information, makes us vulnerable to unwanted exposure, stigmatization, and discrimination. One recent approach to protecting genetic privacy is to create property rights in genetic information. This Article argues against that approach. Privacy and property are fundamentally different concepts. At heart, the term "property" connotes control within the marketplace and over something that is disaggregated or alienable from the self. "Privacy," in contrast, connotes control over access to the self as well as things close to, intimately connected to, and about the self. Given these different meanings, a regime of property rights in genetic information would impoverish our understanding of that information, ourselves, and the relationships we hope will be built around and through its disclosure. This Article explores our interests in genetic information in order to deepen our understanding of the ongoing discourse about the distinction between property and privacy. It develops a conception of genetic privacy with a strong relational component. We ordinarily share genetic information in the context of relationships in which disclosure is important to the relationship--family, intimate, doctor-patient, researcher-participant, employer-employee, and insurer-insured relationships. Such disclosure makes us vulnerable to and dependent on the person to whom we disclose it. As a result, trust is essential to the integrity of these relationships and our sharing of genetic information. Genetic privacy can protect our vulnerability in these relationships and enhance the trust we hope to have in them. Property, in contrast, by connoting commodification, disaggregation, and arms-length dealings, can negatively affect the self and harm these relationships. This Article concludes that a deeper understanding of genetic privacy calls for remedies for privacy violations that address dignitary harm and breach of trust, as opposed to market harms, as the property model suggests.

Commodification↗
PubMed2005

Knowledge of epilepsy among teachers in Khon Kaen Province, Thailand.

INTRODUCTION: Epileptic patients face social stigmatization due to negative attitudes and incorrect knowledge on epilepsy. OBJECTIVES: To evaluate knowledge of epilepsy among teachers in Khon Kaen province. MATERIAL AND METHOD: A self-administered questionnaire distributed to 102 teachers who attended the training lectures on epilepsy. The number of correct responses for each item were collected. The statistical analysis included the percentage of correct response and the means of the total scores. RESULTS: Most (78.4%) respondents understood that a seizure is an abnormal electrical discharge in the brain, while 54.9% thought it included a form of abnormal movement and 1% demonic possession. The generalized tonic-clonic seizure (GTCs) was the type of seizure with which most respondents were familiar (90.2%), while 23.5% had knowledge of absence seizures. The respondents identified the following as causes for epilepsy: 1) head injury (84%); 2) genetic disease (74.5%); 3) high fever (68%); and, 4) brain tumor (57%). A small minority associated epilepsy with eating pork (11%) and even fewer (2%) with a non-organic/non-physical cause. Only 16% of respondents thought epilepsy was incurable, and a quarter (27%) of the teachers thought epileptics required anti-epileptic drugs (AEDs) life long, while 20 and 9 percent believed patients would take AEDs for 3-6 months and only for episodes, respectively. About 57% of the teachers thought epileptics needed AEDs for 2-5 years. Most (77-79%) respondents thought epileptics were prohibited from using machinery or driving, and 63% thought alcohol would be prohibited. Almost two-thirds of the teachers (64%) thought they should try to place an object between the teeth of a person having an episode in order to prevent a biting injury to the tongue and 27% would restrain the person and perform chest compressions (CPR). The average total score for correct answers on the questionnaire was about 60% (29.26/50). Respondents generally understood that epilepsy is controllable (82%) and were able to identify a seizure (78.4%). The lowest scores were found in the section on identifying the types of seizures (37.8%). CONCLUSION: Teachers' knowledge of epilepsy was incomplete; thus, an epilepsy education campaign is needed and should emphasize the types of seizures, the causes of epilepsy, and management.

Developing Countries↗
PubMed2005

Comparing the health services utilization of long-term-care residents, home-care recipients, and the well elderly.

Research has typically supported the concern that health services utilization increases with aging. Yet most health services utilization studies have focused on the use of 1 as opposed to all health services, the use of health services over 1 year as opposed to a longer period, and the use of health services during the 1970s or 1980s. Current, comprehensive utilization studies are needed in order to better inform health policy and health services decision-making. This study was designed to compare the health services utilization of 3 groups of seniors: those residing in long-term-care (LTC) facilities, those receiving home care, and those neither institutionalized nor receiving home care. Individual-anonymous and population-based inpatient hospital data, ambulatory care (day surgery, outpatient clinic, and emergency room) data, and physician services data collected by the health ministry of the Canadian province of Alberta over a 2-year period were analyzed using descriptive and comparative statistical tests available in the SPSS computer program. With the exception of physician and LTC services, LTC residents were the least likely to use health services. Furthermore, and despite concerns that LTC residents may be stigmatized or rationed with regard to access to tertiary care, the data indicate that LTC residents are not disadvantaged in terms of type or scope of hospital services. These and other findings suggest an appreciation for LTC in managing both the health and the care needs of the oldest seniors. The findings also raise concerns about the adequacy of formal home care and of the health care received by the well elderly.

