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Objectives: In order to develop a better understanding of students' access to mental health services, we explored the experiences of health care professionals interacting with university students with mental health problems. Methods: We interviewed 23 professionals working across university advice and counselling services, NHS general practice, crisis, and psychological services in North and East London between June 2022 and January 2023. Our approach drew on reflexive thematic analysis and the principles of abductive analysis. The notion of candidacy – that is, how different needs are deemed deserving of health service attention – was particularly helpful to our understanding of the ongoing phenomenon of interest in the data. Results: Each student's access to mental health support was highly contingent on the student's dynamic social context and the pressures and organisation of the local health system. Professionals described how different students viewed different needs as deserving of health service attention. Which students reached the professional's service depended on the resources and relationships a student could draw upon, and the service's relative permeability. Once there, what action professionals took was strongly influenced by the professional's service expertise, resource constraints, the relationships the professional's service had with other organisations, the students' wishes, and whether students regarded treatment offers as acceptable. Conclusions: Candidacy offers a useful lens to view university students' access to mental health support. Access appears to be an increasingly intricate task for students, given the fragmented service landscape, surging demand for mental health care and challenges of emerging adulthood. Our findings suggest that policy goals to increase use of mental health services are unlikely to improve outcomes for students without policy makers and health systems giving holistic consideration of inter-service relationships and available resources. [ABSTRACT FROM AUTHOR]

• This systematic review represents a significant contribution to the field as it is the first comprehensive review in Latin America that addresses the influence of masculinity stigma on the diagnosis and treatment of metastatic prostate cancer. • One of the unique strengths of this review is its ability to gather and synthesize dozens of studies that were previously published only in Portuguese or Spanish, effectively summarizing and connecting these findings with the international literature. • It highlights the impact of cultural beliefs, gender norms, and social expectations on the stigmatization of prostate cancer, particularly related to notions of masculinity such as strength and invulnerability. • The review addresses the influence of machismo culture and religious/spiritual beliefs, which further complicate the challenges faced by individuals with prostate cancer and hinder open communication about the disease. • By identifying these sociocultural factors, the review contributes to a better understanding of the experiences and obstacles encountered by prostate cancer patients in Latin America. This review examines the impact of masculinity stigma on the diagnosis and treatment of metastatic prostate cancer, particularly in Latin America. It aims to provide insights into the influence of masculinity stigma on patient outcomes and inform strategies to address this issue. A comprehensive search was conducted in electronic databases (PubMed, PsycINFO, CINAHL and LILACS) using relevant keywords and controlled vocabulary related to metastatic prostate cancer, masculinity, stigma, diagnosis, and treatment up to April 2023. The search strategy was developed in consultation with a medical librarian to ensure its comprehensiveness. Thirty-three studies that investigate the role of masculinity stigma in the diagnosis and treatment of metastatic prostate cancer were included. Our findings highlight the unique sociocultural influences in Latin America that shape prostate cancer stigma. It emphasizes the impact of cultural beliefs, gender norms, and social expectations on stigma. Notions of masculinity, such as strength and invulnerability, contribute to the stigmatization of prostate cancer. Machismo culture and religious/spiritual beliefs further compound the challenges and hinder open communication about the disease. Cultural taboos, limited awareness, and misconceptions perpetuate the stigma. These sociocultural factors shape the experiences and challenges faced by individuals with and at risk of prostate cancer in Latin America. [ABSTRACT FROM AUTHOR]

This study focuses on the subjective well-being (SWB) of a sample of military veterans before and after their engagement with a nonclinical, alternative mental health therapies residential retreat in the United Kingdom. The study findings have relevance for trauma-exposed individuals globally. Military veterans will actively avoid seeking traditional mental health treatments due to factors such as stigma and life-long labels, as well as a reluctance to engage in talk therapies. This is despite the widespread occurrence of diagnosed and undiagnosed chronic mental health conditions such as posttraumatic stress disorder following periods of service. Moving beyond trauma-informed practice and embracing a healing-centered approach involving holistic therapies delivered during a retreat-type format has a positive impact on the SWB of service users. Positive changes in SWB were recorded using the Warwick–Edinburgh Mental Well-Being Scale and the lived experiences of the participants. A shared military identity contributes immeasurably to a veteran-centered approach to holistic therapy, healing, and recovery. [ABSTRACT FROM AUTHOR]

