Tuberculosis (TB) associated stigma is well-documented phenomenon that may contribute to sub-optimal TB care in Pakistan. The objective of study was to assess TB related knowledge and perceived stigma among community members. This was cross-sectional survey using convenience sample of 183 individuals recruited between October and December 2017. A validated stigma measurement tool developed by Van Rie et al. was adapted. Data was analyzed using SPSS version 20.0. 183 individuals (73% males; n = 134) participated in survey. Eighty-seven percent were aware that TB is curable disease (n = 159) and 91% thought that it could be transmitted by coughing (n = 167). However, respondents also thought that TB was spread through contaminated food (73%; n = 134), sharing meals (55%; n = 100), sharing utensils (53%; n = 96) and by having sexual intercourse with a TB patient (51%; n = 93). Fifty-seven percent (n = 104) associated TB with high levels of stigma. Persons who had less than six years of education (crude OR = 1.2; 95% CI: 0.89, 1.72) and lacked knowledge that TB is curable (crude OR = 3.42; 95% CI: 1.20, 9.70) were more likely to associate TB with stigma. In addition, females (crude OR = 1.33; 95% CI: 0.87, 2.04) and those who were unemployed (crude OR = 1.06; 95% CI: 0.65, 1.74) were also more likely to associate TB with stigma. We found an association between lack of knowledge about TB and perceived stigma. This highlights need for improved education and awareness about TB.

Pollination in angiosperms depends on a complex communication between pollen grains and stigmas, classified as wet or dry, depending on the presence or absence of secretions at the stigma surface, respectively. In species with wet stigma, the cuticle is disrupted and the presence of exudates is indicative of their receptivity. Most stigma studies are focused on few species and families, many of them with self-incompatibility systems. However, there is scarce knowledge about the stigma composition in Fabaceae, the third angiosperm family, whose stigmas have been classified as semidry. Here we report the first transcriptome profiling and DEGs of Vicia faba L. styles and stigmas from autofertile (flowers able to self-fertilize in absence of manipulation whose exudate is released spontaneously) and autosterile (flowers that need to be manipulated to break the cuticle and release the exudates to be receptive) inbred lines. From the 76,269 contigs obtained from the de novo assembly, only 45,1% of the sequences were annotated with at least one GO term. A total of 115,920, 75,489 and 70,801 annotations were assigned to Biological Process (BP), Cellular Component (CC) and Molecular Function (MF) categories, respectively and 5,918 differentially expressed genes (DEGs) were identified between the autofertile and the autosterile lines. Among the most enriched metabolic pathways in the DEGs subset were those related with aminoacid biosynthesis, terpenoid metabolism or signal transduction. Some DEGs have been related with previous QTLs identified for autofertility traits, and their putative functions are discussed. Results derived from this work provides an important transcriptomic reference for style-stigma processes to aid understanding of the molecular mechanisms involved in faba bean fertilization.

ABSTRACTIntroduction:Human Immunodeficiency Virus (HIV) is a global health problem that is almost recorded in every country. The long-term and long-term negative impacts of HIV cases are stigma and discrimination in people with HIV (PLHIV). The purpose of this study is to find out the stigma and discrimination felt by PLHIV.Method:This study design of systematic review from 4 electronic databases namely Scopus ScienceDirect, Sage and ProQuest by using keywords tailored to Medical Subject Headings (MeSH) including "Stress", "covid", "nursing", "hospital". This study uses PICOS framework to prevent research bias and analysed using descriptive analysis.Results:The results of the analysis of the article showed from 761 articles have been identified title, abstract and full-text so that recorded 15 articles that can be reviewed. The article consists of various designs, namely RCT, cross sectional and qualitative studies. Analysis shows that stigma and discrimination are social phenomena that manifest in several social areas.Conclusion:Stigma and discrimination in people with HIV (PLHIV) is still common, stigma is carried out by the wider community to their own families. The family approach is necessary to improve well-being as well as improve the social community of the family.

