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851 to 875 of 969Stigma, disclosure, coping, and medication adherence among people living with HIV/AIDS in Northern Tanzania.
This study examines a proposed theoretical model examining the interrelationships between stigma, disclosure, coping, and medication adherence among 158 HIV-infected patients on antiretroviral therapy (ART) in northern Tanzania. Perceived and self-stigma, voluntary and involuntary disclosure, positive and negative coping, and demographics were assessed by trained interviewers, and self-reported adherence was collected during 5 months follow-up. Data were examined using correlation and regression analyses. The analyses showed that perceived stigma is primarily related to involuntary disclosure, whereas self-stigma is related to voluntary disclosure. Religious coping positively relates to acceptance, whereas perceived stigma explains higher levels of denial of HIV status. Lastly, adherence was negatively affected by alcohol use, self-stigma, and denial. We conclude that adherence is predom…
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Social cohesion matters in health.
Introduction: The concept of social cohesion has invoked debate due to the vagueness of its definition and the limitations of current measurements. This paper attempts to examine the concept of social cohesion, develop measurements, and investigate the relationship between social cohesion and individual health.
Methods: This study used a multilevel study design. The individual-level samples from 29 high-income countries were obtained from the 2000 World Value Survey (WVS) and the 2002 European Value Survey. National-level social cohesion statistics were obtained from Organization of Economic Cooperation and Development datasets, World Development Indicators, and Asian Development Bank key indicators for the year 2000, and from aggregating responses from the WVS. In total 47,923 individuals were included in this study. The factor analysis was applied to identify dimensions of social cohes…
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The experience of young adult cancer patients described through online narratives.
Background: Young adults are often faced with challenges related to relationships, employment, housing, and emotional development. Experiencing cancer during this time complicates the developmental processes and creates a need for communicating concerns and discussing issues.
Objective: The purpose of this study was to explore the experiences and gain a better understanding of young adults affected by cancer (YAACs) by examining their online narratives (also known as Web logs or blogs).
Interventions/methods: Inclusion and exclusion criteria were used to identify eligible Web sites. The Web site that most corresponded to the selection criteria was chosen for analysis (Planet Cancer, http://www.planetcancer.org/). The blog content generated in July 2011 was collected. The blogs were written by a total of 34 female and 12 male writers and included 136 (by female) and 28 (by male) blog entr…
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Reversing the negative psychological sequelae of exclusion: inclusion is ameliorative but not protective against the aversive consequences of exclusion.
Social exclusion can have devastating personal, social, and clinical consequences, but several recent studies have identified factors that can reduce its aversive impact (e.g., distraction from rumination, control over a noise). In this study, we continued to explore possible strategies for reducing the aversive experiences of being excluded. Three experiments investigated whether an experience of inclusion reduced the impact of exclusion. Specifically, participants engaged in two rounds of a computer ball toss game (Cyberball) in which they were either included or excluded. Participants were told either that they played the two games with the same two sources (Experiment 1), with a different pair of sources (Experiment 2), or with people and then computer controlled sources (Experiment 3). We measured the impact of exclusion and inclusion on the psychological states of belonging, contro…
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A preliminary investigation of moral reasoning and empathy after traumatic brain injury in adolescents.
Primary objective: Traumatic brain injury (TBI) sustained during childhood can affect a number of socio-cognitive skills; however, little attention has focused on the integrity of moral reasoning in the assessment of post-TBI social sequelae and the role of empathy and intelligence on moral maturity.
Research design: In a quasi-experimental, cross-sectional research design, moral reasoning maturity and empathy in adolescents with mild-to-severe TBI (n = 25) were compared to typically-developing peers (n = 66).
Methods and procedures: Participants were administered the So-Moral and So-Mature, tasks of socio-moral reasoning and maturity, the Index of Empathy for Children and Adolescents, the Wechsler Abbreviated Scale of Intelligence and a demographic questionnaire.
Main outcomes and results: Participants with TBI had significantly lower levels of moral reasoning maturity. Further, adolesc…
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Challenges, coping strategies, and unmet needs of families with a child with autism spectrum disorder in Goa, India.
