Letter: Social stigma and tuberculosis.
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Attitude to Health↗
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Results for “Social Stigma”
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Suffering in silence and the fear of social stigma: survivors of violence.
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Communication↗
The dimensions of stigma: the social situation of the mentally ill person and the male homosexual.
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Attitude↗
Stigma and state hospital patients.
This study set out to measure the degree of social stigma experienced by discharged mental hospital patients and the extent to which these patients were viewed as a burden by family and friends. Predictors of stigma included social class and demographic factors, posthospital situation, emotional functioning, and use of aftercare facilities. However, available measures were able to account for little of the variance in stigma, and further research is suggested to establish more reliable predictors of mental patient stigmatization.
Adult↗
HIV in women.
There are three patterns of HIV infection and AIDS. In industrial countries infection is between homosexual and bisexual males and intravenous drug users. Relatively few women are infected but the numbers are increasing. In sub-Saharan Africa the infection is heterosexual. More women are infected. AIDS incidence in other countries is low. Twenty-five percent of babies born to HIV positive women will be infected. Testing of infants at birth is difficult because of placental transmission of antibodies. Anonymous antenatal testing is important to establish prevalence which varies greatly in different areas. HIV infection is unique because of the social stigma, lack of vaccine and lack of effective therapy. There are profound social and psychological implications for the woman, her partner and her family. Therefore, a high level of caring and mature professionalism is required by all involved staff.
Acquired Immunodeficiency Syndrome↗
Attitudes to the psychiatric outpatient clinic.
Fifty patients were interviewed before their first ever appointment at a psychiatric outpatient clinic about their attitude to the forthcoming visit. Many did not know that it was a psychiatrist they were to see at the hospital. Widespread misconceptions about the nature of a psychiatric consultation were uncovered. Many felt the referral carried an implicit threat of social stigma. Patient's misconceptions were relieved, and only 13% subsequently failed to attend the clinic compared with 30% of a control group.
Adult↗
[Psychosocial aspects of certain fundamental needs of families with a child with HIV infection].
The presence of a family of a young child with AIDS, with the exception of a small number of transfusion-infected children, implies almost necessarily the presence of infected adults, usually the mother. The problem in such a situation is not that of a child with a fatal illness but that of an entire family. Our study included a sample of thirty natural caregivers. These were mostly mothers but others responsible for the care of a seropositive child, such as fathers, aunts and grandmothers, were also included. The aim of the project was to describe their perceptions of their own psychosocial needs. Our results reveal that these caregivers are economically disadvantaged. They do not know how to cope with stress and their life situation. They are not ready to confide in others because of the social stigma associated with this illness. Thus they participate unwittingly in the conspiracy of shame which denies them the aid which might help meet their needs. However, they do see the need to learn how to protect themselves and other members of the family against both HIV and other infections and to know the course and the treatments associated with this disease.
Acquired Immunodeficiency Syndrome↗
Comparison of primiparas' perceptions of vaginal and cesarean births.
Twenty primiparous mothers who had cesarean births were compared with 30 primiparous mothers who had vaginal deliveries to determine differences in their perceptions of the birth experience. The effect of general versus regional anesthesia on the satisfaction level of the cesarean mothers was also investigated. All subjects were between 20 and 32 years of age, were interviewed within 48 hours postpartum, and completed a 29-item questionnaire that measures maternal perceptions about the labor and delivery experience. Satisfaction with the birth experience was significantly lower among cesarean mothers and among those who had general anesthesia. The cesarean group displayed greater hesitancy in naming their infants and tended to view their deliveries as abnormal and having social stigma. The presence of a support person in the operating room for a cesarean birth seemed to lessen anxiety among these mothers. These findings suggest that a cesarean birth has a negative impact on the mother's perceptions of her labor and delivery experience. There is a need for further study of factors that can enhance this experience for families.
Adult↗
Community-based rehabilitation: an evaluation study.
Leprosy gives rise to two types of stigmatization, one from the disease and its neuropathetic manifestations, with their resultant disability and handicaps, and the other due to social ostracism. The process of rehabilitation should begin from the moment the disease is diagnosed, and the earlier its detection the better the prognosis for patients. The family unit to which the patient belongs plays a vital role in his social life, ensuring and enhancing his self-respect and dignity in society, and this fact must be recognized when evolving a strategy for rehabilitation. In no circumstances should a patient be removed from his natural home environment. It is important that the community is made leprosy conscious and gets more involved in hastening the social assimilation of patients. Communication plays an important role throughout the rehabilitation process. One of the major functions is the removal of the social stigma in the family and in the community and this involves communication skills to ensure interaction between the staff and patients' families and the education of the community. A highlight of community-based rehabilitation is the excellent rate of repayment of loans by the patients to whom they were made. Also of note is the extent to which former defaulters make repayments due to the continuous rapport and good interpersonal relationship between the staff and patients. Most of the subjects of this study were drawn from the lower economic strata of society and for them the most essential consideration is to make a living, however meagre.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Risk of suicide among persons with AIDS. A national assessment.
