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Children of mentally ill parents are often vulnerable, partly because they may not receive adequate nurturing and partly because they feel stigmatized by their parents' disabilities. The author recommends use in treatment of several children's books that show realistic, positive role models of children coping with parental mental illness.
The wall of the mature pollen grain contains several layers, of which the outermost, the exine, is formed by the mother plant. Numerous proteins are incorporated in the exine. During the normal germination process on the stigma, these proteins interact with the stigmatic proteins. The interaction results into either enhancement or cessation of the pollen tube growth. It has been shown that most of these proteins diffuse into surrounding solutions already in a few seconds. They also cause allergic reactions in man. The diffusion of proteins and their allergic properties are not dependent on the germination of the pollen grains, and probably not either on their viability. The pollen grains of conifers are very weak allergens; their structure and function are different from those of the remaining flowering plants.
We describe two patients who had a typical levamisole-induced agranulocytosis and a severe infection; the view of other cases found in the literature shows a fundamental fact: the complication can occur after a variable time of prescription (from thirteen days to eleven months), continuous or intermittent. The accidents are imprevisible, and circonspection must be used, not for its antihelminthic properties, but for its prolonged use for immunological purposes, even if some authors have not observed any cases of agranulocytosis in large series. Naturally, the purpose is quite different in the case of a severe rheumatoid arthritis or inesthetic warts, and our two observations are very demonstrative. Mechanism of agranulocytosis has not been totaly clarified: we have observed biological stigmates of immunological process against levamisole (responsible of agranulocytosis?), but essentially medullary lesions (successive regenerative aspects and necrosis) as has been described with pyramidon, and this could explain why the other blood cells are affected in an apparently isolated agranulocytosis.
Sickle cell trait is a benign genetic abnormality which has been wrongly projected as a health hazard in aviation. Conflicting reports on the relationship between this trait and flying exist in the literature. Limitations placed on sickle trait individuals unfairly stigmatize large numbers of people, both socially and economically. The imprecise identification of the sickle hemoglobinopathies and unrecognized interactions of other abnormal hemoglobins with hemoglobin S have perpetuated the controversy. There is a tendency to use isolated anecdotal incidents as evidence of increased morbidity in sickle cell trait; however, it has not been documented that hypoxic conditions cause in vivo sickling in pure trait carriers. An analysis of the definitions of the hemoglobinopathies, the molecular basis of hemoglobin S, the interactions of abnormal hemoglobins, and the sickling phenomenon shows both that there is no evidence that the sickle trait is a health hazard and that most of the literature contrary to this finding is invalid.
Impairment, handicap and psychiatric symptoms were systematically studied in 84 dwarfs. Although all subjects were physically impaired by virtue of their skeletal dysplasias, only those with severe physical abnormalities were handicapped in obtained education and employment. Handicap in finding marital partners was present and unrelated to physical impairment rating. Fewer than half the subjects had ever married. Men in this sample, who were often extraverted as measured by the Eysenck Personality Inventory, complained less often of psychiatric symptoms and felt less stigmatized than the women subjects.
The purpose of this investigation was to establish approaches that match a scientific knowledge of the role played by the mentally retarded person who has completed his studies at a Special School. The idea is to learn if he is able to play differents roles in the society, to form a family, to integrate himself in a stable job and to incorporate and participate in a responsive manner in different social groups. Thus, they have been compared with a normal group of similar characteristics. The principal results of the study have shown: Once the person has completed his studies at a special school which used every effort for rehabilitating and capaciting the individual for a responsible social development in life, to enable him to perform a remunerated activity, he discovers that he is "stigmatized", that it is very difficult to find work and of course to be incorporated to the occupational structure. This contributes to the person's anxiety and an increasing insecurity which derives in isolation and lack of social interchange with other people and transform him into a marginal person.
It is a study of sociogenic need satisfactions that determines the homeostasis of 'being' by remaining contingent conditions of perpetuation or debasement of the social 'self'. The paper has a focus on identification satisfaction and differentiation experience of patients of the highly stigmatized leprosy. The study proceeds with an 'Experimental Group--Control-Group' randomized design. Experimental Groups are two, viz., those of Lepromatous and Non-lepromatous patients. 'Control Group' consists of 'disease-free' normal people. The three independent variables are disease types, age, personality factors. The dependent variables are two, viz., score of identification satisfaction and differentiation experience, measured by standardized tools. Each dependent variable has four '3 X 3 X 2' factorial experiments to test 56 'Null Hypotheses'. The sample consists of 360 elements for each one of the eight experiments. Leprosy elements are drawn from the Central JALMA Institute for Leprosy and the 'Kushta Seva Sadan' (Agra). The 'F' test is run for statistical verification of 'Null hypotheses'. Results show presence of 'role-reversion' and 'role negation' of age and personality factors. The disease possesses 'anti-roles'. It does not allow age and personality factors to promote identification satisfaction and to demote differentiation and experience. The disease actively promotes differentiation and demotes identification through its own 'alien system'. The senescents are the greatest sufferers. 'Social Stigma' works a 'social thanatos' and exposes senescents to substantial 'self-erosion'.