Autism Spectrum Disorders (ASD) are increasingly recognized in developing countries like India. However, little is known about the experiences of parents raising a child with ASD. This study aimed to describe the experiences of families in Goa, India with a view to understanding the unmet needs of families raising a child with ASD. Twenty in-depth interviews and nine focus group discussions were carried out with families of children with ASD and key community stakeholders such as special educators, teachers, and parents of typically developing children. This qualitative data was triangulated to explore the experiences, life impact, and unmet needs of raising a child with ASD. Key findings suggest that raising a child with ASD puts a tremendous strain on families due to competing commitments, often leading to initial social withdrawal with later reintegration into social networks. Second,…
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Häfner S, Baumert J, Emeny RT, Lacruz ME, Bidlingmaier M, Reincke M, Kuenzel H, Holle R, Rupprecht R, Ladwig KH, MONICA/KORA Study Investigators (2012)MEDLINE-indexed journal, not yet read by usPsychoneuroendocrinology38 citations To live alone and to be depressed, an alarming combination for the renin-angiotensin-aldosterone-system (RAAS).
Introduction: The renin-angiotensin-aldosterone-system (RAAS) is one of the most important systems involved in the pathogenesis of cardiovascular diseases. Its role in stress response has been generally neglected, although the progression of cardiovascular disease is considerably increased in the presence of stress and especially in the presence of depression risk. With the present analysis we aimed to evaluate whether the activity of the RAAS correlates with depressive symptomatology and with chronic stress. Moreover, we aimed to analyse whether stress response is altered in the presence of depressed symptomatology. We chose "living alone" to be our paradigm of chronic stress.
Methods and results: Aldosterone and renin levels were assessed in 1743 (829 men, 914 women) from the population-based KORA study (Cooperative Health Research in the Region of Augsburg). The relationship between a…
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Inducing sleep by remote control facilitates memory consolidation in Drosophila.
Sleep is believed to play an important role in memory consolidation. We induced sleep on demand by expressing the temperature-gated nonspecific cation channel Transient receptor potential cation channel (UAS-TrpA1) in neurons, including those with projections to the dorsal fan-shaped body (FB). When the temperature was raised to 31°C, flies entered a quiescent state that meets the criteria for identifying sleep. When sleep was induced for 4 hours after a massed-training protocol for courtship conditioning that is not capable of inducing long-term memory (LTM) by itself, flies develop an LTM. Activating the dorsal FB in the absence of sleep did not result in the formation of LTM after massed training.
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Neighborhood protective effects on depression in Latinos.
Neighborhood social ecologies may have protective effects on depression in Latinos, after adjusting for demographic risk factors, such as nativity and length of stay in the US. This study examines the effects of neighborhood collective efficacy and linguistic isolation on depression in a heterogeneous urban Latino population from 1,468 adult respondents in Los Angeles County. We used multilevel models to analyze how major depression is associated with socioeconomic background, length of stay in the U.S., neighborhood collective efficacy and linguistic isolation among Latinos. A significant cross-level interaction effect was found between collective efficacy and foreign-born Latinos who resided in the US ≥ 15 years. We report cross-level interaction effects between linguistic isolation and nativity for U.S.-born and nativity and duration of residence for foreign-born Latinos who had lived…
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Mare RD (2011)MEDLINE-indexed journal, not yet read by usDemography99 citations A multigenerational view of inequality.
The study of intergenerational mobility and most population research are governed by a two-generation (parent-to-offspring) view of intergenerational influence, to the neglect of the effects of grandparents and other ancestors and nonresident contemporary kin. While appropriate for some populations in some periods, this perspective may omit important sources of intergenerational continuity of family-based social inequality. Social institutions, which transcend individual lives, help support multigenerational influence, particularly at the extreme top and bottom of the social hierarchy, but to some extent in the middle as well. Multigenerational influence also works through demographic processes because families influence subsequent generations through differential fertility and survival, migration, and marriage patterns, as well as through direct transmission of socioeconomic rewards, st…
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Self-stigma, empowerment and perceived discrimination among people with bipolar disorder or depression in 13 European countries: the GAMIAN-Europe study.
