Discrimination in the workplace, reported by people with major depressive disorder: a cross-sectional study in 35 countries.

OBJECTIVE: Whereas employment has been shown to be beneficial for people with Major Depressive Disorder (MDD) across different cultures, employers' attitudes have been shown to be negative towards workers with MDD. This may form an important barrier to work participation. Today, little is known about how stigma and discrimination affect work participation of workers with MDD, especially from their own perspective. We aimed to assess, in a working age population including respondents with MDD from 35 countries: (1) if people with MDD anticipate and experience discrimination when trying to find or keep paid employment; (2) if participants in high, middle and lower developed countries differ in these respects; and (3) if discrimination experiences are related to actual employment status (ie, having a paid job or not). METHOD: Participants in this cross-sectional study (N=834) had a diagnosis of MDD in the previous 12 months. They were interviewed using the Discrimination and Stigma Scale (DISC-12). Analysis of variance and generalised linear mixed models were used to analyse the data. RESULTS: Overall, 62.5% had anticipated and/or experienced discrimination in the work setting. In very high developed countries, almost 60% of respondents had stopped themselves from applying for work, education or training because of anticipated discrimination. Having experienced workplace discrimination was independently related to unemployment. CONCLUSIONS: Across different countries and cultures, people with MDD very frequently reported discrimination in the work setting. Effective interventions are needed to enhance work participation in people with MDD, focusing simultaneously on decreasing stigma in the work environment and on decreasing self-discrimination by empowering workers with MDD

L-Plastin nanobodies perturb matrix degradation, podosome formation, stability and lifetime in THP-1 macrophages

Podosomes are cellular structures acting as degradation ‘hot-spots’ in monocytic cells. They appear as dot-like structures at the ventral cell surface, enriched in F-actin and actin regulators, including gelsolin and L-plastin. Gelsolin is an ubiquitous severing and capping protein, whereas L-plastin is a leukocyte-specific actin bundling protein. The presence of the capping protein CapG in podosomes has not yet been investigated. We used an innovative approach to investigate the role of these proteins in macrophage podosomes by means of nanobodies or Camelid single domain antibodies. Nanobodies directed against distinct domains of gelsolin, L-plastin or CapG were stably expressed in macrophage-like THP-1 cells. CapG was not enriched in podosomes. Gelsolin nanobodies had no effect on podosome formation or function but proved very effective in tracing distinct gelsolin populations. One gelsolin nanobody specifically targets actin-bound gelsolin and was effectively enriched in podosomes. A gelsolin nanobody that blocks gelsolin-G-actin interaction was not enriched in podosomes demonstrating that the calcium-activated and actin-bound conformation of gelsolin is a constituent of podosomes. THP-1 cells expressing inhibitory L-plastin nanobodies were hampered in their ability to form stable podosomes. Nanobodies did not perturb Ser5 phosphorylation of L-plastin although phosphorylated L-plastin was highly enriched in podosomes. Furthermore, nanobody-induced inhibition of L-plastin function gave rise to an irregular and unstable actin turnover of podosomes, resulting in diminished degradation of the underlying matrix. Altogether these results indicate that L-plastin is indispensable for podosome formation and function in macrophages

Cross-national variations in reported discrimination among people treated for major depression worldwide: The ASPEN/INDIGO international study

Background: No study has so far explored differences in discrimination reported by people with major depressive disorder (MDD) across countries and cultures. Aims: To (a) compare reported discrimination across different countries, and (b) explore the relative weight of individual and contextual factors in explaining levels of reported discrimination in people with MDD. Method: Cross-sectional multisite international survey (34 countries worldwide) of 1082 people with MDD. Experienced and anticipated discrimination were assessed by the Discrimination and Stigma Scale (DISC). Countries were classified according to their rating on the Human Development Index (HDI). Multilevel negative binomial and Poisson models were used. Results: People living in 'very high HDI' countries reported higher discrimination than those in 'medium/low HDI' countries. Variation in reported discrimination across countries was only partially explained by individual-level variables. The contribution of country-level variables was significant for anticipated discrimination only. Conclusions: Contextual factors play an important role in anticipated discrimination. Country-specific interventions should be implemented to prevent discrimination towards people with MDD

Omics-based molecular techniques in oral pathology centred cancer: Prospect and challenges in Africa