This brief paper presents the need for studies on the social aspects of leprosy; it also describes a current research project in the Philippines with a multidisciplinary team consisting of medical doctors and social scientists. Moreover, it tries to show what the research data might do to improve leprosy control programmes. The research team hopes that these pioneering efforts in the study of the social aspects of leprosy, which is a highly stigmatized disease, will encourage other scientists to follow suit.
We describe a subject who had a positive sickle solubility test and a routine alkaline electrophoretic pattern showing three major hemoglobulin bands migrating to the A, S, and A2 positions. In addition, the non-heme protein carbonic anhydrase appeared to be increased, suggesting the presence of a split A2. Two major hemoglobin bands separated on agar gel electrophoresis using a citrate buffer, pH 6.2. A non-S hemoglobin migrating to the position of Hb S was identified as GPhiladelphia. The electrophoretic pattern of GPhil/S trait most closely resembles S/beta+ thalassemia or sickle cell trait. Careful study is essential to avoid misdiagnosis and unfairly stigmatizing patients whose benign abnormality may be confused with more severe disease entities.
My aim in this paper is to examine the application of the concept stigma to mental disorder and to the mentally ill. I believe that the loose use of this term serves to obscure the real issues that must be confronted in attempting to change public response to mental disorder. I shall examine recent, and in my opinion ill-advised, use of the concept stigma and then present some data that bear upon social responses to mentally ill patients and former patients in contemporary America. My data are derived from a long-term study of mental patients and their families, and I shall document that their feelings of stigmatization are not so much a consequence of the response of others to their having been hospitalized for mental illness or labeled mentally ill as of self-doubts or chronic manifestations of mental illness.
Drooling is a common stigmatizing problem necessitating increased care in the neurologically damaged child or adult. Appropriate physiotherapy frequently reduces drooling but rarely eliminates it. The goal of surgical therapy is to minimize drooling while specifically avoiding the complication of xerostomia. During the past 4 years, 37 of 46 patients assessed have undergone surgery specifically intended to reduce drooling. Good results have been obtained with bilateral transtympanic neurectomy procedures; it is the surgical procedure of choice in the more retarded patient. Encouraging results have been obtained in six patients with bilateral submandibular duct relocation; because of increased operative morbidity, it is the procedure of choice in the less retarded child.
During a term of probation for the doctoral course in sociology at the university of Nijmegen a research was made for the relatinship between patients and staff on the ward of a nursing home. This relation was investigated with the use of Elias and Scotson's model of an established and outsiders figuration. In this figuaration are several sources of power, as fysical capacities, knowledge, key-positions and cohesion, important. These are considered more thoroughly. Some of the central problems of a nursing home are becoming more clear in the elaboratin of processes as exclusion and stigmatization. The questions efficiency or humanity and the normality or abnormality of the behaviour of the patients are considered against the background of the contrast between living environment for the patients and work environment for the staff. One of the conclusions is that because of the central place of medical and nursing-technical thinking there isn't much room left for the living of the patients, in spite of the fact this being an explicit care of the investigated home.
INTRODUCTION: The risk of developing parenterally transmitted infections in health-care personnel has become a challenge because of high costs, laboral incapacity and mortality, and social stigmatization. OBJECTIVES: To inform the incidence of occupational exposure in our institution, to determine the type of personnel affected and the circumstances of the injuries, and to assess the serologic follow-up of these employees. METHODS: The occupational injuries spontaneously reported to our infection control program from June 1987 to December 1993, were reviewed. Personnel categories, type of accident, instrument and circumstances of the injury, as well as serologic follow-up for hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV) infections, baseline and every three months during the first year were evaluated. RESULTS: In 6.5 years 260 injuries were registered in 240 workers. Two cases were registered in the second semester of 1987, 23 in 1988, 25 in 1989, 23 in 1990, 36 in 1991, 90 in 1992, and 61 in 1993. Housekeeping and maintenance staff were mainly affected (32%), nursing staff in second place (27%), followed by senior medical students (20%). Eighty-eight percent were sharp injuries (20% considered deep injuries). Most of the injuries occurred after instrumental utilization: sharp devices disposed without the use of adequate containers (18%), inappropriate handling of sharp containers (14%) and recapping needles (11%); 36% of the injuries occurred during specific procedures. One HBV seroconversion occurred in 10 surface antigen exposures, one in nine exposures with an HCV contaminated source, and none in 54 accidents with HIV contamination. CONCLUSIONS: The increase in the annual incidence of occupational exposures is due most probably to more awareness to report the injuries. Eighty-eight percent were sharp injuries and at least 43% could have been prevented. Our main educational and preventive efforts should be directed to housekeeping staff, nursing staff, and medical students of our institution.