Activities of Daily Living↗
PubMed2006

Lesbian disclosure: disrupting the taken for granted.

The purpose of this interpretive inquiry was to generate understandings about the experience of lesbian disclosure. The inquiry relied on Gadamerian hermeneutic and feminist philosophical thought and was situated in women's health. In a feminist understanding of women's health, experiences of health are inseparable from the everyday experiences of an embodied life and are constituted within each woman's social, material, and discursive realities. The study was informed by conversations with 15 women who self-identified as lesbian for the purpose of the inquiry, accounts of women in the media, and the researcher's reflective journals. The findings move us towards new understandings about the multiple meanings of "lesbian." They challenge nurses to consider the binary categories of homosexual and heterosexual as inadequate signifiers for the reality of women's lives, to consider the particular arrangements of each woman's life, and to disrupt assumptions of heterosexism in order to reduce the negative impact of social exclusion, isolation, discrimination, and stigmatization as social determinants of health.

Adult↗
PubMed2006

Can you ask that over the telephone? Conducting sensitive or controversial research using random-digit dialing.

Social science, medical, and legal researchers often study sensitive or controversial topics and behaviors. This research raises methodological and ethical issues. Using examples from the literature and a recent statewide telephone prevalence survey on sexual assault, we focus on the relative merits of various survey methods, especially those employing new technologies; developing instrumentation that includes explicit behavioral questions; obtaining an appropriate sample in a cost efficient way; gaining informed consent and inquiring about sensitive topics while protecting participants from harm or retraumatization; presenting findings in a way that does not further stigmatize participants; and responding to the media.

Data Collection↗
PubMed2006

Methodologies for interventional myopia studies.

Myopia studies are notoriously difficult to carry out. Past studies on intervention in myopia progression have given conflicting results. Beside inaccurate and inadequate measurements, the most important cause for this is the very variable nature of myopia, which makes it difficult to achieve baseline comparability between the control and the study group. Although there were inclusion criteria in these studies, for age, sex, race, degree of myopia and stigmatism, the most important variate-- the rate of myopia progression-- was not included. Randomisation can achieve baseline comparability of the myopia progression rate, provided the sample sizes are large enough. Unfortunately, past studies have been limited to 100 to 200 children only. Studies on twins are more reliable than random groups because myopia progression rates are more likely to be the same in a pair of twins. Studies on the same subject, comparing the right eye and the left eye would be even better, but this method is practicable for some studies only (e.g., we cannot have a spectacle lens for one eye and a contact lens on the fellow eye). There is another method of doing an interventional study on myopia. Because myopia progression is linear in its early stage until the early teenage years, it is possible to observe what happens to the linear progression upon intervention. In this way, we avoid the problem of trying to compare "apples with apples" but use the "same apple" instead.

Contact Lenses↗
PubMed2004

A nation's genes for a cure to cancer: evolving ethical, social and legal issues regarding population genetic databases.

The advent of the human genome sequence has focused research on understanding underlying genetic links to complex diseases such as cancer, asthma and heart disease. In the past few years, individual countries, such as Iceland, Estonia, Singapore and the United Kingdom, have created national databases of their citizens' DNA for comparative research. Most recently, an international consortium including Nigeria, Japan, China and the United States launched a $100 million project called the International HapMap to map the human genome according to haplotypes, blocks of DNA that contain genetic variation. Such population genetic databases present challenging ethical, social and legal issues, yet regulation of genetic information has developed sporadically, from region to region, without a consistent international standard. Without a clear understanding of the consequences of genetic research in terms of individual and community-wide discrimination and stigmatization, genetic databases raise concerns about the protection of genetic information. This Note provides a survey of the evolving landscape of population genetic databases as a legislative and public policy tool for national and international regulators. It compares different approaches to regulating the collection and use of population genetic databases in order to understand what areas of consensus are formulating a foundation for an international standard. As the first population genetics project that will span multiple countries for the collection of DNA, the International HapMap has the potential to become an influential standard for the protection of population genetic information. This Note highlights issues among the national databases and the HapMap project that raise ethical, social and legal concerns for the future and recommends further protections for both individual donors and community interests.