Sexual minority men (gay, bisexual and other men who have sex with men; SMM) in Nigeria are disproportionately affected by HIV compared to heterosexual men. There is a dearth of research on the correlates of antiretroviral therapy (ART) non-adherence and correlates in both groups. The current study examined the associations of ART non-adherence with sociodemographic and psychosocial characteristics among a sample of Nigerian heterosexual and SMM. Between March and September 2014, we surveyed 120 SMM and 108 heterosexual men receiving ART in Lagos and Abuja, Nigeria. We specified univariate and multivariable linear regression models to examine correlates of ART non-adherence. We found that 50.8% and 29.6% of sexual minority and heterosexual men respectively self-reported ART non-adherence which was significantly associated with psychosocial factors such as stigma, depressive symptoms, and suicidality. Mental health care and psychosocial support should be incorporated into routine HIV care for Nigerian SMM living with HIV. [ABSTRACT FROM AUTHOR]

Vicarious stigma shows how indirect stigmatizing experiences can lead people living with HIV (PLWH) to feel discriminated against. We enrolled 350 PLWH, who were administered a 17-item questionnaire to investigate a subjective experience of stigma experienced in the hospital care setting. We found that at least once 215 PLWH (61.4%) did not want the HIV exemption indicated on the prescription for a specialist medical visit, 232 PLWH (66.3%) never used their HIV-related exemption to make a specialist medical visit, 230 PLWH (65.7%) avoided undergoing a medical assessment outside the infectious disease clinics and 241 patients (68.9%) felt unwelcome during a specialist medical visit. Moreover, 241 patients (61.1%) had heard at least once stories of health workers who did not want to touch PLWH, 213 patients (60.9%) had heard stories at least once of PLWH who had been mistreated by hospital staff, 180 patients (51.4%) had at least once heard stories about PLWH being refused treatment and services and 257 patients (73.4%) had at least once heard stories about health workers talking publicly about PLWH. This is a little explored area, especially regarding the vicarious stigma faced by PLWH. Our findings indicate the importance of combating HIV-related stigma for the wellbeing of PLWH. [ABSTRACT FROM AUTHOR]

This study examined associations between perceived discrimination, treatment adherence self-efficacy, and depressive symptoms among people living with HIV (PLHIV) in the Southern United States. Cross-sectional survey data were collected from 402 PLHIV who self-reported on interpersonal discrimination experiences based on HIV status, sexuality, gender, income, and living condition. Participants also reported on adherence self-efficacy and depressive symptoms. We employed K-means clustering to identify groups based on discrimination experiences, and logistic regressions to examine group differences on adherence self-efficacy and depressive symptoms. Results suggested three groups: a cluster with high perceived discrimination across all identities/conditions (n = 41; 11%; Cluster 1); a cluster with high perceived discrimination based on HIV status, income, and living condition (n = 49; 13%; Cluster 2); and a cluster with low perceived discrimination across all identities/conditions (n = 288; 76%; Cluster 3). Compared to Cluster 3, Cluster 1 and 2 had 2.22 times (p =.037) and 3.98 times (p<.001) greater odds of reporting depressive symptoms. Compared to Cluster 3, Cluster 2 had 3.40 times (p =.003) greater odds of reporting lower adherence self-efficacy. Findings demonstrate the need for individual-level support for PLHIV with discrimination histories, and broader efforts to end the stigma, discrimination, and marginalization of PLHIV based on HIV status and other characteristics. [ABSTRACT FROM AUTHOR]

Internalized HIV-related stigma (IHS) among people living with HIV (PLHIV) has been documented as one of the factors contributing to the ongoing AIDS epidemic. The purpose of this study, which was conducted from September 2021 to January 2022, was to measure prevalence and identify factors associated with IHS among research participants who were living with HIV recruited from a research clinic in Chiang Mai, Northern Thailand. Participants were considered to have IHS if they agreed to at least one of the 8 items of the newly developed Thai Internalized HIV-related Stigma Scale (Thai-IHSS). Of the 104 participants, 65.4% were female. The median age was 51.5 years and the duration of known HIV infection was 19.0 years. Fifty-three percent of the participants had IHS as defined by the study. Reduced probability of having IHS was independently associated with certain levels of education (middle or high school education compared with no or primary school) (AOR = 0.30; 95% CI: 0.12–0.77) and increased mental health-related quality of life (AOR = 0.39; 95% CI: 0.18–0.86). The prevalence of IHS among PLHIV in Chiang Mai was high. These findings highlight the requirement for comprehensive mental health care programs for PLHIV to improve their quality of life. [ABSTRACT FROM AUTHOR]