A 10% sample was drawn from 3000 records on vesicovaginal fistulae operations performed at the Addis Ababa Fistula Hospital for Poor Women with Childbirth Injuries and their content were analyzed. In 88% of the cases under review the operation was classified as successful. The results of this study underline the tremendous maternal health gains which can be achieved by appropriate obstetric care in case of obstructed labour. It also reinforced the need for early detection and referral of high risk births among the very young mothers who are likely to experience an obstructed labour, the loss of the child, vesico-vaginal fistulae and possibly a ruptured uterus. In the absence of likely increases in the availability of transport, the building of waiting homes at maternal clinics is encouraged so that women can await delivery in the vicinity of a referral centre. There is a need for increased attendance of delivery by trained personnel as well as for continuing education for both staff and traditional birth attendants. It is further recommended to train former patients as helpers for the dedicated care which needs to be extended to the unfortunate, and often stigmatized victims.
The social context linked to deinstitutionalization brought the authors to study the impact of labels placed on people having undergone psychiatry. The objective of this research is to better understand the subtleties made by the public concerning the following terms: the mentally ill person (malade mental), the ex-psychiatric patient (ex-patient psychiatrique) and the person suffering from a mental health problem (personne souffrant d'un problème de santé mentale). Data collected from 255 francophone residents from the Montréal area show that the expression "ex-psychiatric patient" is less stigmatizing than the expressions "mentally ill person" or "person suffering from a mental health problem" (PSMHP), as it refers to a past event that is over and done with. The expression "mentally ill person" emphasizes the chronic nature of the health problem suffered by the individual, where as the PSMHP focuses on the person's potential for recovery. The expression "ex-psychiatric patient" points to the capacity to function normally in society.
Leprosy is a chronic disease of the skin and peripheral nerves that afflicts more than 5 million persons worldwide and more than 7,000 persons in the United States. Although leprosy is indigenous to the southern United States, most new cases in this country occur among immigrants from foreign areas where the disease is endemic. Leprosy presents as a skin rash and/or peripheral neuropathy. The diagnosis can be confirmed when acid-fast bacilli are found in skin biopsies or smears. The multiple-drug treatment regimens recommended by the World Health Organization have considerably reduced the length of treatment to six months to two years. The optimum duration of treatment has yet to be determined. In most countries, including the United States, leprosy remains one of the most stigmatizing diseases.
We followed 93 subjects from the San Francisco General Hospital Cohort for one year after notifying them of their HIV-1 antibody test results in order to examine self-disclosure, reactions, and concerns regarding disclosure. By one year post-notification, 92% of gay friends, 82% of primary sexual partners, 56% of new sexual partners, 46% of co-workers, 71% of physicians, 37% of dentists, 57% of psychotherapists, and 37% of family members had been told. Subjects were twice as likely to tell primary sexual partners, and more likely to self-disclose to all categories of persons (except physicians and dentists) than anticipated prior to notification. Least favorable reactions to seropositivity were from male family members and primary sexual partners, while seronegative subjects experienced unfavorable reactions only from some family members. Subjects were most concerned about health insurance (71%) and stigmatization (61%), but the latter declined (to 36%) at 12 months. Although encouraging, these findings suggest that self-disclosure should be discussed in both pre- and post-test counseling sessions.
The last decade has seen the development of military lasers designed to blind. Medical professionals dedicated to the prevention and treatment of visual disability, and particularly ophthalmologists under the terms of their newly acquired Royal Charter, have a responsibility to: document this new technology; explain its medical effects; and influence the threshold at which these weapons might be used. Proposals to prohibit anti-eye laser warfare at The United Nations Convention Conference in September 1995 present a unique opportunity to stigmatize blinding as a method of warfare.