Fighting the stigma caused by mental disorders: past perspectives,present activities,and future directions

People who live with mental illnesses are among the most stigmatized groups in society. In 1996, in recognition of the particularly harsh burden caused by the stigma associated with schizophrenia, the WPA initiated a global anti-stigma program, Open-the-Doors. In 2005, a WPA Section on Stigma and Mental Health was created, with a broader mandate to reduce stigma and discrimination caused by mental disabilities in general. In light of these impor-tant developments, and the growing public health interest in stigma reduction, this paper reflects on the past perspectives that have led us to our current position, reviews present activities and accomplishments, and identifies challenges that the Section members will face in their future efforts to reduce the stigma caused by mental disorders.     

Effectiveness of programs for reducing the stigma associated with mental disorders. A meta‐analysis of randomized controlled trials

The stigma associated with mental disorders is a global public health problem. Programs to combat it must be informed by the best available evidence. To this end, a meta‐analysis was undertaken to investigate the effectiveness of existing programs. A systematic search of PubMed, PsycINFO and Cochrane databases yielded 34 relevant papers, comprising 33 randomized controlled trials. Twenty‐seven papers (26 trials) contained data that could be incorporated into a quantitative analysis. Of these trials, 19 targeted personal stigma or social distance (6,318 participants), six addressed perceived stigma (3,042 participants) and three self‐stigma (238 participants). Interventions targeting personal stigma or social distance yielded small but significant reductions in stigma across all mental disorders combined (d=0.28, 95% CI: 0.17‐0.39, p<0.001) as well as for depression (d=0.36, 95% CI: 0.10‐0.60, p<0.01), psychosis (d=0.20, 95% CI: 0.06‐0.34, p<0.01) and generic mental illness (d=0.30, 95% CI: 0.10‐0.50, p<0.01). Educational interventions were effective in reducing personal stigma (d=0.33, 95% CI: 0.19‐0.42, p<0.001) as were interventions incorporating consumer contact (d=0.47, 95% CI: 0.17‐0.78, p<0.001), although there were insufficient studies to demonstrate an effect for consumer contact alone. Internet programs were at least as effective in reducing personal stigma as face‐to‐face delivery. There was no evidence that stigma interventions were effective in reducing perceived or self‐stigma. In conclusion, there is an evidence base to inform the roll out of programs for improving personal stigma among members of the community. However, there is a need to investigate methods for improving the effectiveness of these programs and to develop interventions that are effective in reducing perceived and internalized stigma.     

美国凌霄柱头行为——一种促进传粉的机制(英文)

引起美国凌霄(campsis radicans(L.)Seem.ex Bureau.)柱头开合行为的原因迄今未知。在本研究中,机械刺激、自花授粉、异花授粉以及不同授粉数量的授粉分别给予美国凌霄的柱头,以期找到影响其柱头行为的原因。研究结果表明,单纯的机械刺激可以使柱头闭合,但不能使之永久闭合;只有柱头表面落置了足够量的花粉(>350)时柱头才会最终闭合。美国凌霄的柱头行为对自花或者异花花粉没有差异,两种花粉授于柱头后花粉管都能成功地萌发并生长。研究结果说明:美国凌霄的柱头行为不是一种异交机制,而是一种促进传粉进而增强繁殖成功的机制。     

美国凌霄柱头行为--一种促进传粉的机制

引起美国(Campsis radicans(L.)Seem.ex Bureau.)柱头开合行为的原因迄今未知.在本研究中,机械刺激、自花授粉、异花授粉以及不同授粉数量分别给予美国凌霄的柱头,以期找到影响其柱头行为的原因.研究结果表明,单纯的机械剌激可以使柱头闭合,但不能使之水永久闭合;只有柱头表明落置了足够量的花粉(>350)时柱头才会最终闭合.美国凌霄的柱头对换自花或者花粉没有差异,两种花粉授于柱头后花粉管都能成功萌发并生长.研究结果表明:美国凌霄的柱头行为不是一种异交机制,而是一种促进传粉进而增强繁殖成功的机制.     

