Stigma, Concealment, Illness Perceptions and Psychosocial Difficulties in Children with Physical Health Conditions and their Parents

Aims: The overall purpose of this study was to understand the relationships between physical health stigma, concealment, illness perceptions, and psychosocial difficulties in children with physical health conditions and their parents. Further objectives were to identify which of these factors predicted children’s psychosocial difficulties, and which factors predicted concealment. Method: A cross-sectional survey was completed by 61 child-parent pairs attending dermatology or urology outpatient clinics in a London paediatric hospital. Children and parents completed validated measures of stigma, concealment, illness perceptions, and children’s psychosocial difficulties. Results: Correlational analyses revealed that in children, stigma was associated with concealment and illness perceptions, both with a large effect size. Children’s psychosocial difficulties were associated with child stigma and parent stigma, both with a medium effect size, and also with illness perceptions, with a small effect size. Multiple hierarchical regression analyses found that both child and parent stigma independently predicted children’s psychosocial difficulties (a composite of emotional and peer problems). Child stigma predicted child concealment, and parent stigma predicted parent concealment. However, there was no relationship between any child and parent-rated factors. Conclusions: The stigma perceptions of both children with physical health conditions and their parents need to be taken into account in the context of understanding the child’s psychosocial difficulties, and families should be supported in making decisions about concealment. As child and parent factors were not associated with each other, wider influences on children’s stigma experiences should also be considered

Natural polymorphism in the thrombospondin-related adhesive protein of Plasmodium falciparum

We have developed a typing system using natural sequence variation in the thrombospondin-related adhesive protein (TRAP) gene of Plasmodium falciparum. This method permits a haplotype to be assigned to any particular TRAP gene. We have applied this method to a hospital-based, case control-study in Mali. Previous sequence variation and conservation in TRAP has been confirmed. Particular TRAP haplotypes can be used as geographic hallmarks. Because of the high level of conflict between characters, we have examined the phylogenetic relationships between parasites using a network approach. Having received patient samples from urban and periurban areas of Bamako, the majority of haplotypes were closely related and distinct from TRAP sequences present in other continents. This suggests that the structure of TRAP can only tolerate a limited number of sequence variations to preserve its function but that this is sufficient to allow the parasite to evade the host's immune system until a long-lived immune response can be maintained. It may also reflect host genetics in that certain variants may escape the host immune response more efficiently than others. For vaccine design, sequences from the major regional variants may need to be considered in the production of effective subunit vaccines

Junkie love : romance and addiction on the big screen

This article investigates the filmic construction of two disparate but intertwining cultural practices: those engaging in the life-affirming rituals of romantic love and those performing the potentially self-destructive rituals of hard drug consumption. Discussing a number of key feature films from the (mini) genre “junkie love”, it aims to show what happens when elements of mainstream romantic drama merge with the horror conventions of the heroin addiction film. Drawing amongst others on Murray Smith’s theory of “levels of [spectator] engagement” and Greg Smith’s concept of the “emotion system”, the article concludes that junkie love films, using tropes of the romantic tragedy in the tradition of Romeo and Juliet, present a more complex and nuanced approach to drug addicts than the predominantly condemnatory media coverage—one that arguably invites the spectator’s understanding and compassion