Lifetime Experience Research Articles

The Intersecting Effects of Lifetime Experiences of Homelessness and Incarceration on Cognitive Aging and Dementia Risk Factors in the United States

Abstract Background and Objectives Alzheimer’s disease and related dementias (ADRD) remain a pressing concern in the US, which also has one of the highest incarceration rates worldwide. Existing research has analyzed dementia risk and care among currently incarcerated and homeless populations; this paper fills a gap by examining later-life cognitive disparities facing formerly incarcerated and/or homeless individuals. Research Design and Methods Using Health and Retirement Study data (HRS; 1998–2018), we tested whether formerly homeless and/or incarcerated people had earlier onset of cognitive decline, and whether they were more likely to have modifiable risk factors for ADRD than those without such experiences. We estimated prevalence of mild cognitive impairment (MCI), dementia, and self-reported ADRD diagnosis. We also used repeated observations of cognitive functioning coupled with nested nonlinear regression to examine the onset of accelerated cognitive decline. Results Adjusting for demographic variables, formerly homeless and/or incarcerated participants have increased odds of having risk factors for dementia, including smoking, drinking alcohol, depression, mental illness, and discrimination from healthcare providers and police. Diagnosis of MCI and ADRD were more common among participants reporting a history of incarceration or homelessness. Nested nonlinear regression revealed that previous experiences of incarceration or homelessness—alone or together—are associated with earlier onset of accelerated cognitive decline compared to those who experienced neither. Discussion and Implications This study suggests that, even if they occur earlier in life, homelessness and incarceration experiences may increase risk of poorer cognitive health in late life. Future work is warranted to understand the lifelong consequences linked to this adversity.

The Intersectionality of Chronic Pain Stigma and Racial Discrimination in Black and White Adults with Chronic Low Back Pain

Abstract Objective We examined the intersection between chronic pain stigma and racial discrimination, separately among Black and White U.S. adults with chronic low back pain. Methods Participants completed measures of chronic pain stigma, lifetime experiences of racial discrimination, pain severity and interference. A composite variable representing the intersectionality of stigma and discrimination was created, and Black and White participants were separately categorized into 4 groups. Black participants were categorized as: 1) high discrimination/high stigma, 2) high discrimination/low stigma, 3) low discrimination/high stigma, and 4) low discrimination/low stigma. White participants were categorized as: 1) any discrimination/high stigma, 2) any discrimination/low stigma, 3) no discrimination/high stigma, and 4) no discrimination/low stigma. Results Black participants reported more frequent experiences of racial discrimination than White participants (p<.05), but there was not a racial difference in chronic pain stigma (p>.05). Among Black participants, those in the high discrimination/high stigma and low discrimination/high stigma groups reported greater pain severity and interference than those in the high discrimination/low stigma and low discrimination/low stigma groups (p<.05). Among White participants, those in the any discrimination/high stigma group reported greater pain severity and interference than those in the no discrimination/low stigma group (p<.05), but there were no differences in pain severity or interference between the any discrimination/no stigma and no discrimination/high stigma groups (p>.05). Conclusion Our findings suggest that the relationship of intersectional chronic pain stigma and racial discrimination with pain is nuanced and differs across racial groups.

Bias-Motivated Physical or Verbal Violence Among Men Who Have Sex with Men: Findings from the Lisbon Cohort of MSM