OBJECTIVE: We sought to describe the rate, risk, trends, methods, and distribution of suicide among persons with the acquired immunodeficiency syndrome (AIDS) in the United States. DESIGN: We used National Center for Health Statistics multiple-cause mortality data from 1987 through 1989 to identify suicides among persons with AIDS (PWAs) and public-access AIDS surveillance data to determine person-years of observation of PWAs. PATIENTS: Residents of the United States with death certificates indicating suicide. MAIN OUTCOME MEASURE: Death certificates indicating both AIDS and suicide. RESULTS: In 1987 through 1989, a total of 165 suicides among PWAs occurred in 45 states and the District of Columbia. All but one case were male. Among males the rate was 165 per 100,000 person-years of observation, 7.4-fold higher than among demographically similar men in the general population. Self-poisoning with drugs was both the most common method (35%) and the method with the highest standardized mortality ratio (35). Suicide risk for PWAs decreased significantly (P < .05) from 1987 to 1989. CONCLUSION: Persons with AIDS have an increased risk of suicide, and assessment of such risk should be a standard practice in their care. These assessments should be carefully considered when potentially lethal medications are prescribed. The declining trend in suicide rates between 1987 and 1989 is encouraging; possible causes include emerging therapies for human immunodeficiency virus/AIDS, better psychiatric care for these patients, and lessened social stigma against PWAs.
Acquired Immunodeficiency Syndrome↗
A comparison study of treated and untreated pregnant and postpartum cocaine-abusing women.
The purpose of this study was to determine whether untreated pregnant and recently post-partum cocaine-abusing women could be differentiated from women who enrolled in drug treatment programs. The experimental sample was selected from women referred to the Georgia Addiction, Pregnancy, and Parenting Project, an intervention program for pregnant and postpartum addicted women, between January 1987 and January 1988 (n = 45). The comparison group was randomly selected from women who were admitted to two (2) day treatment programs during the same time period (n = 50). Groups were compared using the Addiction Severity Index (ASI) and the Psychiatric Symptom Checklist-90 (SCL-90). Results indicated that untreated women were less impaired socially and exhibited fewer symptoms of psychiatric distress. These findings confirm the commonly held belief that the severity of psychosocial distress may be an important motivating factor in the decision to enter drug treatment. Alternatively, the lack of gender-sensitive program components, such as childcare, and the social stigma attached to drug use in pregnancy may also account for the reluctance of pregnant and post-partum mothers to seek drug treatment. Implications for the development of intervention and treatment programs for women are discussed.
Adult↗
Imperforate anus.
Sucessful treatment of the child with imperforate anus yields an individual with satisfactory continence and a healthy urinary tract. These goals are achieved by accurate evaluation of the newborn, optimal technical results, and conscientious follow-up. The infant born with one of these malformations frequently has a serious associated anomaly which also requires early specific diagnosis and management. When the bowel has passed through the puborectalis in utero, the deformity can often be definitively treated in the neonate by dilations or anoplasty. However, if a urinary or high vaginal fistula is present, or if the anomaly is of the supralevator type, definitive surgery is best postponed some months and the neonate given a colostomy. We have found the sacroabdominoperitoneal approach to be the most satisfactory pullthrough procedure for the supralevator lesion. The children with high, supralevator anomalies have higher mortality rates and, in one out of four cases, have suboptimal fecal continence. They require the utmost in technical skill and continuing care if they are to lives free of social stigma. The mortality rate in all other types is low and the functional continence uniformly acceptable.
Abnormalities, Multiple↗
Involuntary deviance: schooling and epileptic children.
There exists in schools an unwritten set of presuppositions defining "normalcy." Students going beyond these boundaries of normalcy are encouraged (sometimes punitively) to change their behaviors. However, there is a growing awareness that not all children going beyond normalcy do so willingly. The phenomenon here termed "involuntary deviance" represents a way of perceiving and dealing with special students. An example, the case of children with epilepsy, is presented to illustrate the need for health educators and other educators to be familiar with such medical problems and, among their students, to help decrease the social stigma attached to some of these conditions. This need will become more urgent as the practice of mainstreaming students becomes increasingly prevalent.
Attitude↗
The long-distance psychiatric patient in the emergency room. Insights regarding travel and mental illness.
This paper deals with the motivational, demographic and clinical characteristics of individuals who seek psychiatric help at facilities located a great distance from their places of residence. The study identifies two subgroups within this category. The first (Intentional or Type A) group is constituted by persons who, owing to their concerns with the social stigma of mental illness, or driven by the desire for a magical solution to their problems, purposely undertake the journey to a distantly located psychiatric center. The second (Incidental or Type B) group consists of vacationers, hitch-hikers and skid-row individuals. While these "long distance patients" (LDP) did not show any differences when compared with the remainder of clinic attendance on demographic variables, distinct clinical features differentiated the two populations. Most significantly the LDP had a higher incidence of schizophrenia and alcohol related problems. The difference was entirely accounted for by the Type B subgroup ((LDP less than 0.01; Type A, NS; Type B less than 0.001). Implications of this finding have been discussed in view of the suggested relationships between travel and mental illness. Administrative problems of the LDP have been briefly commented upon.