This pilot study evaluated a novel psycho-educational group intervention addressing sexuality and intimacy issues among male heterosexual individuals with mental health conditions. Despite the universal need for fulfilling relationships, stigma and lack of support often distort views and promote high-risk behaviors in this population. A cognitive-behavioral framework was used in a six-session program to enhance knowledge and promote healthy sexuality among six participants recruited from an integrated vocational rehabilitation service center in Hong Kong. Quantitative pre- and post-testing alongside qualitative observations revealed that participants significantly improved their understanding of relationships, communication skills, and ability to identify safe practices. Limitations included the small, exclusively heterosexual male sample and evaluation methods. As sexuality is an important yet under-researched topic impacting this population's quality of life, these findings suggest structured group interventions may equip individuals with adaptive tools for intimacy. However, larger trials with expanded curricula are needed to validate this approach. [ABSTRACT FROM AUTHOR]

Background: Patient-centred care must consider service consumers' needs and improve their health and well-being as well as their satisfaction and the quality of their healthcare assistance. However, individuals experiencing mental illness often struggle with barriers and misunderstandings by health care professionals. Nursing Faculties are uniquely positioned to reduce stigmatising attitudes via new educational interventions that could align nursing curricula and individuals with mental illness needs. However, there are few studies about the stigma toward mental illness among nursing students in Spain. Objectives: The present study aimed to analyse the effect of a 9-month educational intervention on the level of stigma in nursing students. Design: a one-group pre-postintervention design with no control group was conducted. Methods: A total of 194 nursing students completed the EVEPEM scale before and after the intervention. The intervention comprised 55 hours of campus sessions and 150 h practicum in mental health settings. Results: A destigmatising tendency was captured by a large main effect and a statistically significant stigma reduction. Conclusions: The educational 9-month intervention was effective in reducing students' stigma by providing theoretical education, personal contact with mental health service consumers, and critical reflection activities. [ABSTRACT FROM AUTHOR]

Introduction: Social media has transformed how music therapists work, with numerous practitioners utilizing the affordances of social media in music therapy practice. So far, music therapy research has been significantly limited regarding the ethical implications of social media use. A better understanding of the ethics of social media use is needed to inform the continuous evaluation of professional ethical guidelines. Methods: We conducted a systematic text condensation of transcripts from one conversational focus group consisting of five participants with diverse connections to music therapy and social media. Results: The results highlight the many ways social media can facilitate both substantial value as well as serious risk in music therapy practice. Through the analysis, it has also become clear that music therapists must make complex considerations in working with social media to maintain a level of responsible practice. Discussion: This study provides (a) insights and experiences from practice gathered in a conversational focus group, (b) discussions exploring the possible value and risks of social media use in music therapy, and (c) implications for practice including a summary of some ethical reflections. [ABSTRACT FROM AUTHOR]

Copyright of Tijdschrift voor Geschiedenis is the property of Amsterdam University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The stigma perceived by many post-stroke persons hinders their social lives. A scale to measure stigma is needed to identify social problems related to stigma, and to evaluate effectiveness of interventions. Objectives: This study aimed to develop a Japanese version of the Stroke Stigma Scale (SSS-J), and confirm its utility by examining reliability and validity. Methods: Eighty community-dwelling post-stroke individuals were enrolled at six sites. After translating the scale into Japanese using back translation methods, psychometric properties of the rating scale, internal scale validity, and reliability were examined to fit the Rasch model. Criterion-related validity, construct validity, and test-retest reliability were examined using total scores transformed to logit. For test-retest reliability, 30 participants completed the SSS-J twice, one week apart. Results: Rasch analysis showed that the SSS-J had the best fit with 15 items on a 3-category rating scale. Item difficulty logits were -2.01 to 2.21, person ability logits were -4.69 to 0.62 (mean, -1.41), person reliability coefficient was 0.71 (separation index, 1.58), and item reliability coefficient was 0.96 (separation index, 5.04). For criterion validity, Spearman's rank correlation coefficient with the Center for Epidemiologic Studies Depression Scale was 0.51 (p < 0.001). For construct validity, Spearman's rank correlation coefficients with each subscale of the Stroke Impact Scale ranged from -0.36 to -0.16 (p = 0.002–0.126). For test-retest reliability, the intra-class correlation coefficient was 0.64 (p < 0.001). Conclusions: The SSS-J adapted to the Rasch model was reliable and valid. This scale can be used to quantitatively measure stigma among community-dwelling post-stroke persons in Japan. [ABSTRACT FROM AUTHOR]