Introduction: Corona Virus Disease 2019 causes health problems in the world in the form of a health crisis that results in psychological problems as fear and anxiety. The purpose of this study to determine the factors that influence psychological and stigma during the Covid-19 pandemic.Methods: This study is a literature review with five databases (Scopus, CINAHL, ScienceDirect, PubMed, and ProQuest), studies design used a cross-sectional or quasi-experimental, with a date of March 2021. The Center for Review and Dissemination and the JBI Guide are used to measure the Quality and Prism checklist for guide reviews. A feasibility study based on title, abstract, full text, and research methodology. The data analysis used narrative analysis based on the research findings.Results: Eleven articles met the predefined review inclusion criteria. Research is base on related factors psychology, related factors stigma, and factors related to psychological and stigma. Most of the factors associated with psychological conditions and stigma have a quasi-experimental and cross-sectional design. Participants averaged over a thousand for each study and discussed psychology factors related to the stigma. Conclusion: Factors related to psychological are age, education, symptoms and health conditions, gender, information, economy, exposure duration, and social support, while factors related to stigma are environment, history of comorbid diseases, discrimination, and public perceptions.

Assessment of stigma among cancer patients is of utmost importance as stigma may lead to various psychological sequelae and lower quality of life. This study aimed to translate the English version of the Shame and Stigma Scale (SSS) into Malay and validate the Malay version of the SSS (SSS-M) among cancer patients in Malaysia. Initially, concurrent translation and back translation of the SSS-M was performed, and face and content validity were assessed. Then, the SSS-M was administered to a total of 234 patients of mixed types of cancer to assess its reliability (internal consistency and test-retest reliability), construct validity (convergent and discriminant validity), exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The SSS-M total score registered good internal consistency (Cronbach’s α of 0.886) and test-retest reliability (intraclass correlation coefficient of 0.846, p < 0.001). EFA and CFA confirmed that the SSS-M consisted of 20 items in 5 domains. Its convergent and discriminant validity were achieved. Hence, the SSS-M demonstrated good psychometric properties and is available for use to assess stigma among cancer patients in Malaysia.

Intersectional experiences, socio-cultural meanings, ethnic traditions and morals compound stigma-related stress (Jackson et al., 2020; Schmitz 2019). Sex workers are subject to various stigmatizing forces which can lead to secrecy, isolation and lack of social and cultural support (Koken 2012). Stigmatizing forces include structural humanitarian governance and aid interventions that conflate migration and sex work with insidious constraints and coercion. This study explored how migrant female sex workers from distinctive ethnic cultures manage their identity on a day to day basis in relation to the separation of work and home life. Methods: The perspectives of female sex workers were collected via a series of in-depth semi-structured interviews. The inclusion criteria were that the women had worked in sex work for over 18months, defined their involvement in sex work as voluntary, and were over 18yrs of age. The perspectives of seven women from South Asian (Pakistani), Brazilian, and British backgrounds were analyzed using Grounded Theory (Glaser and Strauss, 1967). Ethnicity was considered to explore how the women experienced stigma, how it impacted on the management of their identity, and how the process of change occurred. Results: The women used a variety of methods to maintain work and home life boundaries, processes they used switch into a role and all experienced stigma and tried to deal with it in ways such as concealment from friends and family. Two core categories and properties emerged from the data as participants felt guilt and/or shame but only the South Asian participants spoke of this with reference to their culture and religion. Conclusion: It was not migration per se but rather the relationship of migration to culture that was key to identity management. Participants reflected that as their country was considered collectivist country with interdependent thought, that any negativity felt could not only be reflected on the individual, but also the entire family. For these reasons Pakistani sex workers were subject to more complex stigmatizing forces, shame and guilt as regards risk and exposure. Discussion focusses on the processes and management strategies used to extend social and cultural support.

In flowering plants with dry stigmas, pollen hydration involves water movement, which may be facilitated by aquaporins. To explore the possibility underlying this biological process, we identified and characterized a mutant with a T-DNA insertion in PIP2;5, which encodes an aquaporin with water channel activity in the PIP2 subfamily. We monitored the pollination process (pollen hydration, germination, and pollen tube growth) of wild type pollen on stigmas of the mutant and wild type. Pollen hydration was postponed on the stigmas of the mutant, compared with that on wild type stigmas. However, pollen tube germination and growth was unaffected in the mutant. The PIP2;5 protein was located in the cell plasma membrane and was preferentially expressed in the stigma. Based on our results, we concluded that PIP2;5 might play an important role in water movement during pollen hydration.