The functional significance of a stigma color polymorphism in Acer pictum subsp. mono (Aceraceae)

Aims Exploring the characteristics and function of a flower color polymorphism contributes to our understanding of floral evolution in angiosperms. However, little information is available on stigma color polymorphisms in flowering plants despite their important functional role in plant reproduction.Methods We studied a stigma color polymorphism at the individual level in Acer pictum subsp. mono (aka A. mono) by investigating stigma-color morph proportion and comparing stigma performance and components of female fitness (pollen adhesion, pollen germination, fruit set, seed set and fruit weight) between the two morphs (red and greenish-yellow stigma) within natural populations at Dongling Mountain in the north of China. In the flowering period, we conducted hand pollination in natural populations and then made microscopic observations using the aniline blue fluorescence method.Important findings Individuals in the studied populations did not change their stigma color between years, and flowers produced by a single tree were uniform in their stigma color. This strongly suggests that stigma color variation is genetically controlled. The percentage of the red stigma flowers with germinated pollen grains was significantly higher than that of the greenish-yellow stigma flowers when hand pollination was conducted in the early flowering period, but not so in the late flowering period. There was no significant difference in the percentage of flowers with pollen adhesion to the stigma between the two morphs. Fruit set of the red morph was significantly higher than that of the greenish-yellow morph. Our findings suggest that the red morph may be more advantageous for pollen germination and fruit set than the greenish-yellow morph, which may provide a functional explanation for the high incidence of the red stigma morph in the studied populations. Alternative explanations for the stigma color polymorphism are discussed to stimulate further work.     

Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates,correlates, impact and interventions

A systematic electronic PubMed, Medline and Web of Science database search was conducted regarding the prevalence, correlates, and effects of personal stigma (i.e., perceived and experienced stigmatization and self‐stigma) in patients with schizophrenia spectrum disorders. Of 54 studies (n=5,871), published from 1994 to 2011, 23 (42.6%) reported on prevalence rates, and 44 (81.5%) reported on correlates and/or consequences of perceived or experienced stigmatization or self‐stigma. Only two specific personal stigma intervention studies were found. On average, 64.5% (range: 45.0–80.0%) of patients perceived stigma, 55.9% (range: 22.5–96.0%) actually experienced stigma, and 49.2% (range: 27.9–77.0%) reported alienation (shame) as the most common aspect of self‐stigma. While socio‐demographic variables were only marginally associated with stigma, psychosocial variables, especially lower quality of life, showed overall significant correlations, and illness‐related factors showed heterogeneous associations, except for social anxiety that was unequivocally associated with personal stigma. The prevalence and impact of personal stigma on individual outcomes among schizophrenia spectrum disorder patients are well characterized, yet measures and methods differ significantly. By contrast, research regarding the evolution of personal stigma through the illness course and, particularly, specific intervention studies, which should be conducted utilizing standardized methods and outcomes, are sorely lacking.     

Water-conducting properties of lipids during pollen hydration

Based on the authors’ previous work an attempt has been made to study water flow in the lipid matrix during pollen hydration. The present study has demonstrated that in the presence of small amounts of water, the type of lipids used defined the time of hydration of pollen in vivo on the stigma and in vitro. Several approaches were used including cryo‐scanning electron microscopy, magnetic resonance imaging and Fourier transform infrared microspectroscopic imaging, with the purpose of detecting very small amounts of water. The results show that no water is detectable in the lipid matrix. It was observed and concluded that the water for pollen hydration accumulates as a thin layer at the contact side between pollen and stigma, during the normal process of pollination in plant species with a wet stigma. However, using the same species deprived of the stigma by cell ablation, it was shown that the layer of water observed in wild‐type plants is not necessary for pollen hydration.     