Background: There is little information on the degree to which self-stigma is experienced by individuals with a diagnosis of bipolar disorder or depression across Europe. This study describes the levels of self-stigma, stigma resistance, empowerment and perceived discrimination reported in these groups.
Methods: Data were collected from 1182 people with bipolar disorder or depression using a mail survey with members of national mental health non-governmental organisations.
Results: Over one fifth of the participants (21.7%) reported moderate or high levels of self-stigma, 59.7% moderate or high stigma resistance, 63% moderate or high empowerment, and 71.6% moderate or high perceived discrimination. In a reduced multivariate model 27% of the variance in self-stigma scores, among people with a diagnosis of bipolar disorder or depression, was accounted for by levels of empowerment, perceive…
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Acceptance of pain, self-compassion and psychopathology: using the chronic pain acceptance questionnaire to identify patients' subgroups.
The present study explores whether specific subgroups of patients could be identified based on Chronic Pain Acceptance Questionnaire scores. A battery of self-report questionnaire was used to assess acceptance of pain, self-compassion and psychopathology in 103 participants with chronic pain, from Portuguese health care units. K-Means cluster were performed and the results supported three subgroups of patients (low acceptance subgroup; high acceptance subgroup; intermediate subgroup with activity engagement near to the mean and low willingness to pain). One-way ANOVA's showed that the three subgroups identified differed significantly from each other on psychopathology and self-compassion. Results indicated that the intermediate subgroup presented less depression and stress, compared with the low acceptance subgroup. In what concerns self-compassion, the low acceptance subgroup reported h…
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Social conditions and urban health inequities: realities, challenges and opportunities to transform the urban landscape through research and action.
The process of urbanization entails social improvements with the consequential better quality-of-life for urban residents. However, in many low-income and some middle-income countries, urbanization conveys inequality and exclusion, creating cities and dwellings characterized by poverty, overcrowded conditions, poor housing, severe pollution, and absence of basic services such as water and sanitation. Slums in large cities often have an absence of schools, transportation, health centers, recreational facilities, and other such amenities. Additionally, the persistence of certain conditions, such as poverty, ethnic heterogeneity, and high population turnover, contributes to a lowered ability of individuals and communities to control crime, vandalism, and violence. The social vulnerability in health is not a "natural" or predefined condition but occurs because of the unequal social context t…
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Multi-informant predictors of social inclusion for students with autism spectrum disorders attending mainstream school.
This study examined differential profiles of behavioural characteristics predictive of successful inclusion in mainstream education for children with autism spectrum disorders (ASD) and comparison students. Multiple regression analyses using behavioural ratings from parents, teachers and peers found some evidence for differential profiles predicting peer acceptance and rejection. High levels of peer-rated shyness significantly predicted social rejection in comparison students only. Parent-rated prosocial behaviour also differentially predicted social acceptance; high-levels of prosocial behaviour predicted acceptance in comparison students, but low-levels were predictive for students with ASD. These findings suggest that schools may seek to augment traditional social skills programmes with awareness raising about ASD among mainstream pupils to utilise peers' apparent willingness to disco…
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Patients' experiences of acquiring a deep surgical site infection: an interview study.
Background: The negative impact of surgical site infection (SSI) in terms of morbidity, mortality, additional costs, and length of stay (LOS) in the hospital is well described in the literature, as are risk factors and preventive measures. Given the lack of knowledge regarding patients' experiences of SSI, the aim of the present study was to describe patients' experiences of acquiring a deep SSI.
Methods: Content analysis was used to analyze data obtained from 14 open interviews with participants diagnosed with a deep SSI.
Results: Patients acquiring a deep SSI suffer significantly from pain, isolation, and insecurity. The SSI changes physical, emotional, social, and economic aspects of life in extremely negative ways, and these changes are often persistent.