Abstract Introduction Victimization based on sexual orientation or gender identity is a cause for concern. Bias-motivated violence affect not only the individuals targeted but also their communities and societies as a whole. Objective To estimate the proportion of bias-motivated victimization among cisgender men who have sex with men (MSM) and to compare sociodemographic and behavioral characteristics and HIV and syphilis test results between victims and non-victims. Methods We used data from the baseline visit of 2811 adult cisgender MSM from July 2017 to December 2020 in the Lisbon Cohort of MSM. Victimization was defined as self-reported lifetime or recent (in the previous 12 months) experience of physical or verbal violence motivated by sexual orientation or gender identity. Rapid HIV and syphilis tests determined serostatus. We conducted descriptive statistics to summarize the sociodemographic and behavioral characteristics and the prevalence of victimization and compared groups using the Student t-test or Mann–Whitney U test and chi-square test, as appropriate. Results Overall, 40.3% of participants reported lifetime bias-motivated physical or verbal violence, and 11.7% reported recent victimization. Recent victimization contexts more frequently reported were street/neighborhood (67.9%) and workplace/school (35.5%). Victimization was associated with younger age (mean age: 26.5 vs 30.2, p-value < 0.001), being born in Brazil or other American countries, or being 14 or younger at their anal intercourse with a man debut (19.5% vs. 11.0%, p-value < 0.001). Lifetime victimization was not significantly associated with reactive results for HIV (p-value = 0.135) or syphilis (p-value = 0.760). Conclusion The violence motivated by sexual orientation or gender identity was quite frequent in this community. The occurrence of violence based on sexual orientation or gender identity in the Lisbon Cohort of MSM was associated with adverse social conditions and health risk behaviors. Policy Implications Raising awareness about bias-motivated violence as a hate crime may deter potential aggressions. Primary violence prevention should tackle specificities of sexual and gender minorities.

Exploring the Relationship Between Experiences of Violence and Subjective Wellbeing: A Cross-Sectional Survey Among School Teachers in Nyarugusu Refugee Camp in Tanzania.

Experiences of violence have been reported to be associated with lower levels of subjective wellbeing (SWB). However, little is known about this association in conflict settings and among forcibly displaced populations. In this study we exploit data from a representative sample of refugee teachers from Nyarugusu Refugee Camp collected as part of a larger study, to examine the association between demographic characteristics and SWB, and between experiences of violence and SWB. Three cross-sectional surveys of primary and secondary school teachers were conducted, collecting data on lifetime experience of violence (physical and sexual) and SWB (measured by life satisfaction and current happiness, on 1-5 Likert scales). Linear mixed models were used to estimate the associations between violence and SWB accounting for teacher and school clustering, unadjusted and adjusted for main factors associated with SWB. The 3 surveys included 1,666 responses completed by 885 teachers. Country of origin and number of meals consumed per day were strongly associated with SWB. Individuals who experienced physical violence reported on average, 0.13 lower life satisfaction scores (95% CI [-0.23, -0.02], p = .016) compared to those who did not experience physical violence, while survivors of sexual violence reported on average, 0.24 lower happiness scores ([-0.43, -0.05], p = .014) compared to those who did not experience sexual violence, after adjusting for confounders and clustering. We found an important negative association between past experience of violence and SWB in a refugee camp setting. These findings contribute to the evidence that violent experiences are likely to have a long-lasting impact on people's wellbeing. There is a need for improved mental health and psychosocial support in humanitarian settings.

Sexual violence affecting female sex workers in Côte d’Ivoire: prevalence, context, and associated mental health and substance use outcomes

BackgroundFemale sex workers are disproportionately affected by sexual violence, which is associated with an increased risk of poor mental health outcomes, substance use, and decreased access to health resources. Understanding the pathways through which sexual violence impacts these outcomes can inform strategies that appropriately and effectively meet the health needs of sex workers.MethodsThis study investigated the prevalence of sexual violence among female sex workers in Côte d’Ivoire, and the relationship between sexual violence and adverse mental health and substance use outcomes. We examined survey data from female sex workers recruited between November 2019 and May 2020 across five regions of Côte d’Ivoire using respondent driven sampling (RDS), as part of an integrated bio-behavioral survey. The primary exposure of interest was self-reported lifetime experience of sexual violence, and the main outcomes of interest included depression, suicidal ideation, counselling seeking, alcohol consumption, and substance use. Multivariable logistic regression models investigated associations between exposure to sexual violence and the key mental health and substance use outcomes of interest. For each outcome, a directed acyclic graph was developed to identify a minimally sufficient set of covariates for adjustment. Additional sociodemographic characteristics, experiences, and sex work-related behaviors were explored in descriptive analyses using crude and RDS adjusted estimates.ResultsOut of 1,177 participants, 376 (31.9%; RDS weighted: 30.5%; 95% CI: 24.7, 36.3) reported having experienced sexual violence in their lifetime, and of those 31.9% (RDS weighted: 31.2%; 95% CI: 21.3, 41.1) had experienced sexual violence within the previous 12 months. Experience of sexual violence was associated with an increased odds of suicidal ideation (aOR: 1.95; 95% CI: 1.48, 2.55), illicit drug use in the last 12 months (aOR: 2.40; 95% CI: 1.50, 3.86), daily alcohol use (aOR: 1.63; 95% CI: 0.99, 2.67), and having spoken to a counselor or confidant (aOR: 1.90; 95% CI: 1.34, 2.68).ConclusionFindings confirm a high burden of sexual violence among female sex workers in Côte d’Ivoire, and a need to implement large structural changes that enable female sex workers to seek protection as well as health resources after experiencing sexual violence. This may include reform in the form of targeted social, clinical and mental health resources, along with community development opportunities.