Abstract: Fetal Alcohol Spectrum Disorder (FASD) is considered a lifelong disability that has been framed by neurobiological descriptions focused on the brain. These are important features but fail to tell the story of living with FASD. By surveying those with FASD, this work expands upon prior survey work which illustrated a multitude of early onset physiological issues occurring at rates much higher than typical of the general population. The current project, again using an anonymous survey methodology, seeks to open up other direct experiences to better understand the complexity of living with FASD. An anonymous online survey was used to gather data on advresity in childhood, schooling, employment, housing and finances, involvement with the criminal justice system as well as relationships and parenting. Results inform how supports can be enhanced and targeted with a goal of improving the quality of life. The survey was developed by adults living with FASD who have served as a long-standing advocacy and educational group influencing policy and practice in the field.

Abstract Psychiatric care in Spain has experienced relevant changes both in the legislative and conceptual frameworks. This new approach advocates for the combination of carrying out mental health promotion, prevention of alterations and early diagnosis and treatment, enhancing actions against stigma and emphasising the attention on the most vulnerable groups, like childhood and youth. For that, it has seen fit to perform a nursing intervention on Education and Promotion of mental health for teachers and counsellors of a secondary school located in Valencia, with the general objective of assessing their impact on stigma. Non-randomised clinical trial in which a nursing intervention on Education and Promotion of mental health was performed. Pre-intervention tools: multiple choice test validated by a group of experts; pre and post-intervention: AQ-27 (stigma attribution); in order to check its acceptance, satisfaction surveys were used. The inferential analysis included the Wilcoxon Test (pre and post AQ-27) and the Pearson Correlation Test for the quantitative variables of interest. Sample (n=22): women aged 47.96 ± 10.12 years with 18.64 ± 10.34 years of work experience. The predominant stigmatising attitude before and after intervention was “Coercion”. The ones with lower score were “Segregation” and “Anger”. The p-values obtained in the Wilcoxon Test were statistically significant (p-value <0.05) except for “pre and post Responsibility” and “pre and post Pity”. The following constructs of interest were faced: “Age” vs “Fear” (r= -0.48, moderate), “Professional experience” and “Fear” (r= -0.46, moderate) and “Help” and “Psychosis test” (r= 0.51, severe). The overall satisfaction score was 9/10. Despite the scores obtained in “Coercion” and “Psychosis”, the intervention was useful for reducing stigma in the sample.

Just 2 years ago, 35% of Americans were involved with gig work. According to Statista, over half of Americans will be freelancing through online gig work by 2027. Research on how consumers select gig workers, or taskers, is still mostly underexplored. The purpose of this study is to investigate the potential impact of a tasker's gender and self-presentation in their profile picture on consumer perceptions and choices. We proposed that taskers who have a professional headshot as the profile picture will receive higher ratings on competence, warmth, and trustworthiness than taskers whose profile picture is a selfie. We also proposed that taskers who smile in their profile picture will receive higher ratings on competency, warmth, and trustworthiness than taskers who do not smile. Furthermore, we predicted that professionalism has a stronger positive impact on perceptions of male taskers than on female taskers for our third hypothesis. Lastly, we hypothesized that gender bias exists on gig platforms, such that smiling will have a stronger positive effect on female taskers’ competence, warmth, and trustworthiness than on male taskers. Our study had 292 Kennesaw State University students who were tested online through Qualtrics. Our first and second hypotheses are not supported but our last two have partial support. There is a significant main effect of gender, and we find that male taskers are rated significantly higher on competence, warmth, and trustworthiness, compared to female taskers. Professional photos give male taskers an advantage over professional female taskers and female taskers are punished more for not smiling than male taskers. Future directions include looking into factors such as Race, Age, or background setting could be investigated. Conducting similar tests in a larger and more externally valid setting could yield more concrete results. Continuation into this new area of gig work could lead the way into revolutionizing how freelancers conduct their public appearance or how gig work platforms could handle this new market.