Adult↗
Epilepsy: Bridging Epidemiological Landscapes, Molecular Mechanisms, and Emerging Precision Therapeutics.
Epilepsy ranks among the most prevalent neurological disorders worldwide, and recent years have witnessed significant advancements in understanding its epidemiological features, pathophysiological mechanisms, diagnostic methodologies, and therapeutic approaches. This review systematically examines the epidemiology of epilepsy, highlighting pronounced regional and population-based disparities, particularly the substantial treatment gap observed in low-income countries. Regarding pathogenesis, epilepsy development involves aberrant ion channel function, neuroinflammatory processes, dysregulation of the mTOR signaling pathway, and genetic predispositions. Diagnostic innovations, including ultra-high field magnetic resonance imaging, artificial intelligence-enhanced electroencephalogram analysis, and liquid biopsy techniques, have markedly enhanced the precision of epileptogenic focus localization and etiological identification. Genetic investigations have uncovered numerous epilepsy-associated genes, thereby underpinning the advancement of targeted therapies. Therapeutically, novel antiepileptic drugs, neuromodulation modalities such as vagus nerve stimulation and deep brain stimulation, alongside gene therapy, have expanded treatment options for refractory epilepsy. Nonetheless, global epilepsy management continues to confront challenges including limited drug accessibility, social stigma, and pharmacoresistance. The future trajectory emphasizes individualized and precision medicine approaches, integrating genomics, biomarker discovery, and intelligent monitoring technologies to foster comprehensive improvements in epilepsy diagnosis and treatment.
epidemiology↗
Defining a case of leprosy.
The biological and technical hurdles confronting the development of new diagnostic tools are manifestly great in leprosy. Leprosy diagnosis in the field, for control as well as for research purposes, will have to remain, for the time being, predominantly clinical. It is important that the significance and relevance of diagnosing so-called 'early' lesions must be viewed in the context of the objectives of leprosy control. All evidence suggests that the majority of these 'cases' are not likely to progress in the individual, nor is there any evidence that these 'cases' are of any importance for the transmission of the disease. At its best, such 'cases' may be a sign of temporary infection which will disappear spontaneously within a few months without leaving any residual signs. It is more likely that the majority of these are not cases of leprosy. In making such a diagnosis its ethical implications on the individual, his family and the local society must be considered, given the intense social stigma this diagnosis will generate; besides the cost of treatment and the potential risk of serious side-effects due to treatment. It may be justifiable to have a broad definition if the incidence of leprosy is still high and all reported cases are to be accepted as valid. But once the backlog of cases has been detected and, as a result of control efforts, the number of new cases begins to decrease, there is a need to narrow the case definition for national statistics.(ABSTRACT TRUNCATED AT 250 WORDS)
Humans↗
A comparative KAP study of leprosy patients and members of the community in Hlaing and Laung-Lon townships.
A KAP study was conducted in the peri-urban Hlaing and rural Laung-Lon Townships in Myanmar. It was found that both the leprosy patients as well as community members were still not sure about the cause of leprosy. Social stigma of leprosy encountered by patients needs to be addressed especially in peri-urban areas. It was also found that the patient's understanding of treatment regularity was still very unsatisfactory, for which health education measures needs to be introduced.
Adolescent↗
Social and cultural factors in the successful control of tuberculosis.
The burden of tuberculosis on the public health is staggering. Worldwide, annual incidence of new cases is estimated to be about 8 million. Almost 3 million deaths occur yearly. Early case identification and adherence to treatment regimens are the remaining barriers to successful control. In many nations, however, fewer than half those with active disease receive a diagnosis, and fewer than half those beginning treatment complete it. The twin problems of delay in seeking treatment and abandonment of a prescribed regimen derive from complex factors. People's confusion as to the implications of the tuberculosis symptoms, costs of transportation to clinic services, the social stigma that attaches to tuberculosis, the high cost of medication, organizational problems in providing adequate followup services, and patients' perception of clinic facilities as inhospitable all contribute to the complexity. Sociocultural factors are emphasized in this report because hitherto they have not been adequately explored. Salient among those sociocultural factors is the health culture of the patients. That is, the understanding and information people have from family, friends, and neighbors as to the nature of a health problem, its cause, and its implications. A knowledge of the health culture of their patients has become a critical tool if tuberculosis control programs are to be successful. Several anthropological procedures are recommended to help uncover the health culture of people served by tuberculosis clinics.
Adaptation, Psychological↗