Reproductive Coercion: Prevalence and Risk Factors Related to Relationship Health Knowledge and Skills.

Reproductive coercion is any behavior that limits a person's reproductive decision-making and can lead to negative health and safety outcomes. Previous research has explored reproductive coercion prevalence rates in clinical samples, as well as demographic risk factors for experiencing reproductive coercion. The purpose of this study is to assess the prevalence rates of two specific forms of reproductive coercion, pregnancy coercion and condom manipulation, in an ethnically and racially diverse sample of young females. We also explore the association between relationship health knowledge and skills with reproductive coercion. We used a sample of 143 females with previous sexual activity. Participants were diverse in terms of race, ethnicity, sexual orientation, and family immigration status. Descriptive statistics and logistic regression analyses were used to determine prevalence rates of pregnancy coercion and condom manipulation and the likelihood of experiencing reproductive coercion based on participants' knowledge and skills related to relationship health. Results revealed that 16.1% of the sample had experienced reproductive coercion, with all participants in this group reporting lifetime experiences of pregnancy coercion. Lifetime experiences of condom manipulation were reported by 6.3% of the sample. The most common form of reproductive coercion experienced by participants was being told by a partner not to use any birth control. Furthermore, results indicate that higher relationship health knowledge may be a protective factor for pregnancy coercion and condom manipulation. Likewise, higher decision-making skills in relationships and higher confidence in relationships may also protect against condom manipulation. Results from this study suggest implications for sexual and relationship health programming that expands education around consent, choice, decision-making, and communication around the use of contraception.

Mental health and perceived consequences in a clinical sample of women featured in video-based pornography

ContextSeveral reports have shed light on the potentially traumatic filming conditions, and violence experienced by women featured in pornography (WP). However, there is a scarcity of research on the mental health of these women, as well as the perceived consequences of participation in Video-based Pornography (VbP). MethodsThirty-six women, recruited through collaboration with WP support groups, completed an online questionnaire covering socio-demographics, pre-VbP violence experiences, and perceived consequences of their participation in VbP. Additionally, participants completed the French versions of the post-traumatic stress disorder (PTSD) Checklist for DSM-5 (PCL-5), the Dissociative Experiences Scale (DES-II), and the 13-item Beck Depression Inventory (BDI-13). ResultsThe participants had a mean age of 31.2 years (SD = 7), and the median age at first participation in VbP was 21. A majority (77.8%) reported a lifetime experience of sexual violence before featuring in VbP. All participants reported at least one negative effect of participating in VbP, with three in four women citing cyberbullying following VbP dissemination. Additionally, participants reported a range of physical consequences such as vaginal lesions and sexually transmitted diseases. Thirty women (83%) had a PCL-5 score over 33, indicative of probable PTSD, and 28 women (78%) had a DES-II score of 30 or more, indicating high levels of dissociative symptoms. Furthermore, 19 women (53%) reported a BDI-13 score over 13, suggesting potential severe depression. ConclusionThis study underscores psychosocial vulnerabilities and the presence of severe psychopathology among WP. It also documents their perceptions of negative consequences of participation in VbP, such as cyberbullying, physical injuries, and emotional distress. Further, large-scale studies are needed to substantiate these results and better understand the scale of the problem, as well as to optimize care interventions.

Racial Discrimination, Social Support, and Psychological Distress Among Black Pregnant Women.