The new NICE guideline for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), published in October 2021, makes significant changes in treatment recommendations. It acknowledges the complexity of this chronic medical condition, which always impacts quality of life and can be profoundly disabling, recognising the prejudice and stigma that people with ME/CFS often experience in the absence of any specific diagnostic test. The guideline outlines steps for accurate diagnosis, recognising post-exertional malaise as a core symptom; importantly, ME/CFS can now be diagnosed after just 3 months in a bid to improve long-term health outcomes. It recommends the need for individual, tailored management by a multi-disciplinary team, ensuring that the wellbeing of the individual is paramount. The guideline makes clear that any programme based on fixed incremental increases in physical activity or exercise, for example graded exercise therapy (GET), should not be offered as a treatment for ME/CFS and emphasises that cognitive behavioural therapy (CBT) should only be offered as a supportive intervention. Because of the rigorous methodology required by NICE Committee review and the inclusion of the testimony of people with lived experience as committee members, this guideline will influence the future diagnosis and management of ME/CFS in the UK and beyond.

Previous research showed that intersex people face specific challenges in their sexual development, including uncertainties or confusion about their gender, a negative genital self-image, and hesitance to engage in romantic and sexual relationships. However, in-depth knowledge of a central period of this development, adolescence, is missing. In our qualitative study, we explore which factors influence the relational and sexual development of intersex youth and what elements contribute to a positive development. We interviewed eighteen intersex persons aged 18-38. We identified three main themes: (1) intersex experiences, (2) the described sexual and relational life course, and (3) factors influencing a positive development. Our findings show that intersex youth face many obstacles to their relational and sexual development, many of which related to healthcare. However, their life stories also illuminate how healthcare professionals but also parents, friends, partners, teachers and others can make a substantial difference in intersex lives by breaking normative, binary thinking on sex and gender.

Cancers of the head and ne¬ck and their treatment can cause disfigurement and loss of functioning, with a profound negative impact on the person’s self-image and psychosocial wellbeing. This can lead to experiences of shame and stigma, which are important targets for psychosocial interventions. Accurate measurement and identification of these problems enables clinicians to offer appropriate interventions and monitor patients’ progress. This study aimed to validate the Canadian version of the Shame and Stigma Scale (SSS) among French and English speaking head and neck cancer patients. Data from 258 patients from two major Canadian hospitals was analysed. The existing 4-factor structure of the SSS was supported, with the following subscales: Shame with Appearance, Sense of Stigma, Regret, and Social/Speech Concerns. The Canadian SSS showed adequate convergent and divergent validity and test-retest reliability. Rasch analysis suggested scale improvement by removing two misfitting item and two items with differential functioning between French and English speaking patients. The final 16-item scale version had adequate fit to the Rasch model. The SSS provides more accurate measures for people with high levels of shame and stigma, and thus has utility in identifying patients with more severe symptoms who may be in need of psychosocial interventions.

To evaluate the impact of a new Substance Use Disorder (SUD) education program on medical students' representations, we selected the Substance Abuse Attitude Survey (SAAS) questionnaire, which we adapted to our curriculum and cultural context. To validate this adapted version, we conducted an exploratory factor analysis following the administration of our 29-items bSAAS questionnaire to 657 medical students in Belgium (response rate: 71,1%). 23 items correlated to 3 factors namely "Stereotypes and moralism", "Treatment optimism" and "Specialised treatment" were retained (70% of total variance explained, Cronbach's alpha= 0.80) and constituted the new questionnaire called beSAAS. The factor "Specialised treatment", stood out from previous studies which could be explained by our target population and the impact of the formal, informal, and hidden curriculum in medical education. This study highlighted certain factors influencing stereotypical representations such as age, gender, origin, and personal or professional experience with substance use. Our study allowed us to retain the beSAAS as a good questionnaire to evaluate SUD stigma and highlighted interesting findings to improve SUD training in medicine. Further studies are needed to complete its validity and reliability.

