Experience of stigma and discrimination in families of persons with schizophrenia in the Czech Republic.

RATIONALE: Mental health-related stigma and discrimination not only affect persons living with schizophrenia but also their whole families. Stigma and discrimination reduction is key to respond to the unmet needs of persons with mental illness. The local context is of particular importance in this endeavor, as stigma and its manifestations depend on the specific conditions of the target population and across cultures and settings. Evidence on effective approaches to reduce stigma is sparse and lacking from Central and Eastern Europe, including from the Czech Republic. OBJECTIVE: Our aim was to inform an anti-stigma campaign undertaken in the framework of the national mental health reform in the Czech Republic. METHODS: We conducted a qualitative study based on semi-structured in-depth interviews with relatives of patients diagnosed with schizophrenia in the Czech Republic. Initial respondents were identified through local mental health services and users' organizations with a consecutive chain-referral sampling. Transcribed narratives were thematically analyzed within a pre-developed four-level thematic framework to comprehensively identify experiences of stigma and discrimination in all areas of the respondents' lives. RESULTS: Stigma experiences of 25 diverse family members of persons living with schizophrenia spanned four levels of respondents' lives (macro-, meso-, micro-, and intro-level). The overarching issues were: (1) general lack of understanding and misconceptions about mental illness; (2) structural discrimination and paucity of governmental and public support system; (3) burden of "pervasive and unlimited" care and inability of independent living. CONCLUSIONS: We identified several features of mental health related stigma and the ensuing discrimination in Czech Republic experienced by persons with severe mental illness and their relatives. We developed a set of recommendations for policy-makers aimed at reducing ignorance and prejudice amongst the public and professionals, improving health and social services-including employment, housing and community integration-and the provision of family support.

Can video interventions be used to effectively destigmatize mental illness among young people? A systematic review.

Video is considered to be an effective, easy to use tool employed in anti-stigma interventions among young people. Mass media has been shown to be effective for reducing stigma; however, there is insufficient evidence to determine the destigmatization effects of videos specifically. This article systematically reviews the effectiveness of video intervention in reducing stigma among young people between 13 and 25 years. We searched 13 electronic databases including randomized controlled trials, cluster randomized controlled trials, and controlled before and after studies. Of the 1426 abstracts identified, 23 studies (reported in 22 papers) met the inclusion criteria. Video interventions led to improvements in stigmatising attitudes. Video was found to be more effective than other interventions, such as classical face-to-face educational sessions or simulation of hallucinations. According to results of two studies, social contact delivered via video achieved similar destigmatization effect to that delivered via a live intervention. Although the quality of studies as well as the form of video interventions varied, the findings suggest that video is a promising destigmatization tool among young people; however, more studies in this area are needed. There was a lack of evidence for interventions outside of school environments, in low- and middle-income countries, and studies, which looked at long-term outcomes or measured impact on actual behaviour and implicit attitudes. The review generates recommendations for video interventions targeted at young people.

Potential contribution of arbuscular mycorrhiza to cadmium immobilisation in soil.

The contribution of arbuscular mycorrhiza (AM) to immobilisation of Cd in substrate was studied in two experiments. In the first experiment, substrates prepared by cultivating tobacco, either non-mycorrhizal or inoculated with the AM fungus Glomus intraradices were enriched with a range of Cd concentrations, and Cd toxicity in the substrates was assessed using root growth tests with lettuce as a test plant. The tests revealed lower Cd toxicity in the mycorrhizal than in the non-mycorrhizal substrate, and the difference increased with increasing total Cd concentration in the substrates. In the second experiment, extraradical mycelium (ERM) of G. intraradices exposed in vivo to Cd was collected and analysed on Cd concentration. The ERM accumulated 10-20 times more Cd per unit of biomass than tobacco roots. While Cd concentrations were lower in the biomass of mycorrhizal plants than of non-mycorrhizal plants, Cd immobilisation by ERM did not affect the total Cd content in mycorrhizal tobacco. It is concluded that mycorrhiza may decrease Cd toxicity to plants by enhancing Cd immobilisation in soil. The results therefore suggest a potential role of AM symbiosis in the phytostabilisation of contaminated soils, where high Cd availability inhibits plant growth.

Reported and intended behaviour towards those with mental health problems in the Czech Republic and England.

This is one of the first studies, which compares the level of stigmatizing behaviour in countries that used to be on the opposite sides of the Iron Curtain. The aim was to identify the prevalence of reported and intended stigmatizing behaviour towards those with mental health problems in the Czech Republic and to compare these findings with the findings from England. The 8-item Reported and Intended Behaviour Scale (RIBS) was used to assess stigmatising behaviour among a representative sample of the Czech population (n=1797). Results were compared with the findings of an analogous survey from England (n=1720), which also used the RIBS. The extent of reported behaviour (i.e., past and present experiences with those with mental health problems) was lower in the Czech Republic than in England. While 12.7% of Czechs reported that they lived, 12.9% that they worked, and 15.3% that they were acquainted with someone who had mental health problems, the respective numbers for England were 18.5%, 26.3% and 32.5% (P<0.001 in each of these items). On the other hand, the extent of intended stigmatizing behaviour towards those with mental health problems is considerably higher in the Czech Republic. Out of maximum 20 points attached to possible responses to the RIBS items 5-8, Czechs had a lower total score (x=11.0, SD=4.0) compared to English respondents (x=16.1, SD=3.6), indicating lower willingness to accept a person with mental health problems (P<0.001). The prevalence of stigmatizing behaviour in the Czech Republic is worrying. Both, further research and evidence based anti-stigma interventions, should be pursued in order to better understand and decrease stigmatizing behaviour in the Czech Republic and possibly across the post-communist countries in Central and Eastern Europe.

Plasma oxytocin and oxytocinase levels in third trimester of pregnancy and at labour.

In women during the third trimester of normal pregnancy and at labour the level of oxytocin and progesterone in plasma were determined by means of radioimmunoassay and the activity of oxytocinase was measured spectrophotometrically. The plasma oxytocin levels measured from the 25th week of pregnancy showed a gradual increase with the peak values at the 39th and 40th week. At labour, the oxytocin values remain at the same level as these found at the end of pregnancy. The increase in oxytocin levels at contractions compared to its values found between contractions was not statistically significant. Oxytocinase levels showed also an ascending character until the 38th week of pregnancy. Later, a decrease was found which continued until the termination of pregnancy. At labour, there was a decrease in progesterone level in plasma which was about at the limit of significance.

[Hormone levels in the serum of pregnant woman]. / Hormonspiegel im Serum schwangerer Frauen.

The levels of HCG, prolactin, progesterone, 17-beta estradiol and oxytocinase were simultaneously tested in one serum sample in women during the normal course of pregnancy and in those with late toxaemia of pregnancy or threatened premature labour. The significance of the deviations from the mean values measured in both groups of risk pregnancies was estimated in comparison with the values found in physiological pregnancies. On the basis of the comparison of all parameters followed, it has been found out that the deviations in the hormonal levels as measured in both groups of risk pregnancies were as a rule similar.