Black pregnant women who experience racial discrimination are at an increased risk of psychological distress. Studies have not adequately addressed if social support may moderate the association between experiences of racial discrimination and psychological distress among Black pregnant women. We sought to examine the moderating effect of social support on the association between experiences of racial discrimination and psychological distress among Black pregnant women. We report findings based on cross-sectional data collected from 599 Black pregnant women enrolled in a prospective cohort study prior to the COVID-19 pandemic. Women completed questionnaires about experiences of racial discrimination (Experiences of Discrimination), social support (MOS Social Support Survey), and psychological distress (Psychological General Wellbeing Index). Women had an average age of 26 ± 5 years and gestational age at data collection of 17 ± 6 weeks. Approximately 53% of women reported ever experiencing racial discrimination in at least one situation, and 54% reported psychological distress. After adjustment for covariates, racial discrimination was associated with a 2.2-fold increase in psychological distress (odds ratio [OR] = 2.24; 95% confidence interval [CI] 1.35-3.70; P = .002). Low social support (scores below the median) was associated with a 3.8-fold higher likelihood of psychological distress (OR = 3.84, 95% CI 2.27-6.48, P < .001). Social support did not moderate the association of lifetime experiences of racial discrimination with psychological distress. Findings of the study contribute to evidence that lifetime experiences of racial discrimination and low levels of social support relate to psychological distress among Black pregnant women.

Increased Emergency Department Identification of Young People Experiencing Trafficking During the COVID-19 Pandemic: An Interrupted Time-Series Analysis.

Human trafficking is a public health issue affecting young people across the United States, and trafficked young people frequently present to emergency departments (EDs). The identification of trafficked young people by pediatric EDs during the COVID-19 pandemic is not well understood. We examined trends in the identification of young people with current or lifetime experiences of trafficking in US pediatric EDs before and during the COVID-19 pandemic. We performed an interrupted time-series analysis using the Pediatric Health Information System database, which includes data from 49 US children's hospitals, to determine differences in rates of trafficked young people identified in pediatric EDs before and during the COVID-19 pandemic. We included 910 patients; 255 prepandemic (October 1, 2018, through February 29, 2020) and 655 during the COVID-19 pandemic (March 1, 2020, through February 28, 2023). We found a 1.92-fold increase in the incidence rate of identified trafficked young people at the start of the COVID-19 pandemic in March 2020 (incidence rate ratio = 1.92; 95% CI, 1.47-2.51; P < .001), followed by a decrease over time. The observed increase in identified trafficked young people during the onset of the COVID-19 pandemic should alert pediatric ED providers to the opportunity to identify and provide services for trafficked young people as an important part of improving preparedness for future disease outbreaks. Our observed identification trends do not represent the true incidence of trafficked young people presenting to pediatric EDs during the COVID-19 pandemic. Future work should seek to better understand the true occurrence and the health and service needs of trafficked young people during emergencies.

Temporalities in spatial narratives about war ruins in Mostar

The spatial turn in peace and conflict studies and the geographies of peace research agendas have underscored the importance of space in (post-)conflict societies. These fields, despite recognising that space and time are inseparable dimensions, often pay more attention to the former compared to the latter. To address this gap, this article explains how space relates to temporality, a concept that delves into the lived experiences of time. More specifically, I analyse how understandings of the past, present, and future shape spatial narratives about war ruins in Mostar (Bosnia and Herzegovina), where buildings targeted during the 1990s wars remain unreconstructed. Drawing on spatial narratives gathered through walks and elite interviews, I show that temporality is a crucial element of space because lived experiences of time structure individuals' perspectives on war ruins in Mostar. Four temporalities were woven into participants’ narratives: (1) narratives shaped by trauma temporalities where war ruins remind people of wartime violence and collapse past and present; (2) narratives driven by temporalities of nostalgia and opportunities that invite reflections about the future of Mostar; (3) narratives building on a temporality of commodification that sees ruins as marketable attractions for tourists; and (4) narratives framing ruins as barriers to synchronising Mostar to a temporality of modernity, characterised by notions of progress and economic development. Through these findings, I demonstrate that temporalities are a key factor in how individuals perceive space and highlight the importance of temporalities in explaining heterogeneous attitudes toward space in areas affected by violence.