Although it may seem paradoxical, primary care and mental health professionals develop prejudices and discriminatory attitudes towards people with mental health problems in a very similar way to the rest of the population. The main objective of this project was to design, implement and evaluate two awareness interventions respectively tailored to reduce stigma and discrimination beliefs and attitudes towards persons with a mental health diagnosis among primary care (PC) and mental health (MH) professionals. These interventions were developed by Obertament, the Catalan alliance against stigma and discrimination in mental health. The TLC3 (Targeted, Local, Credible, Continuous Contact) methodology was adapted to the Catalan PC and MH professional contexts. Activists with lived experience of mental health diagnosis carried out awareness-raising interventions in PC and MH health centres. The efficacy of these interventions was evaluated using two prospective double-blind cluster-wait-list-randomized-controlled trial experimental designs. Stigmatizing beliefs and behaviours were measured with the Opening Minds Stigma Scale for Health Care Providers in primary care centres and with the Beliefs and Attitudes towards Mental Health Service users’ rights in mental health centres. Positive reductions in both PC and MH professionals’ stigmatising beliefs and attitudes were found in the 1-month follow-up, although a ‘rebound effect’ at the 3-month follow up was also detected. This emphasizes the importance of the continuity of the presence of anti-stigma activities and messages. Attrition rates where high, which can hamper the reliability of the results. Further follow-up studies should enquiry effects of long-term interventions aimed at reducing stigmatising beliefs and attitudes among primary care and mental health professionals.

Parkinson’s disease (PD) is typically well-recognized by its characteristic motor symptoms (e.g., bradykinesia, rigidity, and tremor). The cognitive symptoms of PD are increasingly being acknowledged by clinicians and researchers alike. However, PD also involves a host of emotional and communicative changes which can cause major disruptions to social functioning. These include problems producing emotional facial expressions (i.e., facial masking) and emotional speech (i.e., dysarthria), as well as difficulties recognizing the verbal and non-verbal emotional cues of others. These social symptoms of PD can result in severe negative social consequences, including stigma, dehumanization, and loneliness, which might affect quality of life to an even greater extent than more well-recognized motor or cognitive symptoms. It is therefore imperative that researchers and clinicians become aware of these potential social symptoms and their negative effects, in order to properly investigate and manage the socioemotional aspects of PD. The present review provides an examination of the current research surrounding some of the most common social symptoms of PD and their related social consequences, and argues that proactively and adequately addressing these issues might improve disease outcomes.

While persons with schizophrenia find steady employment difficult to sustain, many of the women take on the most difficult task of all – motherhood. The aim of this paper is to review the challenges of motherhood in this population and the treatment strategies needed to keep mothers and children safe, protecting health and fostering growth. This is a narrative review reflecting the author’s life experience and a non-systematic search of the recent literature. Topics added are the stigma against motherhood in the context of schizophrenia, mothers’ painful choices, issues of contraception, abortion, and child custody, fostering and kin placement of children, the effects of antipsychotics, specific perinatal delusional syndromes, and parental supports. Recommendations are to work collaboratively with mothers who struggle with serious mental illness, take note of their strengths as well as their failings, offer a wide array of family services, monitor closely for safety, and appreciate the challenges these women daily face.

Hepatitis B virus (HBV) is a major global health challenge. Emerging evidence suggests that poor knowledge and stigma are impacting HBV control efforts in sub-Saharan Africa (SSA), however their role is not well understood. We conducted a cross-sectional study of adults aged ≥ 18 years in a community and pharmacy setting in Freetown, Sierra Leone. A structured questionnaire was used to assess knowledge, stigmatizing attitudes, and health-seeking behaviors regarding HBV. Logistic regression was used to identify predictors of HBV knowledge and related stigma. A total of 306 adult participants were enrolled (50.7% male, 7.5% HBV positive and 11.7% vaccinated). Overall, 52.2% had comprehensive HBV knowledge and 49.3% expressed a stigmatizing attitude towards people with HBV. Notwithstanding, 72.2% stated they would receive the HBV vaccine if offered, 80.4% would take anti-HBV medication and 78.8% would be willing to attend clinic regularly. Comprehensive HBV knowledge was associated with HBV positive status (aOR 4.41; p = 0.029) and being vaccinated against HBV (aOR 3.30; p = 0.034). HBV-related stigma was associated with secondary or higher level of education (aOR 2.36; p &lt; 0.001), good HBV knowledge (aOR 2.05; p = 0.006) and pharmacy setting (aOR 1.74, p = 0.037). These findings suggest that education and stigma reduction may benefit HBV elimination efforts in SSA.