Access to Information↗
PubMed2006

Submassive acute pulmonary thromboembolism with normal D-dimer. A case report.

Pulmonary thromboembolism is a relatively common disease in an Emergency Department. Diagnosis, often difficult, is based on careful evaluation of risk factors, clinical examination, radiological and laboratory investigations. Plasma D-dimer, a degradation product of cross-linked fibrin with low specificity and very high sensibility, is considered extremely useful as screening to rule out a pulmonary thromboembolism. We report the case of a 74 year old woman who presented in the Emergency Department suffering from the sudden onset of dyspnea 4 hours before. Plasma D-dimer (automated latex-enhanced turbidimetric test) was normal (253 ng/mL; normal value: 278 ng/mL), but spiral CT angiography showed a sub-massive thromboembolism of the principal branch of the right pulmonary artery, also involving the middle and the inferior lobar branches. A cardiac echo-color-Doppler demonstrated an enlargement of the right cardiac section with telediastolic pressure in the pulmonary artery of 74 mmHg (normal value 4-12 mmHg). A second measurement of plasma D-dimer, 12 hours later, remained in the normal range (274 ng/mL) and only after four days was there a significant increase (1017 ng/mL). The authors, taking the case as a starting point, stigmatize the difficulties that such diagnosis involves, despite indications of guidelines.

Acute Disease↗
PubMed2006

Can social marketing approaches change community attitudes towards leprosy?

This essay explores how the concept of social marketing can be employed to change attitudes towards leprosy. Firstly, the concept of social marketing is discussed, then the attitudes that people have about leprosy, the stigma that people with leprosy and their families may face, and the detrimental effects that this can have on their lives. The effect of knowledge and education on attitudes towards leprosy is discussed, as this can be a key component of social marketing campaigns. Various methods of social marketing used to change attitudes and reduce stigma are examined, such as mass media campaigns, school based education, methods which involve community leaders, and the integration and improvement of leprosy services. Principles of social marketing which can lead to the success of campaigns such as incorporating local beliefs are emphasized. The success of the social marketing campaign in Sri Lanka is described, which aimed to remove the fear of leprosy, and to encourage patients to seek and comply with treatment. Finally, it is argued that social marketing, used correctly, can be highly effective at changing community attitudes towards leprosy, reducing stigma and improving the lives of patients, who become able to seek treatment sooner as they lose their fear of stigmatization.

Attitude to Health↗
PubMed2006

A comparison of methods for collecting self-report data on sensitive topics.

Insufficient attention has been paid to whether disclosure rates of sensitive or stigmatizing information vary as a function of method of inquiry. Methods vary both in terms of the anonymity afforded the participant and the opportunity to make a connection with the researcher, both of which might affect participants' willingness to disclose such information. In this investigation, 215 undergraduate students were randomly assigned to complete identical questionnaires using one of the three most common methods of data collection (in-person interview, telephone interview, and paper-and-pencil questionnaire) or an automated telephonic data collection (ATDC) system. Questions on six topic areas of increasing social sensitivity (study habits, substance use, physical and sexual aggression, victimization and perpetration) were included. The results indicated that there were no differences in disclosure rates due to methods and no method by topic interaction, but the two telephonic methods both produced significantly higher participation rates than the two other methods. The results suggest that, at least for a college student sample, an automated telephonic system produces data comparable to that of more traditional methods, while offering greater convenience, economy, and participation.

Adolescent↗
PubMed2006

[Diagnosis and treatment of mental states at high risk for psychosis].

Despite the fact that the need for and possibility of diagnosing and treating schizophrenia in the prodromal phase is as old as the disease category itself. the first controlled studies were published only in the last 15 years. Using structured interviews and rating scales, the development/first episode of psychosis can be forecast only with a modest specificity: 30-60% of the persons with prodromal symptoms based on operationalised criteria develop full-blown psychosis during a 12-month follow-up period. A 6-month, low-dose antipsychotic treatment combined with psychotherapy can reduce this risk of psychosis by 50-60%. The treatment based on the clinical picture can be supplemented with antidepressants and anxiolytics. Despite the successful prevention, patients continue to show considerable residual symptoms and decreased coping abilities. Long-term effects of intervention, false positive cases, and stigmatization are among the most problematic, unresolved issues. According to international results and our own experience, psychosis prevention is currently adequate only in the case of help-seeking patients if the operationalised criteria of the prodrome are present. Detailed patient education and the ensuing informed consent are indispensable. Biological relatives of schizophrenia patients should be assessed with special care. Persons at increased risk of psychosis should be offered long-term follow-up and care and an "open doors" policy in the case of worsening symptoms and crisis.

