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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent work demonstrates that hearing impairment is much more common than previously suspected. The disability may be unrecognized or denied by the sufferer and may attract social stigma rather than sympathy from others. The effect on mental health is surprisingly neglected. Early studies of psychiatric patients suggested hearing impairment is an important cause of paranoid illness, but more recent studies of wider populations have failed to confirm this association. Hearing impairment is unrelated to intellect when controlled for age, but is an important differential diagnosis of dementia in the elderly. Evidence accumulates to suggest that the hearing impaired are vulnerable to depression, social stress and isolation, but reliable controlled studies of psychiatric sequelae are needed.
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PMID:Mental health and acquired hearing impairment: a review. 218 May 15

Changing Minds--Every Family in the Land is a national campaign launched by the Royal College of Psychiatrists which aims to reduce discrimination against people who suffer from mental disorders. One of its target areas is dementia. What is the stigma associated with Alzheimer's disease and how can hospital doctors challenge it in everyday practice?
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PMID:Challenging the stigma of Alzheimer's disease. 1078 87

Very few of the 100 studies of the prevalence of dementia have been carried out in Africa. Much of the early work concerned small hospitalised samples. However, a series of studies from Ibadan, Nigeria, have produced consistently low rates for dementia, especially for Alzheimer's Disease. The most recent studies reveal rather higher rates, but still lower than surveys carried out elsewhere. The possible reasons for these findings are considered: differential survival rates, the hiding of cases by relatives because of stigma, reluctance to seek medical assistance as inappropriate, poor access to medical care, the feeling that the old person has come to the end of his useful life and defective case-finding techniques. The need for further research is emphasised.
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PMID:The epidemiology of dementia in Africa: a review. 1079 72

The National Institutes of Health is making efforts to increase the representation of minority elders in aging research. While it is often noted that cultural barriers may make the recruitment of minority elders into research more difficult, relatively little empirical exists to support this claim. The purpose of this study was to identify sociocultural barriers to recruitment that emerged during a four-year study of dementia caregiving among Chinese families in the Boston area. More specifically, this paper examines how culturally shaped conceptions of health, aging, and dementia impacted the recruitment process. This paper is based on a qualitative analysis of interviews with 23 Chinese families and extensive fieldnotes generated by project ethnographers and interviewers. The following themes emerged in this analysis: 1) dementia-related changes were construed as a normal part of the aging process rather than a disease, making it more difficult to identify dementia-affected elders and to recruit families, 2) research participation was viewed as potentially harmful because it can lead to excessive worry 3) Alzheimer's disease carries a social stigma among Chinese, leading families to shun formal diagnosis and research participation, and 4) practitioners viewed research as an intrusion offering no direct benefit to participants.
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PMID:Working with culture: a qualitative analysis of barriers to the recruitment of Chinese-American family caregivers for dementia research. 1461 6

Prevalence of dementia is expected to increase three- to four-fold in the next 50 years. In 1986, New York State established the Alzheimer's Disease and Other Dementias Registry, one of a few such registries in the United States. We identify surveillance challenges within the Registry. Data quality--specifically, the attributes of completeness and accuracy--is the primary challenge to the New York State dementias registry. Completeness may be undermined when hospitals and nursing homes fail to report data, and hospital charts do not record dementia diagnoses. Failure to record diagnoses may occur because of diagnosis uncertainty, perceived stigma, clinical attention on the primary reason for hospitalization, and financial disincentives. Dementia is well recorded in nursing home data because care planning requires frequent resident evaluations. The accuracy of recording specific forms of dementia is limited because coding terminology has not kept pace with physicians' perspectives on dementias. Hospitals and nursing homes document dementia and comorbidities more effectively among frail individuals and those with advanced dementias than among individuals who appear to be relatively healthy. One way to overcome challenges of data quality is to form partnerships with organizations that have expertise in managing medical records and coding dementias. As medical advances make early diagnoses more possible outside the hospital or nursing home setting, we will need to redesign the current surveillance system to capture this additional dementia data and ensure a representative system.
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PMID:Challenges in surveillance of dementias in New York State. 1563 70