Though network scholars long have observed that people experience high rates of network turnover, theorization on how ties dissolve has lagged behind, with natural tie decay dominating as the primary explanation. Many deviants face stigma and become social pariahs from communities of origin, yet current network theories struggle to explain how such processes of network dissolution occur. Using interviews conducted with Korean unwed mothers, a highly stigmatized and hard-to-reach population, this study shows that shared culture in networks—norms, expectations, and meanings—plays a key role in how people navigate stigma in their networks. I demonstrate that tie severance requires work : relational work that matches network-specific culture. I propose a typology of tie severance processes along two dimensions, actor and motive, and identify associated relational work for each type. This study shows that macro-level cultural values are adapted to each network and (re)interpreted before relational work can be engaged to manage social relations. • Explores how tie severance occurs beyond natural tie decay. • Stigmatized alters engage relational work throughout the tie severance process. • Case study of a hard-to-reach population, Korean unwed mothers. • Proposes a tie severance typology along two axes, actor and motive. [ABSTRACT FROM AUTHOR]

In this study, we looked at the variables affecting Turkish attitudes towards seeking psychological help (ASPH). Thus, we aimed to determine the relationships between mental health literacy (MHL), the self-stigma of seeking help, the social stigma of receiving psychological help, masculinity, emotional expression, and ASPH. The research survey consisted of 557 participants aged between 18 and 60 (399 female, 158 male). The stepwise regression analysis indicated that the self-stigma of seeking help could significantly explain 37.1% of the variation in ASPH. The model incorporated the following factors: knowledge-oriented MHL, beliefs-oriented MHL, resource-oriented MHL, emotional expression, and masculinity. Together with self-stigma of seeking help, these factors explained 44.8% of ASPH. Knowledge-oriented MHL made the second-most substantial contribution, explaining 2.8% of the variance, while self-stigma emerged as the most significant contributor. The findings reinforce the importance of MHL in determining ASPH for clients and mental health professionals. [ABSTRACT FROM AUTHOR]

Jail incarceration remains an overlooked yet crucial component of the U.S. carceral system. Although a growing literature has examined the mortality costs associated with residing in areas with high levels of incarceration, far less is known about how local jails shape this burden at the intersection of race, sex, and age. In this study, I examine the relationship between county-level jail incarceration and age-specific mortality for non-Hispanic Black and White men and women, uniquely leveraging race-specific jail rates to account for the unequal racial distribution of jail exposures. This study finds evidence of positive associations between mortality and jail incarceration: this association peaks in late adulthood (ages 50–64), when increases in jail rates are associated with roughly 3% increases in mortality across all race–sex groups. However, patterns vary at the intersection of race, sex, and age. In particular, I find more marked and consistent penalties among women than among men. Additionally, a distinctly divergent age pattern emerges among Black men, who face insignificant but negative associations at younger ages but steep penalties at older ages—significantly larger among those aged 65 or older relative to their White male and Black female counterparts. Evidence further suggests that the use of race-neutral incarceration measures in prior work may mask the degree of harm associated with carceral contexts, because the jail rate for the total population underestimates the association between jail rates and mortality across nearly all race–age–sex combinations. These findings highlight the need for future ecological research to differentiate between jail and prison incarceration, consider the demographic distribution of incarceration's harms, and incorporate racialized measures of exposure so that we may better capture the magnitude of harm associated with America's carceral state. [ABSTRACT FROM AUTHOR]

Background. Caregiver affiliate stigma concerning neurodegenerative disorders (NDDs) profoundly affects caregivers' well-being, though its full impact remains to be fully elucidated. Objectives. This scoping review aims to consolidate the current knowledge on caregiver affiliate stigma related to NDDs, explore its connection to caregiver psychosocial well-being, and pinpoint the gaps in the existing research. Methods. Adhering to the PRISMA-ScR guidelines, a comprehensive search of five databases was conducted for peer-reviewed, English language studies focusing on caregiver-affiliated stigma in relation to NDDs. Results. The initial search yielded 9033 articles, with 19 meeting the inclusion criteria after rigorous screening. Bronfenbrenner's ecological systems theory was employed to analyze various stigma conceptualizations, including public, courtesy, affiliate, and family stigma. Analysis revealed a correlation between elevated levels of affiliate stigma and increased caregiver burden, deteriorated mental health outcomes, and diminished quality of life. The internalization of stigma was found to vary across demographic groups, influenced by factors such as education level and social support. The review also highlighted the mediating role of coping strategies and the protective function of social support against stigma internalization. Conclusions, These findings underscore the necessity for targeted, culturally sensitive interventions that address caregiver affiliate stigma across multiple ecological levels. This review contributes to a more nuanced understanding of caregiver affiliate stigma in relation to NDDs, laying the groundwork for future research and intervention development aimed at enhancing caregiver well-being in diverse cultural contexts. [ABSTRACT FROM AUTHOR]