有花植物触敏柱头的闭合行为及其适应意义

有花植物触敏柱头的闭合行为一直是传粉生态学和进化生物学研究的热点问题之一。植物花的多裂片柱头在传粉者接触后迅速闭合的现象主要存在于玄参目的一些类群中。早在上个世纪初,植物学家就对花的柱头闭合现象进行过初步的研究,认为柱头闭合主要是由于花粉在柱头上萌发时吸收水分导致柱头细胞膨压降低而引起的;并对柱头闭合的适应性提出了一些假说。近年来,许多学者研究证实柱头闭合能促进花粉萌发及花粉管伸长,或减少花粉散出与柱头接受花粉间的相互干扰,提高传粉者访问过程中花粉的散播量,并且柱头的状态会直接影响传粉者的取食行为。到目前为止,对柱头闭合的机制及其避免自交的假说还存在许多争议。关于触敏柱头的闭合行为,尤其是其适应机制及其生态学意义还有待更加系统和深入的研究。本文概述了触敏柱头的研究进展,并对研究中尚存在的一些问题进行了讨论。     

Relationship of stigma behaviors and breeding system in three Mazus (Phrymaceae) species with bilobed stigma

Sensitive stigma has been recognized to facilitate outcrossing. We hypothesized that species with different levels of sensitivity might have corresponding differences in components of their breeding system. In this study, three Mazus species with bilobed stigmas were used to test the hypothesis. We explored stigma behaviors of the species in reaction time, recovery time, permanent closing time, and the minimum pollen load causing permanent closure. We investigated floral traits, pollinator type and behavior, pollination intensity, and natural schedule of pollen deposition on stigma. Moreover, we evaluated the mating system of the species by checking seed set after controlled pollination treatments, namely, natural flowers with open pollination, enclosed flowers without pollination, and enclosed flowers with self and outcross hand pollination. Results indicated that stigma of M. pumilus (N. L. Burman) Steenis was not sensitive, whereas stigmas of M. miquelii Makino and M. stachydifolius (Turcz.) Maxim. closed and reopened quickly in response to pollination. Accordingly, hand pollination treatments revealed that seed set of self-spontaneous pollination in M. pumilus was similar to the other treatments. For M. miquelii, outcross pollen resulted in significantly higher seed set than self-pollen.Mazus stachydifolius was self-incompatible. Additionally, the corresponding characteristics in other components of the breeding system for each species were found. Our study indicated that the sensitivity of bilobed stigma might be linked with floral traits and the mating system in a given species. Sensitive stigma should be regarded as an evolutionary mechanism for enhancement of outcrossing.     

烟台甜樱桃柱头的可授性、形态特征与坐果率

采用数码照相、电镜扫描、联苯胺-过氧化氢测试及去雄套袋等技术手段, 对烟台甜樱桃(Cerasus avium)花期不同发育阶段柱头的可授性、形态特征和坐果状况进行了观察。结果表明, 烟台甜樱桃在套袋状态下, 柱头可授期从开花前1天开始可持续5–7天。从杯状花期到花瓣平展期, 柱头逐渐有乳突细胞破裂并呈现分泌液, 出现渐强的可授性; 从花瓣平展期到花瓣脱落期, 柱头由暗黄渐变至暗黑, 逐渐萎缩并丧失可授性。去雄套袋及人工授粉实验结果显示, 在大蕾期、杯状花期、花瓣展放期、花瓣平展期和花瓣脱落期进行人工授粉, 烟台甜樱桃的坐果率分别为60.50%、58.33%、62.08%、57.14%和39.13%。在自然条件下烟台甜樱桃的坐果率一般为30%–42%, 传粉成功的最佳期主要发生在杯状花期至花瓣平展期。     

芍药花粉活力和柱头可授性的研究

用TTC法测定了芍药花粉的活力和寿命,用联苯胺—过氧化氢法测定了其柱头的可授期。结果表明,栽培芍药单瓣花植株的花粉活力和重瓣花植株的花粉活力在开花初期(1～2d)无明显差别,但重瓣花植株的花粉活力比单瓣花植株的花粉活力下降快;通常情况下,花粉寿命约为7d。栽培品种的柱头有个体差异,单瓣花植株有的开花后2h即可分泌粘液,而重瓣花植株的柱头在开花后,有的一直不分泌粘液,有的在开花后两天才分泌粘液;单瓣花植株的柱头可授性比重瓣花植株的强,一般分别在开花后6d和3d之内具可授性。移栽的野生芍药植株的花粉活力比栽培品种下降的慢,其寿命也较长,一般为15d;柱头的可授性和粘液分泌比栽培植株强。     

