This paper explores the positive implications that stigma has for organizations and how it may lead to broader acceptance for them among social audiences. We conduct a qualitative study of ...stigmatized—but increasingly accepted—mixed martial arts (MMA) organizations and the audiences that evaluated them through an analysis of interviews, media reports, and texts documenting their experiences. We found the following. First, there were three different types of stigma associated with MMA organizations: aesthetic, lawlessness, and harm-based. Second, MMA organizational actors used stigma to their advantage in two, opposing manners. They coopted negative labels to gain the awareness of supportive audiences, as well as drew from them to correct negative evaluations held by critical audiences regarding their organizations. This demonstrates that, rather than attempting to "pass as normal," stigmatized organizational actors can actively construct those attributes that are the focus of stigma and persuade audiences to reconsider their negative evaluations, rendering their organizations more acceptable.
Thoracic sarcoidosis is the most common form of sarcoidosis, encompassing a heterogeneous group of patients with a wide range of clinical features and associated outcomes. The distinction between ...isolated thoracic lymphadenopathy and pulmonary involvement matters. Morbidity is often higher, and long-term outcomes are worse for the latter. Although inflammatory infiltrates in pulmonary sarcoidosis may resolve, persistent disease activity is common and can result in lung fibrosis. Given the distinct clinical features and natural history of pulmonary sarcoidosis, its pathogenesis may differ in important ways from other sarcoidosis manifestations. This review highlights recent advances in the pathogenesis of pulmonary sarcoidosis, including the nature of the sarcoidosis antigen, the role of serum amyloid A and other host factors that contribute to alterations in innate immunity, factors that shape adaptive T-cell profiles in the lung, and how these mechanisms influence the maintenance of granulomatous inflammation in sarcoidosis. We discuss questions raised by recent findings, including the role of innate immunity in the pathogenesis, the meaning of immune cell exhaustion, and mechanisms that may contribute to lung fibrosis in sarcoidosis. We conclude with a reflection on when and how immunosuppressive therapies may be helpful for pulmonary sarcoidosis, a consideration of nonpharmacologic management strategies, and a survey of potential novel therapeutic targets for this vexing disease.
Both inherited and acquired immunodeficiency and chronic pulmonary disease predispose to the development of a variety of pulmonary syndromes in response to Aspergillus , a fungus that is ubiquitous ...in the environment. These syndromes include invasive aspergillosis, which is now recognized to occur in patients with critical illness without neutropenia and in those with mild degrees of immunosuppression, including from corticosteroid use in the setting of COPD. Chronic pulmonary aspergillosis includes simple aspergilloma, which is occasionally complicated by life-threatening hemoptysis, and progressive destructive cavitary disease requiring antifungal therapy. Allergic bronchopulmonary aspergillosis occurs almost exclusively in patients with asthma or cystic fibrosis. Recent advances in each of these syndromes include a greater understanding of the underlying pathophysiology and hosts at risk; improved diagnostic algorithms; and the availability of more effective and well-tolerated therapies. Improvement in outcomes for Aspergillus pulmonary syndromes requires that physicians recognize the varied and sometimes subtle presentations, be aware of populations at risk of illness, and institute potentially life-saving therapies early in the disease course.
We propose that stigma and legitimacy are distinct constructs. Drawing from extant research, empirical observations, and the theoretical assumptions of both constructs we assert that, in spite of ...increasing efforts to equate stigma as illegitimacy, the opposite of legitimacy, that it is not. Specifically, we argue that organizations and their actors can be both stigmatized and legitimate at the same time. With this recognized, we propose a stigma-focused research agenda, separate from - and untainted by - legitimacy. Further, we propose an agenda that broadens conceptualizations of audiences and their dynamics, addresses how normal “deviants” take action in the face of stigma, and reconceptualises how audiences and the stigmatized interact.
Since its introduction as a concept, organizational stigma has become central to explaining how organizations or industries become tainted, and how they overcome and manage such taint. In this ...introduction to the Special Issue on organizational stigma, we start by exploring the origins of the concept, providing basic definitions and reviewing the existing research on stigmatization, stigma transfer and experienced stigma. The papers in this issue flesh out our understanding of what causes organizational stigma and its implications at different levels. The remainder of this introduction takes stock of this recent work to explore future research opportunities around the micro‐ and macro‐foundations of organizational stigma, the links with scandals, controversies and other negative social evaluations and research methods. As the concept of organizational stigma reaches a new stage, we argue that its explanatory power can be harnessed to explore new and increasingly relevant phenomena and contexts.