Le Petit Prince Hong Kong (LPPHK): Naturalistic fMRI and EEG data from older Cantonese speakers

Currently, the field of neurobiology of language is based on data from only a few Indo-European languages. The majority of this data comes from younger adults neglecting other age groups. Here we present a multimodal database which consists of task-based and resting state fMRI, structural MRI, and EEG data while participants over 65 years old listened to sections of the story The Little Prince in Cantonese. We also provide data on participants’ language history, lifetime experiences, linguistic and cognitive skills. Audio and text annotations, including time-aligned speech segmentation and prosodic information, as well as word-by-word predictors such as frequency and part-of-speech tagging derived from natural language processing (NLP) tools are included in this database. Both MRI and EEG data diagnostics revealed that the data has good quality. This multimodal database could advance our understanding of spatiotemporal dynamics of language comprehension in the older population and help us study the effects of healthy aging on the relationship between brain and behaviour.

Comparing Two-Step Approaches to Measuring Gender Identity: The Reliability and Applications of Asking About Sex Assigned at Birth versus Transgender Self-Identification.

Inclusive measures of gender are critical for health equity research. This study compared the reliability and applications of two different approaches for measuring gender in response to emerging community concerns regarding the potential harms of asking about sex assigned at birth (SAAB) within transgender and gender diverse (TGD) populations. Using data from a 2021 survey of LGBTQ+ people in Washington state, we compared approaches for measuring gender via a two-step question that collected data on: (1) current gender and SAAB versus (2) current gender and transgender self-identification. Among 2,275 LGBTQ+ participants aged 9-81, 63% were cisgender, 35% TGD, and 2% were not categorized. There was near perfect agreement between the two methods in their ability to identify TGD participants (percent agreement=99.7%, unweighted Cohen's Kappa=0.99). Among gender diverse participants, stratification by SAAB revealed differences in sexual health outcomes, while stratification by transgender self-identification revealed differences in access to gender-affirming care and lifetime experiences of discrimination. Ascertaining SAAB may be most useful for identifying sexual health disparities while transgender self-identification may better illuminate healthcare needs and social determinants of health among TGD people. Researchers and public health practitioners should critically consider the acceptability and relevance of SAAB questions to their research goals.

Associations Among Racial Discrimination, Perceived Stress, and Birth Satisfaction in Black Women in the Postpartum Period

ObjectiveTo examine associations among experiences of racial discrimination, perceived stress, and birth satisfaction and to test if perceived stress mediates the relationship between racial discrimination and birth satisfaction among Black women in the postpartum period. DesignSecondary analysis of data from the Biosocial Impact on Black Births study. SettingA postpartum unit of a large hospital in Central Florida. ParticipantsBlack women (N = 154) in the postpartum period. MethodsParticipants completed the lifetime Experiences of Discrimination scale, Perceived Stress Scale and Birth Satisfaction Scale–Revised between 24 hours and 23 days after birth. We calculated descriptive statistics and Spearman’s ρ correlation coefficients to evaluate associations among variables. We used multiple linear regression to evaluate perceived stress as a mediator between racial discrimination and birth satisfaction. ResultsRacial discrimination had a positive association with perceived stress (β = 2.445, p = .03), and perceived stress had a negative association with birth satisfaction (β = –0.221, p = .02). Racial discrimination had no significant direct effect on birth satisfaction (β = –0.091, p = .94); therefore, perceived stress did not mediate the relationship. ConclusionMore experiences of discrimination over the life span were associated with higher levels of perceived stress. Participants who reported higher levels of perceived stress reported lower levels of birth satisfaction. Our study adds to the body of knowledge regarding associations between racial discrimination and perceived stress and perceived stress and birth satisfaction.

Ableist microaggressions and psychological distress among adults with disabilities: The role of disability visibility.