Abstract: Background: Stigma in health can result in a broad range of vulnerabilities and risk for patients and healthcare providers. The media plays a role in people’s understanding of health and stigma is socially constructed through many communication channels including via media framing. Among health issues that were affected by stigma recently were the Monkeypox and Covid-19. Objectives: This research aims to examine how The Washington Post framed stigma around mon-keypox and COVID-19. Guided by the framing theory and stigma theory, online news coverage for monkeypox and COVID-19 were analyzed to understand the construction of social stigma through the media reporting. Methods: This research employed a qualitative content analysis to compare news framing in The Washington Post online news regarding monkeypox and COVID-19. Results: Based on endemic, reassurance, and sexual transmission frames, the The Washington Post predominantly defined Africa as the source of the disease, blames gay communities, and empha-sizes no need to worry about the spread of the monkeypox virus. For the COVID-19 coverage, The Washington Post described China as the source of the coronavirus and constructs the image of panic towards the spread of the virus. Conclusions: The shifts in stigma discourse essentially manifest racism, xenophobia, and sexism in public health. This research affirms that the media reinforces stigma phenomenon in health through framing and offers constructive suggestions for mitigating this issue.

Appropriate diagnosis, treatment and care contributes to better service engagement, improvements to wellbeing, cost savings, reductions in morbidity and mortality for people with Alcohol Related Brain Damage. In the North-East of England large amounts of alcohol are consumed, reflected in the number of alcohol-related deaths in the region. However, the pathway for people with Alcohol Related Brain Damage to receipt of diagnosis, treatment and care is unknown and could be unwittingly influenced by stigma. Qualitative in-depth semi-structured interviews were completed with 25 health and social care professionals from organisations involved with people with Alcohol Related Brain Damage recruited via snowball-sampling. Interviews were recorded, transcribed verbatim, coded, and analysed. People with Alcohol Related Brain Damage were stigmatised both by society and professionals which inhibited entry into services therefore Alcohol Related Brain Damage remained underdiagnosed and misdiagnosed. There was no dedicated service but silos with revolving doors and underfunded generic care with long waiting lists typically excluding those with alcohol or neurological problems. Professionals need to be challenged on the assumption that Alcohol Related Brain Damage is self-inflicted via training aimed at challenging unconscious bias. Reducing stigmatising processes associated with Alcohol Related Brain Damage could counteract professionals’ reluctance to provide care.

This study evaluated the impact of didactic videos and service user testimonial videos on mental illness stigma among medical students. Two randomized controlled trials were conducted in Nepal. Study 1 examined stigma reduction for depression. Study 2 examined depression and psychosis. Participants were Nepali medical students (Study 1:n=94, Study 2:¬n=213) randomized to three conditions: a didactic video based on the mental health Gap Action Programme (mhGAP), a service user video about living with mental illness, or a control condition with no videos. In Study 1, videos only addressed depression. In Study 2, videos addressed depression and psychosis. In Study 1, both didactic and service user videos reduced stigma compared to the control (F2,91=6.37, p=0.003). In Study 2 (depression and psychosis), there were no differences among the three arms (F2,210=2.07, p=0.13). When comparing Study 1 and 2, there was greater stigma reduction in the service user video arm with only depression versus service user videos with depression and psychosis (t(31)=-3.04, p=0.005). In summary, didactic and service user videos were associated with decreased stigma when content addressed only depression. However, no stigma reduction was seen when including depression and psychosis. This calls for different strategies based on types of mental illnesses. ClinicalTrials.gov identifier: NCT03231761

Individuals with BPD grapple with unstable relationships, marked by extreme emotional swings and interpersonal conflicts. Emotional instability, a distorted self-image, and impulsivity further complicate matters, often leading to self-harm and suicide attempts as desperate coping mechanisms. Genetics and adverse childhood experiences contribute to BPD's development, shaping brain function and emotional regulation. Diagnosis involves meticulous assessments, paving the way for personalized treatments like dialectical behavior therapy and, in severe cases, hospitalization. Early intervention, professional support, and societal understanding are pivotal for positive outcomes, and challenging mental health stigma.