Asthma during pregnancy poses a common, increasingly prevalent threat to the health of women and their children. The present article reviews recent insights gained from the epidemiology of asthma ...during pregnancy, demonstrating the many short- and long-term risks to mother and fetus incurred by poorly controlled maternal asthma. We further discuss emerging evidence that active management of asthma during pregnancy can positively influence and perhaps completely mitigate these poor outcomes. Recent high-quality trials examining best methods for asthma treatment are reviewed and synthesized to offer an evidence-based pathway for comprehensive treatment of asthma in the outpatient setting. Safe and effective medications, as well as nonpharmacologic interventions, for asthma during pregnancy are discussed, and treatment options for related conditions of pregnancy, including depression, rhinitis, and gastroesophageal reflux, are presented. Throughout, we emphasize that an effective treatment strategy relies on a detailed patient evaluation, patient education, objective measurement of asthma control, and frequent and supportive follow-up. The cardiovascular and respiratory physiology of pregnancy is reviewed, as well as its implications for the management of patients with asthma, including patients requiring intubation and mechanical ventilation. For the situation when outpatient asthma management has failed, an approach to the critically ill pregnant patient with status asthmaticus is detailed. Multidisciplinary teams that include pulmonary specialists, obstetricians, primary care providers, nurses, pharmacists, and asthma educators improve the care of pregnant women with asthma.
Drawing from Goffman’s original observations on stigma and the consequences of interactions between the stigmatized and supportive or stigmatizing audiences, we conduct a 20-year review of the ...diverse literature on stigma to revisit the collective nature of stigmatization processes. We find that studies on stigma’s origins, responses, processes, and outcomes have diverged from Goffman’s relational view of stigma as they have overlooked important relational mechanisms explaining the processes of (de)stigmatization. We draw from those conclusions to justify the need to study stigma as a collective phenomenon. We develop a relational perspective on stigma based on understanding how attributes are stigmatized (or not) by audiences in their interactions. We argue that to advance stigma research, it is necessary to build on Goffman’s theory to include the stigmatizers (i.e., the normal) and supporters (i.e., the wise); how they create, sustain, or remove stigma; and how they relate to the stigmatized (i.e., the targets). Accordingly, we provide a research agenda on stigma as a collective phenomenon that theorizes a relational perspective, proposes a typology of how audiences relate to stigmatization, and identifies patterns of relations between audiences. We thus offer a missing piece to existing accounts of stigma by focusing on the key role of audiences (i.e., stigmatizers or supporters of the stigmatized) rather than on the targets of stigma (i.e., the own).
Sarcoidosis is a systemic inflammatory disease with a predilection for the respiratory system. Although most patients enter remission and have good long-term outcomes, up to 20% develop fibrotic lung ...disease, whereby granulomatous inflammation evolves to pulmonary fibrosis. There are several radiographic patterns of pulmonary fibrosis in sarcoidosis; bronchial distortion is common, and other patterns, including honeycombing, are variably observed. The development of pulmonary fibrosis is associated with significant morbidity and can be fatal. Dyspnea, cough, and hypoxemia are frequent clinical manifestations. Pulmonary function testing often demonstrates restriction from parenchymal involvement, although airflow obstruction from airway-centric fibrosis is also recognized. Complications of fibrotic pulmonary sarcoidosis include pulmonary hypertension from capillary obliteration and chronic aspergillus disease, with hemoptysis a common and potentially life-threatening manifestation. Immunosuppression is not always indicated in end-stage sarcoidosis. Lung transplantation should be considered for patients with severe fibrotic pulmonary sarcoidosis, as mortality is high in these patients.
One of the current dominant theories in the management literature is institutional theory. Scholars within the institutional theory tradition have examined the creation and evolution of institutions, ...the impact that institutions have on organizations and their actions, and the constraints that institutions place on arenas of organizational activity. Much of institutional theory is reflected within in the sport management literature. However, we argue in this review piece, that there is more to institutional theory than the concepts that are currently being used in the sport management literature. First, we provide a review of the dominant concepts of institutional theory, and a summary of how institutional theory has been used in the sport management literature. Then we offer two broad discussion points about the use of institutional theory in sport management research. The first point is a call for further elaboration of institutional theory in sport management by examining issues of institutional change and organizational field dynamics. The second is point as to suggest that scholars extend the use of institutional theory into different types of sport management questions.
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