Copyright of Neurosciences is the property of Neurosciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The COVID-19 pandemic has uniquely impacted people living with HIV (PLWH) worldwide. The negative impacts on PLWH's mental health from fear of COVID-19 are labeled as "a double stress." The association between fear of COVID-19 and HIV (internalized) stigma has been found among PLWH. Studies that explore the relationships between fear of COVID-19 and physical health outcomes are few, especially among PLWH. In this study, we explored the relationship between fear of COVID-19 and physical health among PLWH and the mediated effects of HIV stigma, social support, and substance use. A cross-sectional online survey of PLWH (n = 201) from November 2021 to May 2022 was carried out in Shanghai, China. The data on socio-demographics, fear of COVID-19, physical health, HIV-related perceived stigma, social support, and substance use were gathered and analyzed by structure equation modeling (SEM). In SEM analysis, fear of COVID-19 showed a significant and indirect effect on physical health (β=-0.085) which was primarily mediated by HIV stigma. In SEM analysis, the final model had a good fit. Fear of COVID-19 showed a significant effect on HIV stigma (β = 0.223) with the majority being direct effects (β = 0.262) and a small indirect effect via substance use (β=-0.039). Furthermore, HIV stigma showed a significant effect on physical health (β=-0.382), the majority of which was direct (β=-0.340), and a small indirect effect via social support (β=-0.042). This is one of the first studies to explore how fear of contracting COVID-19 can affect PLWH's coping behaviors (e.g., using substances and obtaining social support) used to combat HIV stigma as well as to achieve better physical health in China. [ABSTRACT FROM AUTHOR]

Background: Maternal substance use disorders (SUD) have challenged relationships between women with SUD and their nurses. Nurses have reported biased attitudes toward women with SUD, which can interfere with their care. However, it is not well known how nursing students perceive women with SUD and their infants. This article describes nursing students' attitudes toward women with SUD, which can be used to inform educational strategies. Method: An inductive content analysis was used to analyze 76 reflection papers written by nursing students at a midwestern university. Results: Three main themes were identified: (1) stigma toward women with SUD; (2) concerns for infants with neonatal abstinence syndrome; and (3) influence of clinical experiences on attitudes toward women with SUD. Conclusion: Nursing students need more evidence-based guidance on managing their biases as well as the biases of nurses who work in maternity settings. [J Nurs Educ. 2024;63(10):659–664.] [ABSTRACT FROM AUTHOR]

Violence and abuse in rural America are exacerbated by limited access to support services for victims of intimate partner violence (IPV) due to family connections with people in positions of authority, geographic isolation, transportation barriers, stigma of abuse, lack of available shelters and affordable housing, poverty as a barrier to care, and other challenges. Victims of abuse who live in small communities may be well-acquainted with local health care providers and often voter-elected law enforcement officers. Individuals may fear being seen walking into a mental health clinic, with subsequent (and reality-based) fear that deter them from seeking help. Thus, advances in technology are becoming a much-needed option. Although telehealth has been used for some time in rural health settings, only in more recent years has there been an increase toward quality trauma-informed care. With increasing focus on the impact of social determinants of health, agencies continue to shift to telehealth to provide virtual support. Specifically, telehealth visits can potentially extend the reach of the limited number of primary care and mental health providers to those who are significantly in need of services. [Journal of Psychosocial Nursing and Mental Health Services, 62(10), 25–30.] [ABSTRACT FROM AUTHOR]

On May 31, 2021, Naomi Osaka, one of the top-ranked female tennis players, and one of the highest-paid female athletes in the world, announced her withdrawal from the French Open on her social media (Twitter) account, citing mental health issues. There exists a stigma around mental health; and people suffering from mental health conditions often experience "discrimination and stigma" (World Health Organization, 2019). Such disclosures by a noted sportsperson provide an opportunity to help combat the stigma. The present study uses unsupervised machine learning and qualitative thematic analysis to analyze 11,800 English language responses to her tweet. Results indicate that Osaka's tweet mostly garnered a lot of support and encouragement. However, there also existed some negative comments. Additionally, 40% of the negative comments were disseminated by bot-like automated accounts. Practical implications for sports communication are also discussed. [ABSTRACT FROM AUTHOR]