JUSTICE, STIGMA, AND THE NEW EPIDEMIOLOGY OF HEALTH DISPARITIES

Recent research in epidemiology has identified a number of factors beyond access to medical care that contribute to health disparities. Among the so-called socioeconomic determinants of health are income, education, and the distribution of social capital. One factor that has been overlooked in this discussion is the effect that stigmatization can have on health. In this paper, I identify two ways that social stigma can create health disparities: directly by impacting health-care seeking behaviour and indirectly through the internalization of negative interpersonal judgments. I then argue that social arrangements that foster self-respect can reduce the impact of stigmatization on health disparities. I conclude by showing how John Rawls' conception of justice can be used to address the intersection of stigma, health, and self-respect, in contrast to critics of his position, who have seen him as excessively focused on the allocation of material goods.     

Stigmatization in the long-term treatment of psychotic disorders

Stigma is linked to negative prejudices without examining whether there is any justification for such behaviour. Over time, various efforts have been made to reduce prejudice toward people with mental illness. Yet, the World Health Organization (WHO) World Health Report still describes stigma as one of the greatest obstacles to the treatment of mental illness. While schizophrenia, among other mental illnesses, is the most stigmatized even to the point that some want the name of the illness to be hidden or changed, patients with bipolar illness may also be exposed to stigma. The degree of stigmatization has been found to be positively associated with the severity of the mental disorder, and stigma is carried out not only by patients but also by their families in correlation with the severity. Tragically, people with mental illness themselves are as negative in their opinions about mental illness as is the general public, and concerns about stigma adversely affect self-esteem and adaptive social functioning. There are many programmes worldwide for the fight against stigmatization, and there is clear recognition of the fact that stigma can only be successfully eliminated if the programme becomes a normal part of health service rather than of campaigns of limited duration.     

Società Botanica Italiana Congresso Sociale 1982 Parto—12-14 Ottobre Relazioni

Abstract

« Harmomegathy »: a still open problem not yet well-known. - Wodehouse used the term « Harmomegathy » to indicate the form and volume change in pollen grains, due to water loss or assumption. Roundish and tricolporate grains in the anther become oval and decrease in volume during the dehydration preceeding anthesis. Viceversa during rehydration on the stigma they undergo the opposite process.

Pollen water content at an thesis varies from species to species and it usually ranges between 10 and 20%; nevertheless in some families as Zingiberaceae and Araceae it is higher. Anther and pollen dehydrations are affected by environmental factors, such as humidity of air and temperature, before the anthesis and when pollen is suspended in air. Besides, to avoid the further loss of water during pollen flow, an oily layer derived from tapetum degeneration is deposited outside the pollen grains.

During dehydration and rehydration pollen grains undergo a stress due to shape and volume changes expecially in the colpus and/or pore areas. Pollen walls are structured in order to avoid their own damage, which could be followed by protoplast death and/or irregularities in grain shape. Intine, formed by pectocellulosic filaments, has elastic properties, as sporopollenin, the component of exine.

Stigma can be dry or wet, namely covered or not by stigmatic exudate giving place to different hydration patterns. The structure of intine and exine has to match that of the stigma, in fact pollen will find the best place and way to proper hydration only on stigmas of its own species. Grains structure also must be sterically conform to stigma: this is well-shown in species as Linum, Lytrum and Primula which have an heteromorphic autoincompatibility.

The right keeping of shape and structure of grains, despite the hydration and dehydration, is therefore essential to the physical-morphological recognition between pollen and stigma, which preceedes the biochemical recognition.     