Experiences of disability-based discrimination among adults with disabilities (AWD) span individual, interpersonal, and structural domains that are implicated in mental health disparities. Ableist microaggressions, a subtle and contemporary form of disability-based discrimination, are positively associated with psychological distress. Additionally, disability characteristics may impact mental health outcomes differently. This study investigated (a) the association between lifetime experiences of ableist microaggressions and psychological distress and (b) the moderating effect of disability visibility. A cross-sectional survey-based online study through Amazon's Mechanical Turk was conducted among 995 AWD whose ages ranged from 18 to 70 (M = 34.73, SD = 9.45). After adjusting for confounds linear regression analyses revealed a significant, positive relationship between ableist microaggressions and depressive, anxiety, and stress symptoms. Models explained approximately 18%-23% of the variance in psychological distress. Moderation analyses indicated that associations were stronger among participants with less visible disabilities. Findings underscore disability visibility as an important correlate in AWD mental health disparities. Results should be interpreted within the scope of the sampling procedures and sample demographics. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Lifetime Experiences of Housing Insecurity among Gay Men Living with HIV at Midlife: An Exploratory Study Utilizing a Social Determinants of Health Perspective

Understanding the socioecological contexts of gay men living with HIV is critical to addressing the environmental conditions that influence their lifetime experiences of housing insecurity and homelessness. In line with the strategies of the US Center for Disease Control and Prevention to end the HIV epidemic, it is of utmost importance to recognize how the allocation of available resources impacts health inequities affecting gay men living with HIV who experience housing insecurity and homelessness. Drawing from the World Health Organization’s social determinants of health (SDoH) framework, we used an exploratory, community-based research (CBR) approach to examine the lifetime experiences and important sources of support of gay men living with HIV at midlife who have experienced housing insecurity in Southern Nevada. Thematic analysis of our semi-structured interviews with 12 gay men living with HIV at midlife revealed three overarching themes: (1) challenges to obtaining housing and related support, (2) informal support from friends, and (3) formal support from community-based sources employing diverse support strategies. In this article, we discuss the different sub-themes we identified under these overarching themes and the implications of our findings from an SDoH perspective. We conclude with a discussion on the dire need to (1) highlight the considerable value of both informal and formal sources of support for the housing insecure, and (2) generate recommendations for interventions to address housing insecurity and homelessness with greater consideration for the impacts of SDoH in the work dedicated to helping gay men living with HIV at midlife overcome housing insecurity as they age.

Facility design and management. Strategies for high level biocontainment.

UK Health Security Agency is required to investigate the pathogenesis of emerging or re-emerging infections and to test novel interventions, such as vaccines and therapeutics against these and other diseases, such as tuberculosis and Ebola, that have a significant impact on human health world-wide. Research into the causative agents (mainly BSL 3 and 4) using a wide range of animal species as pre-clinical models brings a number of challenges in terms of effective biocontainment to address human safety whilst optimising delivery of scientific objectives and the welfare of the animals. Here we describe the strategies used for high containment of species that include mice, ferrets, hamsters, rabbits and macaques that have been infected with high consequence pathogens. To ensure relevance of these models we frequently challenge by the aerosol route and monitor the development of disease and protective or therapeutic efficacy by methodologies similar to those used in the clinic. We have devised methods of sampling that can inform on pathogenesis and immune function that include lung lavage and medical imaging such as computed tomography and positron emission tomography-computed tomography. Imaging assists our assessment of progression to disease whilst providing refinement in application of early humane endpoints. We have developed directional flow containment systems that provide quantifiable operator protection whilst allowing group housing and a wide range of enrichment strategies appropriate for each species. Furthermore, we have demonstrated our improvements in animal welfare through use of a software-based Animal Welfare Assessment Grid that was developed with help of NC3Rs funding and enables us to quantify the lifetime experience of animals.

P.A.V.I.A. Study: Pervasiveness and Associated Factors of Video Slot Machine Use in a Large Sample of Italian Adolescents.

