Development of a scale to measure stigma related to podoconiosis in Southern Ethiopia

Background: Health-related stigma adds to the physical and economic burdens experienced by people suffering from neglected tropical diseases (NTDs). Previous research into the NTD podoconiosis showed significant stigma towards those with the disease, yet no formal instrument exists by which to assess stigma or interventions to reduce stigma. We aimed to develop, pilot and validate scales to measure the extent of stigma towards podoconiosis among patients and in podoconiosis-endemic communities. Methods: Indicators of stigma were drawn from existing qualitative podoconiosis research and a literature review on measuring leprosy stigma. These were then formulated into items for questioning and evaluated through a Delphi process in which irrelevant items were discounted. The final items formed four scales measuring two distinct forms of stigma (felt stigma and enacted stigma) for those with podoconiosis and those without the disease. The scales were formatted as two questionnaires, one for podoconiosis patients and one for unaffected community members. 150 podoconiosis patients and 500 unaffected community members from Wolaita zone, Southern Ethiopia were selected through multistage random sampling to complete the questionnaires which were interview-administered. The scales were evaluated through reliability assessment, content and construct validity analysis of the items, factor analysis and internal consistency analysis. Results: All scales had Cronbach’s alpha over 0.7, indicating good consistency. The content and construct validity of the scales were satisfactory with modest correlation between items. There was significant correlation between the felt and enacted stigma scales among patients (Spearman’s r = 0.892; p < 0.001) and within the community (Spearman’s r = 0.794; p < 0.001). Conclusion: We report the development and testing of the first standardised measures of podoconiosis stigma. Although further research is needed to validate the scales in other contexts, we anticipate they will be useful in situational analysis and in designing, monitoring and evaluating interventions. The scales will enable an evidencebased approach to mitigating stigma which will enable implementation of more effective disease control and help break the cycle of poverty and NTDs

Experiences of mental illness stigma, prejudice and discrimination: A review of measures

Background: There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties. Method. A narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. Results: 57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. Conclusions: The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose. © 2010 Brohan et al; licensee BioMed Central Ltd

The 2011 'riots': reflections on the fall and rise of community

This paper argues that sociological engagement with the 2011 summer unrest in England has thus far overlooked an important aspect of the 'rioting': the troubling by 'rioters' of the communitarian publics and moral geographies which constitute marginalised city-space. In response to this knowledge gap, this paper seeks to argue that the unrest was transgressive of governance logics which construct inner city 'communities' as spatialised units housing ethno-class legacies and sociations; environments in which remoralised urban citizenships are increasingly being located by policymakers and urban managers. A key goal of the paper is to briefly unpack and situate these projects within repertoires of urban management within the neoliberal city. Another goal is to reflect on media and policy responses to the 'riots' to illustrate the existence and reinforcement of these projects, evinced by the popular construction of 'rioting' as contravening ordered community practice. By mapping the representation and vectoring of community within these narratives either as a fallen or resurgent entity, the paper contends that they provide important insights into the contested socio-moral management strategies increasingly brought to bear on the urban poor. The paper also considers foregrounding such urban strategies as context as crucial for a sociological framing of the unrest and the repudiation of depoliticised victim-blaming accounts. The paper also briefly reflects on the periodised, networked and disparate practices of the 'riots' to stress the dangers of boxing unrest, or indeed rest, within narrow spatial or behavioural boundaries or essentialised causal categories. Amongst other things, the diffuseness and multi-scalar nature of the 'riots' revealed the deficiency of this normative reading of the registers of urban citizenship. In this sense, the paper suggests that some academic commentary on the 'riots' has been in danger of reinforcing the same localised and residualised cartographies of citizenship generated by communitarian governance strategies at a time when sociologists should be exposing and resisting such articulations. In developing this discussion therefore, the paper seeks to challenge the formulations and boundaries of 'community' as conceptualised by urban governance strategies driving the functional reproduction of neoliberal marginalities

The Impact of Universal Access to Antiretroviral Therapy on HIV Stigma in Botswana

Objectives. We sought to examine the impact of treatment access on HIV stigma in Botswana 3 years after the introduction of a national program of universal access to antiretroviral therapy

The English Riots of 2011: summoning community, depoliticizing the city

The urban uprisings which occurred across England in the summer of 2011 are deemed in this paper to highlight the unstable, depoliticised ‘publics’ being increasingly convened within neo-liberalised cities. It contends that the diverse, dispersed and multiple events of August 2011 were ‘staged’ and ‘storied’ by assorted media and political narratives to represent socio-spatial ‘communities’ as fallen, harmed or resurgent entities. The paper exposes some of the evidential limitations of these reworkings but largely focuses on these imaginaries to reflect on how they implicate the city in the delineation of fragile and contradictory socio-spatial formations emerging from, through and in response to neo-liberalisation. In this regard, the scripting of the ‘riots’ around narratives of community crisis and redemption belies the sifting, bordering and reproducing of urban populations through the strategic governing dualities of abjection/exclusion and participation/responsibility. The paper suggests that these modalities produce landscapes of both depoliticisation and contingent disruption, an apparent contradiction which appears to be both intensifying and unravelling in a period of ‘alchemic austerity’, and which renders logics of restructuring as both unremitting and glaringly problematic