Providing patient-centered care to manage chronic pain and opioid use disorder (OUD) is associated with improved health outcomes. However, adopting a holistic approach to providing care is often challenging in rural communities. This study aims to identify and contrast challenges to providing patient-centered care from the perspective of patients and providers. A participatory design approach was adopted to elicit the perceptions of providers and patients with lived experiences of chronic pain and OUD in Jefferson County, Wisconsin. Two focus groups were conducted with each stakeholder group to identify problems that participants face with respect to chronic pain management and OUD and possible solutions. Four interviews were conducted with providers experienced in chronic pain management. Analysis of focus group sessions and interviews show consensus among patients and providers that lack of behavioral health and recovery resources create barriers to effectively manage OUD and chronic pain. However, there was discordance among the two groups about other barriers such as patient and provider attitudes, tapering approach, and access to medications for OUD. This tension among patients and providers can influence patients’ retention in therapy. More efforts are needed to mitigate stigma among providers in rural communities and support psychosocial needs of patients.

The purpose of this study was to assess the extent to which self-esteem and depression mediated the influence of internalized stigma on life satisfaction among Korean out-of-school youths. Cross-sectional data on 318 youths provided information on perceived stigma, self-esteem, depression, life satisfaction, and personal characteristics. A multinomial logistic regression analysis was followed by structured path analysis to investigate the mediation effects. Internalized stigma was negatively associated with life satisfaction. Self-esteem significantly mediated the influence of stigma on depression and the influence of depression on life satisfaction. Further, stigma directly and significantly influenced depression. This study demonstrated that self-esteem and depression were important to the relationship between internalized stigma and life satisfaction. Implications for possible policies and programs with the aim of helping out-of-school youths to integrate and lead successful satisfying lives are discussed.

AbstractBackground: Empowering Communities, Combating HIV/AIDS: The Indispensable Role of Community-Based Strategies in Awareness and PreventionObjective: Highlight the significance of community-based approaches in addressing the ongoing HIV/AIDS pandemic through enhanced awareness, reduced stigma, and effective prevention measures.Method: This article provides a theoretical analysis of community-based HIV/AIDS interventions, drawing upon key strategies and successful examples from diverse settings.Results: Community-based initiatives emerge as critical factors in empowering individuals and communities to take ownership of their health. Through culturally-sensitive education, accessible testing, and comprehensive support services, these initiatives effectively diminish the social stigma surrounding HIV/AIDS and promote preventative behaviors. Examples of successful programs illustrate the potential of community-driven approaches to achieve measurable reductions in transmission rates and improved health outcomes.Conclusion: The fight against HIV/AIDS necessitates robust community engagement. Community-based interventions, grounded in local knowledge and addressing specific needs, offer a promising pathway towards fostering health equity, reducing stigma, and ultimately curtailing the spread of the virus. Further research and investment in these initiatives are crucial to ensuring their scalability and sustained impact on global HIV/AIDS prevention efforts.

Children with epilepsy are affected by several factors, including clinical and social variables, which can lead to reductions in quality of life (QOL). Among these variables, factors relating to seizure severity such as frequent seizures and status epilepticus (SE) have been identified as important predictors of QOL. In addition, frequency of interictal epileptiform discharges (IEDs) on the electroencephalogram (EEG) may also lead to cognitive declines and behavioral disturbances. Moreover, frequent seizures and/or IEDs may play a role in emotional mediators such as stigma and fatigue in childhood epilepsy. Seizure severity and/or IEDs are thus important QOL-related factors in childhood epilepsy. Frontal lobe dysfunctions such as cognitive decline and behavioral disturbances can result in reduced QOL for both the child and their family. Frontal and prefrontal lobe growth disturbances can be present during active-phase epilepsy in some children with neuropsychological impairments. Recovery from prefrontal lobe growth disturbance may depend on the active seizure period. Disturbance of prefrontal lobe growth can recover more rapidly in children with a shorter active seizure period. In contrast, recovery may be delayed in children with a longer active seizure period. Accordingly, severe seizures can lead to neuropsychological impairments in association with prefrontal lobe growth disturbance in children with epilepsy. Moreover, frequent seizures can lead to having seizure-associated headache, perception of self-stigma and parental stigma, and fatigue. In addition, IEDs on EEG, representing persistent pathological neuronal discharges, may be associated with several pathological aspects. Frontal IEDs can be a risk factor for recurrent seizures, cognitive decline, and behavioral disturbances and may also play a role as an emotional mediator similar to stigma. In addition, behavioral disturbances may result in the presence of secondary bilateral synchrony (SBS) on EEG. Behavioral disturbances can be improved in association with reduction of IEDs in children with frontal IED and SBS. Seizure severity and IEDs on EEG may thus be associated with neuropsychological impairments, leading to QOL reduction. Therapeutic management may be desirable to remit seizures and EEG abnormalities such as frontal IED and SBS as soon as possible to improve QOL in children with epilepsy.