Background: Among individuals who use substances, the perceived stigma of substance use harms their quality of life and may be an obstacle to quitting. We explored the effect of the stigma perceived due to substance use on executive functioning. Methods: This cross-sectional study involved 80 individuals who used substances and sought to quit while admitted to a public neuropsychiatric hospital in south Iran in March 2022. Data were collected using the Barkley Executive Function Questionnaire and the Stigma Scale. Statistical analyses were done using SPSS v. 25. Results: The participants' mean age was 36.56 ± 9.37 years, and most (85.0%) were males. Among them, 28 (35%) used narcotics, 7 (8.8%) used stimulants, and 45 (56.3%) used multiple substances. Increased total sigma scores correlated with deficits in self-management to time, self-organization/problem-solving, self-regulation of emotion, self-motivation, self-restraint, and total executive function. Moreover, each stigma dimension had some correlations with executive dysfunction or its subscales. Conclusions: Self-perceived stigma is directly linked with executive dysfunction in individuals who use substances and seek to quit. Since stigma and executive function both play essential roles in addiction treatment success, interventions should be adjusted to reduce self-perceived stigma and executive function deficits among individuals who use substances. [ABSTRACT FROM AUTHOR]

Objective: Women smokers are overlooked because of their current low smoking rates compared to men smokers. However, smoking among women in developing countries, including Indonesia is increasing due to the weakening of social stigma that was previously said to prevent them from uptake cigarettes. The study aimed to explore the stigmatization of smoking women from women's perspectives. Methods: We interviewed 39 women—19 smokers and 20 nonsmokers aged 18 years old and above in Banda Aceh and Jakarta representing urban contexts. The transcribed interviews were analyzed using the self-categorization theory where women characterized identity at different levels of inclusiveness. Results: Our study found most participants perceived the social stigma of women smokers still exists. Women's viewpoints toward women smokers are situated between challenging and compromising women and their smoking conduct, illustrated by why they smoke, where they choose to smoke, and how the smokers look like. Conclusion: Women's perceptions and attitudes toward women smoking provide insights into how the remainder of social judgment can serve as a barrier to capturing accurate information about women smokers and solving smoking-related issues, particularly in developing countries, such as Indonesia. Policymakers and health professionals need to determine and implement more gendered sensitive tobacco control interventions. [ABSTRACT FROM AUTHOR]

Objective: The study was conducted to determine the effect of mindfulness-based psychoeducation on internalized stigma and substance abuse proclivity in individuals with substance use disorder. Design and Methods: The study was carried out as an experimental model with a pretest–posttest control group. The sample used in the study consisted of 100 individuals (50 for control group, 50 for experimental group) via power analysis. The Patient Information Form, the Internalized Stigma of Mental Illness Scale (ISMI), and the Substance Abuse Proclivity Scale (SAP) were used to collect the data. An eight-session mindfulness-based psychoeducation program was applied to the experimental group. Findings: It was determined that there was a mild decrease in the posttest SAP total mean score and the ISMI subscale and total mean score of the experimental group patients compared to the pretest. The difference between the posttest ISMI and substance abuser proclivity of the control and experimental groups was statistically significant (p <.05). Conclusion: It was determined that MB psychoeducation was effective in decreasing internalized stigma and substance abuse proclivity in patients with substance use disorder. [ABSTRACT FROM AUTHOR]

Health communication is a critical component of public health, which includes health education resources. Resource effectiveness is improved where health literacy demands, including the cultural appropriateness of resources, match the intended audience. International guidelines support the tailoring of resources for migrants from culturally and linguistically diverse backgrounds (CaLD). Five focus groups (n  = 18) and interviews (n  = 9) with people from CaLD migrant backgrounds explored community perspectives on sexual health resources developed by a state department of health, specifically clarity, comprehensiveness, cultural appropriateness and strategies for dissemination. We identified three major thematic areas relating to simplicity, cultural norms and beliefs and dissemination. Participants recommended resource delivery in different formats as part of a broader intervention. Generally, sexual health information was deemed appropriate and easily understood. However, the resources used simplified language that participants reported was vague and inaccurate at times, potentially contributing to misinformation and reinforcing stigma relating both to the status of being a migrant and sexual health. Findings suggest the need for more nuanced health resource development beyond translation and language simplification. Resources developed in different formats, including different health literacy demands, using approaches that engage the target group in design and dissemination and contextualized within a comprehensive health promotion project, are likely to be more effective. [ABSTRACT FROM AUTHOR]

