This study examined the perceived public stigma for alcohol use and treatment among a sample of 733 at-risk drinkers living in the South. Substantial levels of perceived stigma were reported for the community's judgment about at-risk drinking (86.1%), community's judgment about seeking primary care treatment for alcohol disorders (48.9%), community's judgment about seeking specialty treatment (56.3%), and primary care providers' judgment about their patients who were at-risk drinkers (35.7%). Similarly, respondents perceived a substantial lack of privacy associated with primary care treatment (42.0%) and specialty treatment (45.2%). African Americans were more likely to perceive a lack of treatment privacy but they were less likely to perceive community judgment about seeking specialty treatment. Those with greater social network contact intensity were more likely to perceive community judgment about at-risk drinking and more likely to perceive a lack of treatment privacy. Rural at-risk drinkers were more likely to perceive a lack of privacy in primary care.

Primary care providers had significantly more negative attitudes toward the vignette patient with schizophrenia compared with the patient without schizophrenia on 2 of 3 attitude measures (stereotyping and attribution of mental illness); however, this difference was not observed for mental health providers on the 2 measures. Conclusions and Implication for Practice: Primary care providers' negative attitudes toward individuals with schizophrenia represent a potential target for interventions to reduce disparities in care for individuals with schizophrenia.

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Significance Heme protein sensors interact with various gaseous molecules, such as CO, NO, or O 2 , and play a crucial role in transcriptional and regulatory events. In general, the sensory domains of heme proteins control signal transduction domains such as histidine kinases, phosphodiesterases, DNA-binding domains, guanylate cyclases, diguanylate cyclase, and aerotaxis transducers. Here we report globin-coupled heme containing adenylate cyclase from Leishmania major (HemAC-Lm), which regulates O 2 -dependent cAMP synthesis. Oxygen binding at heme iron of HemAC-Lm presumably triggers a conformational change in the sensor domain that sequentially stimulates the catalytic activity of the adenylate cyclase domain, resulting in the synthesis of the second messenger cAMP. This O 2 -dependent cAMP signaling is likely to function in cellular adaptability during hypoxia.

This study examines whether a diagnosis of mental impairment of a care recipient influences the strain of family caregiving. Two competing hypotheses, derived from labeling theory, provide alternative views. One posits that a diagnosis reduces strain by linking problematic characteristics of care recipients' impairment to an illness. The competing hypothesis suggests that a diagnosis increases strain by reifying the existence of a progressive chronic condition. LISREL analysis with data from a sample of 576 primary caregivers shows that the diagnosis has an important effect, but this influence varies for different types of strain. Relationship strain and restrictions in social activities are increased for caregivers of diagnosed care recipients. Functional impairment also causes a greater restriction of social activities when a diagnosis has been made. A different pattern emerges for depression, with caregivers in the diagnosed group being less depressed and less negatively affected by care recipients' impaired ability for social interaction, but more depressed by disruptive behavior and functional impairment.

Even when interventions are shown to be both clinically effective and cost-effective within a system of care, they are rarely sustained beyond the period of external funding. The reason may be that these interventions are often developed and introduced in a "top-down" manner, with little input from frontline clinicians. The purpose of this article is to describe a "bottom-up" approach in which services researchers assist frontline clinicians in testing interventions that clinicians themselves have devised. This approach is explored in the clinical partnership program developed by the Veterans Healthcare Administration's South Central Mental Illness Research, Education, and Clinical Center. The program is expected to expand the evaluation and research capacity of clinicians, enhance the collaborative skills of services researchers, and result in interventions that are more likely to be sustained over time.

For both mental health and primary care providers, a history of schizophrenia was found to negatively affect provider expectations of patients' adherence to treatment, ability to understand educational materials, and capacity to manage their treatment and financial affairs as well as some treatment decisions, such as referral to a weight-reduction program.