Video slot machines (VSM) are considered a particularly harmful gambling format; however, scant data is available on their use among underage Italian individuals. Two surveys were conducted in 2018 and 2022 involving 7,959 underage high school students (57.8% female) in Pavia, Northern Italy. We estimated adjusted odds ratios (aOR) and corresponding 95% confidence intervals (CI) for lifetime experience and current regular (at least monthly) use of VSM, according to family, educational and behavioral factors. Overall, participants reporting lifetime VSM experience were 13.2% (95% CI: 12.5 - 13.9), 15.2% (95% CI: 14.0-16.4%) in 2018, and 12.0% (95% CI: 11.1-13.0%) in 2022. Current regular VSM users were 1.4% (95% CI: 1.1-1.7) in total, 1.2% (95% CI: 0.8-1.6%) in 2018 and 1.5% (95% CI: 1.1-1.8%) in 2022. VSM lifetime experience and current regular use were significantly more frequent in males (aORs: 1.55 and 4.81, respectively), students who failed a year (aORs: 2.07 and 3.44), or with daily gambling parents/siblings (aORs: 2.83 and 4.86). Lifetime use of alcohol, tobacco, or illicit substances was significantly directly associated with lifetime VSM use (aORs between 2.64 and 4.75); monthly alcohol, tobacco, or illicit substances use was significantly directly associated with current regular VSM use (aORs between 4.47 and 18.21). Sexting and voluntary self-injury were significantly more frequent among VSM lifetime/current regular users. VSM use, which is directly associated with other risky behaviors, may be pervasive among Italian minors. Such public health concern calls for legislative enforcements and integrated multidisciplinary health promotion and prevention strategies.

The Merit and Beyond; Portraying Student Exchange as Synergetic International Relations

The breakthrough on developing the synergy of international relations among countries is by fostering student exchange as the so-called worthwile programs that link the bilateral relationship and cultural identities. These student exchange programs accentuate the mutual liaison among the countries. It, indeed, exerts influence on students both positively and unforgettably. This research was designed in qualitative method and researcher utilized inquiry strategy of phenomenological study. Three main informants were participated in this research because they experienced the student exchange in advance. Researcher gathered the data through in-depth interview. Specifically, there were four major themes found in the research, they were 1) The lifetime experiences, 2) The challenges and barriers, 3) The problem solving, and 4) The impacts and changes. These findings highlighted the primary goal of the student exchange program itself and also fostered interconnection among the countries in forging impacts for the students as well as the country they belong to. Keywords: Student Exchange, Synergetic Impacts, and International Relations.

Attitudes on Psychedelics in a Sample of Croatian Mental Health Professionals: A Cross-Sectional National Survey Study

ABSTRACT For some time now, there has been an increased interest in psychedelics among scientists and mental health experts. Given that experts introduce therapy and advise patients, it is important to know their views. Therefore, the aim of our research was to examine and compare the attitudes of psychiatrists and psychologists toward psychedelics. We were interested in how they are formed and what is the role of personality in that process. We included 218 respondents, of which 92 were psychiatrists and 126 were psychologists. Attitudes toward psychedelics were examined using the Attitudes on Psychedelics Questionnaire. We used the Big Five Inventory to examine personality traits. On the Legal Use of Psychedelics subscale, it was shown that psychiatrists have more negative attitudes toward psychedelics (p = .033). Higher Openness (β = 0.184, p < .001) and lower Conscientiousness (β = -0.144, p = .009) contribute to positive attitudes toward psychedelics, as well as previous lifetime experience with psychedelics (β = 0.411, p < .001) and younger age (β = -0.278, p < .001). In conclusion, we can say that mental health professionals are open but also wary of psychedelics. Openness motivates them to learn. For this reason, additional education could have an impact on the attitudes of psychiatrists and psychologists and prepare them for the practical use of psychedelics.

Working Through It: Lifetime Experiences of Employment Discrimination Among Older Black Americans and Implications for Labor Force Participation, Job Dissatisfaction, and Mental Health in Older Adulthood.

To examine lifetime experiences of employment discrimination and their association with Black older adults' employment status and well-being. We use data from the Health and Retirement Study's leave-behind questionnaire to characterize lifetime experiences of being unfairly fired, not hired, or not promoted among Black older adults (N = 2948) and test associations with labor force status at age 62, job satisfaction among those working, and depressive symptoms. Employment discrimination was commonly reported by Black older adults, especially among men and those with college educations. Employment discrimination was not associated with employment status at age 62 but was associated with job dissatisfaction (OR = 2.00, p = .001) and depressive symptoms (Beta = 0.34, p < .001). Findings suggest a negative association between employment discrimination at any point in the life course and Black older adults' well-being. Employment discrimination is an obstacle to healthy aging, yet improved discrimination survey items are needed to fully capture its impact on Black Americans.