Relationship between TNF-<alpha> Gene Promoter Polymorphisms and Outcomes of Hepatitis B Virus Infections: A Meta-Analysis

Background: The clearance of hepatitis B virus (HBV) is a complex process which may be influenced by many factors including polymorphisms in the tumor necrosis factor,alpha. (TNF-,alpha.) gene promoter. However, previous reports regarding the relationship between polymorphisms in the TNF-,alpha. promoter and HBV clearance have been inconsistent. Therefore, we performed a meta-analysis on a large population to address this inconsistency. Methods: A meta-analysis was performed to examine the association between TNF-,alpha. promoter polymorphisms (-1031T/C,-863C/A,-857C/T,-308G/A and-238G/A) and chronic hepatitis B infection. Odds ratio (OR) and its 95 % confidence interval (CI) were used. Results: Twelve studies were chosen in our meta-analysis, involving 2,754 chronic HBV infection cases and 1,630 HBV clearance cases. The data showed that TNF-,alpha.-863 CC genotype was significantly associated with HBV clearance (-863 CC vs. AA: OR, 0.64; 95 % CI, [0.42, 0.97]; p = 0.04) while patients carrying-308 GG genotype had a significantly increased risk of HBV persistence compared with those with GA or AA genotype (GG vs. GA+AA: OR, 1.35; 95 % CI, [1.08, 1.70]; p = 0.01). For the other polymorphisms, no association with HBV infection outcome was found. Conclusions: The data showed that polymorphisms-863 A and-308 G in the TNF-,alpha. gene promoter region might be risk factors for HBV persistence. Furthermore, ethnicity might play an important role in HBV infection outcome, leading t

The Psychological Mechanism of Stigmatizing Attitudes toward Help Seeking Behavior for Mental Health Problems

Stigmatizing attitudes toward psychological help seeking is a significant obstacle for the people with mental health difficulties to obtain sufficient psychological help. Therefore, this paper examines the psychological mechanism of stigmatizing attitudes towards people with mental illness and help seeking performance. Data were gathered using already developed and validated scales with modifications. They are; mental Health Service Utilization Questions (MHSUQ), the Inventory of Attitudes toward Seeking Mental Health Services (IASMHS), Griffith’s public stigma sacle, Griffith’s self stigma scale, perceived need and utilization theory of mental health services, and General Help Seeking Questionnaire – Vignette Version (GHSQ-V). 600 students were interviewed from three state universities in Sri Lanka. The interviews were done based on three vignettes of young persons with a mental disorder consisting with statement show much they agree or not agree for each statement. Additionally, demographic information was collected. Data were analyzed using Statistical Package for Social Sciences (SPSS 19) and AMOS 20 software. Outcomes suggest that public stigma, and self stigma make influence on help seeking behavior negatively whereas public stigma makes greater influences on help seeking behavior negatively than self-stigma. However, in all vignettes, ‘dangerous person’ is the most responded item in both public stigma and self-stigma. It was found that female students have more positive attitudes, intention and actual help seeking behavior that male students.  Further, results indicate that stigma reduction programs are more essential to effectively increase of help-seeking behavior among students. Results further suggest that policy makers to make interventions to change public attitudes towards mental illnesses rather than self-attitudes