An instrument to measure the stigma perceived by people with HIV was developed based on the literature on stigma and psychosocial aspects of having HIV. Items surviving two rounds of content review were assembled in a booklet and distributed through HIV-related organizations across the United States. Psychometric analysis was performed on 318 questionnaires returned by people with HIV (19% women, 21% African American, 8% Hispanic). Four factors emerged from exploratory factor analysis: personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes toward people with HIV. Extraction of one higher-order factor provided evidence of a single overall construct. Construct validity also was supported by relationships with related constructs: self-esteem, depression, social support, and social conflict. Coefficient alphas between .90 and .93 for the subscales and .96 for the 40-item instrument provided evidence of internal consistency reliability. The HIV Stigma Scale was reliable and valid with a large, diverse sample of people with HIV.

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The perceived stigma inherent in progressive neurological diseases, such as Alzheimer's dementia (AD) and Parkinson's Disease (PD), has been under-recognized. The purposes of this pilot study were to examine: (1) the psychometric properties of the Stigma Impact (SIS) and Stigma Experience Scales (SES) when used with persons with AD or PD; and (2) differences in perceived stigma by disease diagnosis. The sample included 26 persons with AD and 14 persons with PD. Findings support the reliability of the total SIS scale for both persons with AD or PD. The four SIS subscales had acceptable reliability when used with persons with PD, while two of the four subscales had adequate reliability when used with persons with AD. Internal consistency reliability of the SES was acceptable in PD sample only. Validity of the total SIS scale and the four subscales was supported through significant correlations with mental status (AD sample only), self-esteem, depression, and personal control. Persons with AD scored higher on the SIS internalized shame subscale and lower on personal control compared to persons with PD. Overall, support was found for the SIS as a reliable and valid measure of perceived stigma in persons with AD or PD. The magnitude of perceived stigma in persons with AD is comparable to or greater than other populations of persons with chronic illness, including cancer and PD. de men tia d e m e n t i a http://dem.sagepub.com vol 7(1) 31-53

People with chronic obstructive pulmonary disease (COPD) can experience severe dyspnea, tenacious secretions, and a disruptive cough. They often struggle with daily activities and over time tend to decrease the amount of time they spend outside the home. The functional decline accompanying these changes is not adequately explained by physical changes alone. This descriptive, qualitative study describes social changes and experiences of stigma from the perspective of people with moderate to severe COPD. A total of 16 participants (11 men, 5 women) participated in individual interviews regarding effects of COPD on social relationships and experiences with COPD-related stigma. Participants were aware of the potential for stigma related to COPD. Emerging themes included the prevalence of blame related to smoking, both from others, including health care providers, and from themselves. Although many decreases in social activities appear to be pragmatic adaptations to functional limitations, these decisions may also be attempts to avoid potentially stigmatizing situations.

Functional meaning of oscillatory brain activity in various frequency bands in the human electroencephalogram (EEG) is increasingly researched. While most research focuses on event-related changes of brain activity in response to external events there is also increasing interest in internal brain states influencing information processing. Several studies suggest amplitude changes of EEG oscillatory activity selectively influencing cortical excitability, and more recently it was shown that phase of EEG activity (instantaneous phase) conveys additional meaning. Here we review this field with many conflicting findings and further investigate whether corticospinal excitability in the resting brain is dependent on a specific spontaneously occurring brain state reflected by amplitude and instantaneous phase of EEG oscillations. We applied single pulse transcranial magnetic stimulation (TMS) over the left sensorimotor cortex, while simultaneously recording ongoing oscillatory activity with EEG. Results indicate that brain oscillations reflect rapid, spontaneous fluctuations of cortical excitability. Instantaneous phase but not amplitude of oscillations at various frequency bands at stimulation site at the time of TMS-pulse is indicative for brain states associated with different levels of excitability (defined by size of the elicited motor evoked potential). These results are further evidence that ongoing brain oscillations directly influence neural excitability which puts further emphasis on their role in orchestrating neuronal firing in the brain.

Transiently storing information and mentally manipulating it is known as working memory. These operations are implemented by a distributed, fronto-parietal cognitive control network in the brain. The neural mechanisms controlling interactions within this network are yet to be determined. Here, we show that during a working memory task the brain uses an oscillatory mechanism for regulating access to prefrontal cognitive resources, dynamically controlling interactions between prefrontal cortex and remote neocortical areas. Combining EEG with non-invasive brain stimulation we show that fast rhythmical brain activity at posterior sites are nested into prefrontal slow brain waves. Depending on cognitive demand this high frequency activity is nested into different phases of the slow wave enabling dynamic coupling or de-coupling of the fronto-parietal control network adjusted to cognitive effort. This mechanism constitutes a basic principle of coordinating higher cognitive functions in the human brain.

In healthy humans, it has been shown that executive functions are associated with increased frontal-midline EEG theta activity and theta phase coupling between frontal and posterior brain regions. In individuals with schizophrenia, central executive functions are supposed to be heavily impaired. Given that theta phase coupling is causally involved in central executive functions, one would expect that patients with an executive function deficit should display abnormal EEG theta synchronization. We therefore investigated executive functioning in 21 healthy controls and 21 individuals with schizophrenia while they performed a visuospatial delayed match to sample task. The task required either high executive demands (manipulation of content in working memory [WM]) or low executive demands (retention of WM content). In addition, WM load (one vs. three items) was varied. Results indicated higher frontal theta activity for manipulation processes than for retention processes in patients with schizophrenia, as compared with healthy controls, independently of WM load. Furthermore, individuals with schizophrenia revealed a reduction in theta phase coupling during early stages of the delay period for retention, as well as for manipulation processes at high-WM loads. Deviations in theta phase coupling in individuals with schizophrenia were mainly characterized by aberrant fronto-posterior connections, but also by attenuated posterior connections during manipulation of high-WM load. To conclude, fronto-parietal theta coupling seems to be substantially involved in executive control, whereas frontal theta activity seems to reflect general task demands, such as deployment of attentional resources during WM.

Knowledge gained from the hospital's preoperative education class did affect patient experiences. Further comparisons of face-to-face versus online structured education are warranted.