Smoking-Related Stigma Expressed by Physiotherapists toward Individuals with Lung Disease.

Purpose: We determined the extent and nature of stigma exhibited by a sample of Canadian cardiorespiratory physiotherapists toward people with lung disease who had a smoking history. Method: A quantitative online survey was distributed to Canadian cardiorespiratory physiotherapists, and an anti-smoking attitudes questionnaire was used to measure explicit stigma. We used two case studies with questions to measure implicit stigma. The first involved a patient with chronic obstructive pulmonary disease (COPD) and a smoking history, and the second described a patient with COPD with no smoking history. Results: Of the respondents (n=50), 56% demonstrated mild explicit stigma and 44% demonstrated moderate to severe explicit stigma. The extent of explicit stigma was not associated with respondents' age, area of practice, personal smoking history, or family history of lung disease resulting from smoking. The results indicated no evidence of implicit stigma, and no significant differences were found between the participants' prospective treatments and their professional attitudes toward patient cases. Conclusions: Canadian cardiorespiratory physiotherapists demonstrated explicit stigma toward people with lung disease with a significant smoking history, but there was no evidence of implicit stigma. These findings suggest that further research is needed to investigate how stigma held by cardiorespiratory physiotherapists may affect the quality of care provided for patients with a smoking history.

Objectif : déterminer l'étendue et la nature de la réprobation dont fait preuve un échantillon de physiothérapeutes cardiorespiratoires canadiens envers les fumeurs atteints d'une maladie pulmonaire. Méthodologie : les physiothérapeutes cardiorespiratoires canadiens ont reçu un sondage quantitatif en ligne. Ils ont répondu à un questionnaire sur les attitudes négatives envers le tabagisme pour mesurer leur réprobation explicite. Deux études de cas accompagnées de questions mesuraient leur réprobation implicite. La première portait sur un patient fumeur atteint d'une maladie pulmonaire obstructive chronique (MPOC) et la deuxième, sur un patient non-fumeur atteint d'une MPOC. Résultats : au total, 56 % des 50 répondants ont démontré une légère réprobation explicite et 44 %, une réprobation explicite modérée à importante. L'étendue de leur réprobation explicite n'était pas associée à leur âge, à leur région de pratique, à leur propre tabagisme, ni à une histoire familiale de maladie pulmonaire causée par le tabagisme. Les résultats ne faisaient état d'aucune réprobation implicite, et il n'y avait pas de différence significative entre les traitements prospectifs des répondants et leur attitude professionnelle envers les cas des patients. Conclusions : les physiothérapeutes cardiorespiratoires canadiens faisaient preuve d'une réprobation explicite envers les fumeurs atteints d'une maladie pulmonaire, sans toutefois démontrer de réprobation implicite. Selon ces résultats, d'autres recherches s'imposent pour évaluer si la réprobation des physiothérapeutes cardiorespiratoires nuit à la qualité des soins aux patients fumeurs.

Sox9 knockout mice have improved recovery following stroke.

The partial recovery that can occur after a stroke has been attributed to structural and functional plasticity that compensate for damage and lost functions. This plasticity is thought to be limited in part by the presence of growth inhibitors in the central nervous system. Blocking or reducing signals from inhibitors of axonal sprouting such as Nogo and chondroitin sulfate proteoglycans (CSPGs) increases post-stroke axonal sprouting and improves recovery. We previously identified the transcription factor SOX9 as a key up-regulator of CSPG production and demonstrated that conditional Sox9 ablation leads to increased axonal sprouting and improved recovery after spinal cord injury. In the present study we evaluate the effect of conditional Sox9 ablation in a transient middle cerebral artery occlusion (MCAO) model of stroke. We demonstrate that conditional Sox9 ablation leads to reduced CSPG levels, increased tissue sparing and improved post-stroke neurological recovery. Anterograde tract tracing studies demonstrate that in the Sox9 conditional knockout mice corticorubral and corticospinal projections from the contralateral, uninjured cortex increase projections to targets in the midbrain and spinal cord denervated by the injury. These results suggest that targeting SOX9 is a viable strategy to promote reparative axonal sprouting, neuroprotection and recovery after stroke.