Neurological manifestations of HIV infection and AIDS are being recognized with a frequency that parallels the increasing number of AIDS cases. Next to sub-Saharan Africa, India has the second largest burden of HIV related pathology, essentially caused by HIV-1 clade C in both the geographic locales, in contrast to USA and Europe. But the true prevalence of HIV related neuroinfections and pathology is not available due to inadequate medical facilities, social stigma and ignorance that lead to underdiagnosis. Neurotuberculosis, followed by cryptococcosis and toxoplasmosis in various combinations are the major neuropathologies reflecting the endemicity and manifesting clinically by reactivation of latent infection. Discordance in the clinical prevalence of various infections, when compared to pathological studies highlight similarities in clinical, radiological modalities of diagnosis and inherent problems in establishing definitive diagnosis. Viral infections appear to be relatively rare. Inspite of heavy burden of HIV/AIDS, HIV associated neoplasia is infrequent, including primary CNS lymphomas. HIV encephalitis and HIV associated dementia are considered infrequent, though systematic studies have just been initiated in various centres. Peripheral neuropathy characteristically manifests with vasculitic neuropathy while diffuse infiltrative lymphocytosis syndrome (DILS) involving nerves has not been reported from India. Spinal cord pathology including vacuolar myelopathy is rare, even in asymptomatic cases. Till now the AIDS cases in India were drug naive but a new cohort of cases following initiation of HAART therapy as a national policy is soon emerging, altering the biology and evolution of HIV/AIDS in India. Lacunae in the epidemiology, diagnosis and study of biology of HIV/AIDS are outlined for future research.
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PMID:Neuropathology of HIV/AIDS with an overview of the Indian scene. 1581 57

Experts from eight European countries (Belgium, France, The Netherlands, Ireland, Italy, Portugal, Spain and the United Kingdom) and the disciplines of clinical psychology, general practice, geriatric medicine, old age psychiatry, medical sociology, nursing and voluntary body organisation met in 2003 to explore obstacles to recognition of and response to dementia in general practice within Europe. A modified focus group methodology was used in this exploratory process. Groups were conducted over a two-day period, with five sessions lasting 1-1.5 hours each. An adapted nominal group method was used to record themes arising from the group discussion, and these themes were used in a grounded theory approach to generate explanations for delayed recognition of and response to dementia. The overarching theme that arose from the focus groups was movement, which had three different expressions. These were: population movement and its consequences for localities, services and professional experience; the journey of the person with dementia along the disease process; and the referral pathway to access services and support. Change is the core issue in dementia care, with multiple pathways of change that need to be understood at clinical and organisational levels. Practitioners and people with dementia are engaged in managing emotional, social and physical risks, making explicit risk management a potentially important component of dementia care. The boundary between generalist and specialist services is a particular problem, with great potential for dysfunctionality. Stigma and ageism are variably distributed phenomena both within and between countries.
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PMID:Understanding obstacles to the recognition of and response to dementia in different European countries: a modified focus group approach using multinational, multi-disciplinary expert groups. 1584 26

The inevitable deterioration in hearing ability that occurs with age--presbycusis--is a multifactorial process that can vary in severity from mild to substantial. Left untreated, presbycusis of a moderate or greater degree affects communication and can contribute to isolation, depression, and, possibly, dementia. These psychological effects are largely reversible with rehabilitative treatment. Comprehensive rehabilitation is widely available but underused because, in part, of social attitudes that undervalue hearing, in addition to the cost and stigma of hearing aids. Remediation of presbycusis is an important contributor to quality of life in geriatric medicine and can include education about communication effectiveness, hearing aids, assistive listening devices, and cochlear implants for severe hearing loss. Primary care physicians should screen and refer their elderly patients for assessment and remediation. Where hearing aids no longer provide benefit, cochlear implantation is the treatment of choice with excellent results even in octogenarians.
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PMID:Presbycusis. 1618

Memory clinics were first described in the 1980s. They have become accepted worldwide as useful vehicles for improving practice in the identification, investigation, and treatment of memory disorders, including dementia. They are provided in various settings, the setting determining clientele and practice. All aim to facilitate referral from GPs, other specialists, or by self referral, in the early stages of impairment, and to avoid the stigma associated with psychiatric services. They bring together professionals with a range of skills for the benefit of patients, carers, and colleagues, and contribute to health promotion, health education, audit, and research, as well as service to patients.
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PMID:Memory clinics. 1651 2

Although there is extensive literature on electroconvulsive therapy (ECT), little documentation exists about how an individual makes the decision to receive ECT. This phenomenological study is an exploratory examination of the decision making process of older adults with mental illness who elect to receive ECT. Study participants included 7 older adults without dementia from a suburban geriatric medicine/psychiatry practice who elected to receive ECT. The lived experience of decision making as perceived by these 7 participants was a process that moved them toward wellness. The data revealed four significant themes: Support, Trust, Past Experience, and Desperation. An overriding substantive theme identified as an obstacle was the Stigma of Mental Illness. This study provided a basis for planning clinical practice and building further research.
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PMID:The decision making process of older adults who elect to receive ECT. 1854 70


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