Acute Disease↗
PubMed2006

The science of well-being: an integrated approach to mental health and its disorders.

Psychiatry has failed to improve the average levels of happiness and well-being in the general population, despite vast expenditures on psychotropic drugs and psychotherapy manuals. The practical failure of psychiatry to improve well-being is the result of an excessive focus on stigmatizing aspects of mental disorders and the neglect of methods to enhance positive emotions, character development, life satisfaction, and spirituality. In this paper, a simple and practical approach to well-being is described by integrating biological, psychological, social, and spiritual methods for enhancing mental health. Evidence is presented showing that people can be helped to develop their character and happiness by a catalytic sequence of practical clinical methods. People can learn to flourish and to be more selfdirected by becoming more calm, accepting their limitations, and letting go of their fears and conflicts. People can learn to be more cooperative by increasing in mindfulness and working in the service of others. In addition, people can learn to be more self-transcendent by growing in self-awareness of the perspectives that lead to beliefs and assumptions about life which produce negative emotions and limit the experience of positive emotions. The personality traits of self-directedness, cooperativeness, and self-transcendence are each essential for well-being. They can be reliably measured using the Temperament and Character Inventory. A psychoeducational program for wellbeing has been developed, called "The happy life: voyages to well-being". It is a multi-stage universal-style intervention by which anyone who wants to be happier and healthier can do so through self-help and/or professional therapy.

Journal Article↗
PubMed2006

Knowledge and attitude of youth (ages 15-25 years) to HIV/AIDS and to routine HIV screening.

BACKGROUND: AIDS is still an incurable disease and is very costly to control. Since the first case of Acquired Immune Deficiency Syndrome (AIDS) in Nigeria was reported in 1986, the human immune deficiency virus (HIV) infection has attained epidemic proportion. In an effort to control this rapid spread, certain preventive measures have been developed. In spite of these and the campaigns to control it, the knowledge and attitudes of youths towards HIV/AIDS leaves much to be desired. OBJECTIVE: To determine knowledge and attitude of youths (15 - 25 years) of HIV/AIDS and to Routine HIV Screening. STUDY DESIGN: The study was cross-sectional. SETTING: The study was carried out at the University of Benin Teaching Hospital, Benin City, Nigeria, between January and December 2003. RESULTS: Five thousand three hundred and twenty STUDY POPULATION: The knowledge and attitude of youths (15 - 25 years) of HIV/AIDS and to routine HIV screening was assessed, using anonymous questionnaires, among 9500 respondents, 4950 males and 4550 females. 5750 respondents were from the University of Benin with a population of 20,000 students while 3750 were from some of the Secondary Schools (post primary Schools) randomly selected in Benin City, Nigeria. The University of Benin Teaching Hospital where the work was done is adjacent to the University of Benin. The Secondary Schools selected where the work was done were within a radius of 20 kilometers of the Teaching Hospital and were 5 in numbers with average of 750 students selected per school. Subjects (56%) indicated that they have heard about HIV/AIDS, 4180 (44%) had no knowledge of HIV/AIDS at all. 2240 of 5320 (42.1%) had some knowledge; 1593 (29.9%) had adequate knowledge and only 1487 (28.0%) had sufficient knowledge. 6365 (67%) did not believe it exists and as a result they are not bothered by it. 825 of the 3750 secondary school students had multiple sexual partners. Majority had single partners for those who had at all. While among the University students 2990 (52%) had multiple sexual partners, while others had between one and two sexual partners. Only 36210 (38%) believe it is real and a killer disease frightened about it and are already changing their sexual behaviours; 1900 (20%) believe it is a western propaganda to enslave the developing world. Three thousand nine hundred and ninety respondents (42%) would agree to routine HIV screening and 5510 (58%) would not agree to routine screening. The reasons adduced for rejecting routine HIV screening included psychological trauma, not necessarily high cost of and lack of anti-retroviral drugs, infringement on fundamental human rights, fear of living with positive screening, stigmatization and victimization at place of work if positive. CONCLUSION: Intensive massive awareness campaign through Radio, Televisions jingles and education about HIV/AIDS of the population is recommended to alter their current negative attitude to routine HIV testing and increase their knowledge about HIV/AIDS and perhaps help to change their sexual behaviours.

Acquired Immunodeficiency Syndrome↗