This study explored intraindividual multidimensional profiles integrating psychosocial factors, namely, body image and satisfaction, weight-related self-stigma, positivity, and happiness, and behavioural-lifestyle factors, namely, adherence to a healthy diet, among Spanish adults with overweight or obesity. We further aimed to investigate the association of excess weight (i.e., measured body mass index, BMI) with the abovementioned multidimensional configurations. A convenience sample of adult individuals with excessive weight completed self-reports regarding the study variables, and their weight and height were measured. With a perspective centered on the individual, a cluster analysis established three distinct intraindividual psychosocial and diet-related profiles: a group of healthy individuals with excess weight; a group of individuals who were negatively affected by their excessive weight and showed the most distressed profile; and a group of dysfunctional individuals who seemed to be excessively unrealistic and optimistic regarding their excessive weight and unhealthy lifestyles. Furthermore, individuals in the affected cluster had higher obesity. The results showed that there are specific psychosocial and lifestyle profiles in the adult population with excess weight and that there are relationships among psychological, behavioural, and body-composition factors. For clinical application purposes, it is important to account for the heterogeneity within individuals who are obese and to individualize the interventions, with a focus from weight change to individual's overall well-being.

This study explored intraindividual multidimensional profiles integrating psychosocial factors, namely, body image and satisfaction, weight-related self-stigma, positivity, and happiness, and behavioural-lifestyle factors, namely, adherence to a healthy diet, among Spanish adults with overweight or obesity. We further aimed to investigate the association of excess weight (i.e., measured body mass index, BMI) with the abovementioned multidimensional configurations. A convenience sample of adult individuals with excessive weight completed self-reports regarding the study variables, and their weight and height were measured. With a perspective centred on the individual, a cluster analysis established three distinct intraindividual psychosocial and diet-related profiles: a group of healthy individuals with excess weight; a group of individuals who were negatively affected by their excessive weight and showed the most distressed profile; and a group of dysfunctional individuals who seemed to be excessively unrealistic and optimistic regarding their excessive weight and unhealthy lifestyles. Furthermore, individuals in the affected cluster had higher obesity. The results showed that there are specific psychosocial and lifestyle profiles in the adult population with excess weight and that there are relationships among psychological, behavioural, and body-composition factors. For clinical application purposes, it is important to account for the heterogeneity within individuals who are obese.

The present study is an attempt to investigate the factors behind spinsterhood, the sort of perception popular mindset hold on spinsters and the consequences of being a spinster. It starts with a theoretical part as a background to the topic. Then, it moves to the practical part where the study depends a field work for testing the constructed hypothesis. The field work is conducted through distributing quiet a big number of representative questionnaires. Briefly, the findings proved that the majority of respondents, 51/° believe that the society considers spinsters as those who had never been proposed to. Moreover, 52/° of respondents believes that spinsters are old women who had never been married. Both may imply a negative connotation set by society and culture for unmarried women. As to the factors behind spinsterhood, the findings proved that the majority of the respondents, 75/° refer spinsterhood to the fact that women prioritize their education and careers on marriage. For the consequences of spinsterhood, the major result demonstrates that 53/° of respondents believe that spinsters’ isolation and embarrassment is one major impact of spinsterhood.