Conclusion: Health care professionals should focus on strategies to enable early diagnosis and treatment of SSIs. The unacceptable …
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Adult burn survivors' views of peer support: a qualitative study.
This qualitative study examined 30 burn survivors' perceptions of the value of peer support in their own psychosocial rehabilitation. Little research is available that investigates the role of peer support in post-burn recovery in terms of perceived benefits and costs. Findings revealed strong positive views regarding the helpfulness of peer support. Burn survivors reported that peer supporters provided a sense of belonging and affiliation and gave hope and confidence. Two-thirds of the sample had served as peer supporters themselves after receiving their injuries, suggesting that mutual aid does involve reaching out to others. At the same time, survivors spoke of possible costs in helping others. Involving peer supporters in the psychological rehabilitation of burn survivors may be an important complement to the medical team.
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Turning to God in the face of ostracism: effects of social exclusion on religiousness.
The present research proposes that individuals who are socially excluded can turn to religion to cope with the experience. Empirical studies conducted to test this hypothesis consistently found that socially excluded persons reported (a) significantly higher levels of religious affiliation (Studies 1, 2, and 4) and (b) stronger intentions to engage in religious behaviors (Study 2) than comparable, nonexcluded individuals. Direct support for the stress-buffering function of religiousness was also found, with a religious prime reducing the aggression-eliciting effects of consequent social rejection (Study 5). These effects were observed in both Christian and Muslim samples, revealing that turning to religion can be a powerful coping response when dealing with social rejection. Theoretical and practical implications of these findings are discussed.
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The impact of culture and sociological and psychological issues on Muslim patients with breast cancer in Pakistan.
Breast cancer is the most common form of cancer in Muslim women in Pakistan. The impact of the initial diagnosis, culture, religion, and psychosocial and psychological aspects of the disease is not well established. This qualitative study examined the experience and coping strategies used by patients with breast cancer in relation to its impact on their physical, mental health, religious, and family issues. Thirty patients with breast cancer were interviewed. Data were analyzed using thematic analysis. The patient's experience of breast cancer focused on the range of emotions felt throughout the illness trajectory, the importance of religion and family support on coping strategies used to manage the adverse effects of chemotherapy, and also the financial concerns. This is the first study to examine Pakistani Muslim women's views on the lived experience of breast cancer. This article prov…
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The effect of racial residential segregation on black infant mortality.
Economic differences and proximal risk factors do not fully explain the persistent high infant mortality rates of African Americans (blacks). The authors hypothesized that racial residential segregation plays an independent role in high black infant mortality rates. Segregation restricts social and economic advantage and imposes negative environmental exposures that black women and infants experience. The study sample was obtained from the 2000-2002 US Linked Birth/Infant Death records and included 677,777 black infants residing in 64 cities with 250,000 or more residents. Outcomes were rates of all-cause infant mortality, postneonatal mortality, and external causes of death. Segregation was measured by using the isolation index (dichotomized at 0.60) from the 2000 US Census Housing Patterns. Propensity score matching methods were used. After matching on propensity scores, no independent…
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Chandola T, Britton A, Brunner E, Hemingway H, Malik M, Malik M, Kumari M, Badrick E, Kivimaki M, Marmot M (2008)MEDLINE-indexed journal, not yet read by usEuropean heart journal356 citations Work stress and coronary heart disease: what are the mechanisms?
Aims: To determine the biological and behavioural factors linking work stress with coronary heart disease (CHD).
Methods and results: A total of 10 308 London-based male and female civil servants aged 35-55 at phase 1 (1985-88) of the Whitehall II study were studied. Exposures included work stress (assessed at phases 1 and 2), and outcomes included behavioural risk factors (phase 3), the metabolic syndrome (phase 3), heart rate variability, morning rise in cortisol (phase 7), and incident CHD (phases 2-7) on the basis of CHD death, non-fatal myocardial infarction, or definite angina. Chronic work stress was associated with CHD and this association was stronger among participants aged under 50 (RR 1.68, 95% CI 1.17-2.42). There were similar associations between work stress and low physical activity, poor diet, the metabolic syndrome, its components, and lower heart rate variability. Cross…
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Stressor-specific alterations in corticosterone and immune responses in mice.