濒危植物蒙古扁桃花粉活力和柱头可授性研究

用过氧化氢酶法测定蒙古扁桃花粉的活力和寿命,用联苯胺-过氧化氢法测定柱头可授性。结果表明,蒙古扁桃花粉活力在散粉后第2天最高,3d后活力迅速下降,三种类型的植株的花粉活力下降速度存在差异,其活力可持续30d左右。短柱头植株柱头在开花后1d可分泌黏液,长柱头和中柱头花植株的柱头在开花后2d才分泌黏液,短柱头分泌黏液的持续时间较后者长。柱头可授性持续时间同种之间也存在差异,长柱头和中柱头植株可达6d,而短柱头花植株可持续10d左右。     

Improving outcomes for ill and injured children in emergency departments: protocol for a program in pediatric emergency medicine and knowledge translation science

Background

Implementation of evidence-based mental health assessment and intervention in community public health practice is a high priority for multiple stakeholders. Academic-community partnerships can assist in the implementation of efficacious treatments in community settings; yet, little is known about the processes by which these collaborations are developed. In this paper, we discuss our application of community-based participatory research (CBPR) approach to implementation, and we present six lessons we have learned from the establishment of an academic-community partnership.

Methods

With older adults with psychosis as a focus, we have developed a partnership between a university research center and a public mental health service system based on CBPR. The long-term goal of the partnership is to collaboratively establish an evidence-based implementation network that is sustainable within the public mental healthcare system.

Results

In building a sustainable partnership, we found that the following lessons were instrumental: changing attitudes; sharing staff; expecting obstacles and formalizing solutions; monitoring and evaluating; adapting and adjusting; and taking advantage of emerging opportunities. Some of these lessons were previously known principles that were modified as the result of the CBPR process, while some lessons derived directly from the interactive process of forming the partnership.

Conclusion

The process of forming of academic-public partnerships is challenging and time consuming, yet crucial for the development and implementation of state-of-the-art approaches to assessment and interventions to improve the functioning and quality of life for persons with serious mental illnesses. These partnerships provide necessary organizational support to facilitate the implementation of clinical research findings in community practice benefiting consumers, researchers, and providers.     

黄瓜雌花发育过程中柱头的腺特征(英文)

利用透射电镜技术研究了黄瓜（Ｃｕｃｕｍｉｓ　ｓａｔｉｖｕｓ　Ｌ．）雌花柱头发育过程中传递组织、分泌组织和乳突细胞的超微结构。在整个发育过程中,乳突细胞和分泌组织细胞的细胞质内密布很多管状及槽库膨大的内质网,产生很多分泌囊泡;在成熟柱头的传递组织和分泌组织细胞间观察到大量的胞间连丝;乳突细胞和分泌细胞高度液泡化,质膜内折;在柱头发育过程中分泌组织细胞的核周腔扩大形成裂瓣状核,到柱头成熟阶段裂瓣状核更加明显。进一步的研究显示,在成熟柱头的不同组织细胞中,　ＡＴＰａｓｅ的活性呈现在质膜和液泡膜上,随着柱头的发育,ＰＭ－Ｈ＋－ＡＴＰａｓｅ的比活性明显增强。结果表明,黄瓜雌花柱头的腺特征随发育进程而趋于显著。     

宁夏枸杞柱头和萌发花粉中钙分布特征

用焦锑酸钾沉淀法对宁夏枸杞柱头和花粉中的钙离子分布进行了研究.结果显示,宁夏枸杞柱头表皮有一覆盖层,其中有许多含钙沉淀颗粒的小泡,当花粉落到柱头后从覆盖层中吸水,在萌发孔的表面上聚集了较多的钙沉淀颗粒.同时,花粉内部出现许多含钙的小液泡,使花粉体积增大,内部产生膨压,花粉萌发;生长在覆盖层中的花粉管顶端穿过覆盖层小泡时,附近聚集了较多的钙沉淀颗粒,在花粉管壁上也附着较多的细小钙沉淀颗粒.萌发的花粉粒中由大液泡占据,在其亚顶端的细胞质中,聚集较多钙沉淀颗粒的线粒体膨大形成了一些含钙沉淀颗粒的小液泡,由这些小液泡融合形成的大液泡,将花粉管细胞质挤到其顶端,使其极性生长.这是首次发现在植物柱头覆盖层中有钙离子的现象,从体内证明了钙离子在花粉萌发过程中的现象.讨论了枸杞柱头组织中钙的分布和花粉管的萌发与生长的关系.