: The completion of the human genome project and the accomplished milestones in the human proteome project; as well as the progress made so far in computational bioinformatics and “big data” processing have contributed immensely to individualized/personalized medicine in the developed world.At the dawn of precision medicine, various omics-based therapies and bioengineering can now be applied accurately for the diagnosis, prognosis, treatment, and risk stratifcation of cancer in a manner that was hitherto not thought possible. The widespread introduction of genomics and other omics-based approaches into the postgraduate training curriculum of diverse medical and dental specialties, including pathology has improved the profciency of practitioners in the use of novel molecular signatures in patient management. In addition, intricate details about disease disparity among diferent human populations are beginning to emerge. This would facilitate the use of tailor-made novel theranostic methods based on emerging molecular evidences

Perspectives of hospitalized patients with mental disorders and their clinicians on vocational goals, barriers, and steps to overcome barriers

Background: People with mental disorders experience difficulties with finding competitive jobs. In countries with longer psychiatric hospitalization periods, the vocational rehabilitation process can start during hospitalization. Yet, rehabilitation can be hindered by a lack of focus by clinicians on the patients’ vocational goals and a lack of agreement between clinicians and patients. Aims: To compare (i) vocational goals, (ii) barriers to employment and (iii) support needed to overcome barriers faced by patients. Method: The paired data-set comprised 733 hospitalized patients and their 279 clinicians. Patients selected their vocational goals and clinicians indicated options that seemed realistic. Patients and clinicians indicated how many barriers exist and what support is needed to overcome barriers. Results: Almost 45% of patients prefer competitive jobs, while 32% of clinicians find this realistic, indicating a moderate relationship between patients’ goals and clinicians’ perceptions. Patients and clinicians also differ in their perception of the level of barriers and types of support to overcome them. Patients perceive fewer vocational barriers than clinicians and prefer less intense vocational support options. Conclusions: Patients and clinicians have different perspectives concerning vocational recovery. Improving vocational rehabilitation requires a stronger alignment between patients and clinicians’ vocational goals and barriers. Keywords:Clinician, hospitalized patients, vocational rehabilitatio

Counsellors’ focus on competitive employment for people with severe mental illness:An application of the Theory of Planned Behaviour in vocational rehabilitation programmes

Although the evidence-based Individual Placement and Support programme highlights the importance of the vocational rehabilitation (VR) counsellors' focus on competitive employment during career counselling, studies have shown that counsellors do not always target such jobs. This study examines which determinants affect the counsellors' intentions using an extended version of the Theory of Planned Behaviour. Cross-sectional data of 263 VR counsellors of three public employment services were analysed using structural equation modelling. A path model comprising attitudes, prior behaviour, and subjective and moral norms explained 69% of the variance in intentions. The findings indicate that counsellors focus more on competitive employment when they (1) view the placement in a competitive job as positive, (2) experience support and (3) have prior relevant experiences. Keywords: Theory of Planned Behaviour, vocational rehabilitation, severe mental illness, counsellors, structural equation modellin

Beliefs of vocational rehabilitation counselors about competitive employment for people with severe mental illness in Belgium

Vocational rehabilitation (VR) counselors do not always focus on competitive employment for people with severe mental illness (SMI). Based on the Theory of Planned Behavior (TPB), this study examines how three types of VR counselors (i.e., gatekeepers, case managers, and specialists) vary in their underlying beliefs about competitive employment. VR counselors (N = 286) from Belgium completed an online TPB survey measuring behavioral, normative, control, and self-efficacy beliefs. Differences in beliefs were analyzed by one-way ANOVAs and post hoc comparisons using Bonferroni correction. Results indicate that counselors differ in their beliefs regarding competitive employment for people with SMI. Specialized counselors are stronger convinced that competitive employment results in latent benefits (e.g., increased integration and self-confidence). In contrast, gatekeepers consider income as the most recurrent and positive effect. The more specialized VR counselors are, the more often they perceive significant others valuing competitive employment and the more often they may comply with these norms. Finally, specialized counselors experience fewer barriers, more control, and more self-efficacy in dealing with problems compared with less specialized counselors. The differences in beliefs determining the focus on competitive employment may result in a lack of an integrated approach. Training, outcome feedback, and intersectoral communication can enhance consistency between different VR services