What insights can postcolonialism and decoloniality offer into workplace accentism? Drawing upon these two strands of literature, this article contributes to workplace research through proposing a view of accentism as an intersectional phenomenon, rooted in the historically sedimented unequal social structure and relations formed during the colonial past. Based on a qualitative study of Brazilians in Portugal, we identify two forms of workplace accentism experienced by the participants: (1) overt accentism – which involves an explicit, direct reference to a person's accent; and (2) accent-activated stigmatisation – which occurs upon the listener's realisation that the speaker is a member of a particular group (specifically, nationality). We theorise the experiences of accentism as contemporary manifestations of the workings of colonial power and prejudices. In addition, we distinguish between four approaches to managing workplace accentism: suppressing, confronting, marginalising and exiting. We theorise these as contemporary expressions of resistance strategies historically used by the colonised in response to colonial power. We also highlight the intersectional differences – along the axes of class, race and gender – with regard to individuals' deployment of each of these approaches. The article enriches our knowledge about how colonial power relations continue to underpin discrimination and its consequences throughout the global economy. [ABSTRACT FROM AUTHOR]

Objectives: To examine the associations of two measures of minority stress, non-affirmation minority stress and internalized transphobia, with subjective cognitive decline (SCD) among transgender and gender diverse (TGD) veterans. Method: We administered a cross-sectional survey from September 2022 to July 2023 to TGD veterans. The final analytic sample included 3,152 TGD veterans aged ≥45 years. We used a generalized linear model with quasi-Poisson distribution to calculate prevalence ratios (PR) and 95% confidence intervals (CIs) measuring the relationship between non-affirmation minority stress and internalized transphobia and past-year SCD. Results: The mean age was 61.3 years (SD = 9.7) and the majority (70%) identified as trans women or women. Overall, 27.2% (n = 857) reported SCD. Adjusted models revealed that TGD veterans who reported experiencing non-affirmation minority stress or internalized transphobia had greater risk of past-year SCD compared to those who did not report either stressor (aPR: 1.09, 95% CI: 1.04–1.15; aPR: 1.19, 95% CI: 1.12–1.27). Conclusion: Our findings demonstrate that proximal and distal processes of stigma are associated with SCD among TGD veterans and underscore the need for addressing multiple types of discrimination. Above all, these results indicate the lasting sequelae of transphobia and need for systemic changes to prioritize the safety and welfare of TGD people. [ABSTRACT FROM AUTHOR]

Objectives: The aim is to assess the level of stigmatization and knowledge of dementia among university students of medical, rehabilitation and social faculties in Poland. Possible correlates of these concepts and group differences are also investigated. Methods: We applied quantitative methods using an online questionnaire comprising sociodemographics, the Alzheimer's Disease Knowledge Scale, a vignette of a person with dementia and the modified Family Stigma in Alzheimer's Disease Scale. Results: Students had low levels of dementia knowledge and moderate levels of stigma. Medical science students had significantly better knowledge than the other groups but did not differ in their level of stigma. Relationships between the main variables were complex. Emotional and cognitive stigmatizing attributions were negatively correlated with knowledge about communication and behaviors of people with dementia. Better knowledge on causes and characteristics, as well as on risks and health promotion of the disease also triggered fewer negative attributions toward people with dementia. Conclusions: If health-related programs are to be effective, they should provide opportunities for the acquisition of relevant knowledge and skills that also address the stigmatization of people living with dementia. Well-established biomedical knowledge on dementia must be supplemented with a person-centered approach and proper communication skills. [ABSTRACT FROM AUTHOR]

Women living with HIV/AIDS (WLHA) encounter numerous challenges, such as stigma and gender disparities, that hinder their access to care, especially in patriarchal societies like Vietnam. We developed a hybrid intervention with online and offline (in-person) components to empower WLHA in Vietnam. The intervention was pilot tested with 91 WLHA in Hanoi. During baseline and 4-month, study investigators delivered two in-person sessions, one Zoom session, and 15 weeks of Zalo (social media platform) discussions to enhance positive coping strategies, treatment utilization and adherence, and engagement of support from family and peers. The participants continued their Zalo discussions from 4-month to 6-month without investigators' involvement. Intervention outcomes, including active coping and perceived barriers to care, were evaluated at baseline, 4-, and 6-month surveys. Mixed-effects regression models showed that the participants' active coping significantly increased from baseline (50.5 ± 9.4) to 4-month (53.8 ± 6.2; p = 0.0001), although there was a slight decrease at 6-month (52.8 ± 7.2), the change from 4-month to 6-month was not significantly significant (p = 0.3256). There was a significant reduction in participants' perceived barriers to care, from 19.8 ± 5.2 at baseline to 17.4 ± 5.2 at 4-month (p < 0.0001), which remained stable at 17.8 ± 4.3 at 6-month (p < 0.0001 compared to baseline). This intervention presents a promising model to empower WLHA in Vietnam and potentially in similar global contexts. Future interventions could benefit from leveraging natural peer leaders and adopting a more person-centered approach to meet WLHA's varying needs. [ABSTRACT FROM AUTHOR]