Different stressors likely elicit different physiological and behavioral responses. Previously reported differences in the effects of stressors on immune function may reflect qualitatively different physiological responses to stressors; alternatively, both large and subtle differences in testing protocols and methods among laboratories may make direct comparisons among studies difficult. Here we examine the effects of chronic stressors on plasma corticosterone concentrations, leukocyte redistribution, and skin delayed-type hypersensitivity (DTH), and the effects of acute stressors on plasma corticosterone and leukocyte redistribution. The effects of several commonly used laboratory stressors including restraint, forced swim, isolation, and low ambient temperatures (4 degrees C) were examined. Exposure to each stressor elevated corticosterone concentrations, with restraint (a putative psy…
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Control, uncertainty, and expectations for the future: a qualitative study of the impact of drought on a rural Australian community.
Many rural Australian communities continue to endure a prolonged drought. The mental health effects of short-term natural disaster are well known; those of a long-term and chronic natural disaster such as drought are less well understood. However, in addition to immediate distress there are likely to be feelings of loss, grief and hopelessness, all of which are implicated in an increased risk of subsequent psychiatric morbidity. Furthermore, rural Australia is at a relative disadvantage for early and effective mental health intervention due to a lack of resources, compared with urban Australia. This qualitative research investigates the experience of drought in two farming communities in the state of New South Wales. Farmers, farm and non-farm businesspeople, and health workers took part in focus group discussions of the effects of drought on themselves, their families and their communit…
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Parenting very low birth weight children at school age: maternal stress and coping.
Objective: To compare severity and determinants of stress and coping in mothers of 8-year-old very low birth weight (VLBW) and term children varying in medical and developmental risk.
Study design: Three groups of mothers/infants were prospectively compared in a longitudinal study from birth to 8 years (110 high-risk VLBW, 80 low-risk VLBW, and 112 term). Maternal psychological distress, coping, parenting/marital stress, child health, and family impact were measured in the children at age 8 years.
Results: Mothers of VLBW children differed from term mothers, reporting less consensus with partners, more concern for their children's health, less parent-child conflict, and fewer years of education attained. Mothers of high-risk VLBW children experienced the greatest family and personal strains and used less denial and disengagement coping. The groups exhibited no differences in the sense of…
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Perceptions of the neighbourhood environment and self rated health: a multilevel analysis of the Caerphilly Health and Social Needs Study.
Background: In this study we examined whether (1) the neighbourhood aspects of access to amenities, neighbourhood quality, neighbourhood disorder, and neighbourhood social cohesion are associated with people's self rated health, (2) these health effects reflect differences in socio-demographic composition and/or neighbourhood deprivation, and (3) the associations with the different aspects of the neighbourhood environment vary between men and women.
Methods: Data from the cross-sectional Caerphilly Health and Social Needs Survey were analysed using multilevel modelling, with individuals nested within enumeration districts. In this study we used the responses of people under 75 years of age (n = 10,892). The response rate of this subgroup was 62.3%. All individual responses were geo-referenced to the 325 census enumeration districts of Caerphilly county borough.
Results: The neighbourhood…
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Mothers' experiences of having their newborn child in a neonatal intensive care unit.
Background: From birth the child has an ability to respond to the environment, which influences the interaction between mother and child. If this attachment is interrupted, the child's emotional development is negatively influenced. When the child needs care in a neonatal intensive care unit (NICU) it is difficult to establish contacts between mother and child. Separation from the child is found to be the most difficult aspect for mothers when their newborn child is hospitalized in a NICU.
Aim: The aim of this study was to describe mothers' experiences when their full-term newborn child was cared for in a NICU during the postpartum maternity care period.
Method: A phenomenological hermeneutic interview study was performed. Ten mothers were interviewed once, 6 months to 6 years after the experience.
Results: The essence of the experience is understood as an alternation between two opposit…
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