Mobile populations such as fisherfolk show high HIV incidence and prevalence. We pilot-tested implementation strategies to enhance pre-exposure prophylaxis (PrEP) uptake and adherence in the context of healthcare outreach events in two mainland fisherfolk communities on Lake Victoria, Uganda from September 2021 to February 2022. The implementation strategies included PrEP adherence supporters (selected from PrEP users' social networks), community workshops (to address misconceptions and stigma, and empower PrEP advocacy), and check-in calls (including refill reminders). PrEP medical records data were collected from 6-months pre-intervention to 6-months post-intervention. Qualitative interviews with 20 PrEP users (10 who continued, 10 who discontinued), 9 adherence supporters, and 7 key partners (providers, community leaders) explored acceptability. Percentages of PrEP initiators (of those eligible) were significantly higher during the intervention (96.5%) than 6-months before the intervention (84.5%), p < 0.0001; percentages of PrEP users who persisted (i.e., possessed a refill) 6-months post-initiation (47.9% vs. 6.7%) and had at least 80% PrEP coverage (based on their medication possession ratio) from the initiation date to 6-months later (35.9% vs. 0%) were higher during versus pre-intervention, p < 0.0001. A comparison fisherfolk community with better healthcare access had lower uptake (78.3%; p < 0.0001) and persistence at 6-months (34.0%; p < 0.001), but higher coverage during the intervention period (70.4%; p < 0.0001). Qualitative data suggested the strategies promoted PrEP use through reduced stigma and misconceptions. The intervention bundle cost was $223.95, $172.98, and $94.66 for each additional person for PrEP initiation, persistence, and coverage, respectively. Enhanced community-based PrEP implementation that fosters a supportive community environment can improve PrEP use in mobile populations without easy access to healthcare. (NCT05084716). [ABSTRACT FROM AUTHOR]

Drug use, mental distress, and other psychosocial factors threaten HIV care for youth living with HIV (YLWH). We aimed to identify syndemic psychosocial patterns among YLWH and examine how such patterns shape HIV outcomes. Using baseline data from 208 YLWH enrolled in an HIV treatment adherence intervention, we performed latent class analysis on dichotomized responses to 9 psychosocial indicators (enacted HIV stigma; clinical depression and anxiety; alcohol, marijuana, and illicit drug misuse; food and housing insecurity; legal history). We used multinomial logistic regression to assess latent class-demographic associations and the automatic Bolck-Croon-Hagenaars method to assess HIV outcomes by class. Mean age of participants was 21 years; two thirds identified as cis male, 60% were non-Hispanic Black, and half identified as gay. Three classes emerged: "Polydrug-Socioeconomic Syndemic" (n = 29; 13.9%), "Distress-Socioeconomic Syndemic" (n = 35, 17.1%), and "Syndemic-free" (n = 142, 69.0%). Older, unemployed non-students were overrepresented in the "Polydrug-Socioeconomic Syndemic" class. Missed/no HIV care appointments was significantly higher in the "Polydrug-Socioeconomic Syndemic" class (81.4%) relative to the "Syndemic-free" (32.8%) and "Distress-Socioeconomic Syndemic" (31.0%) classes. HIV treatment nonadherence was significantly higher in the "Polydrug-Socioeconomic Syndemic" class (88.5%) relative to the "Syndemic-free" class (59.4%) but not the "Distress-Socioeconomic Syndemic" class (70.8%). Lack of HIV viral load suppression was non-significantly higher in the "Polydrug-Socioeconomic Syndemic" class (29.7%) relative to the "Syndemic-free" (16.2%) and "Distress-Socioeconomic Syndemic" (15.4%) classes. Polydrug-using, socioeconomically vulnerable YLWH are at risk for adverse HIV outcomes, warranting tailored programming integrated into extant systems of HIV care. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Black women living with HIV (BWLWH) face adversities associated with lower HIV medication adherence, viral non-suppression, and mental health symptoms (e.g., post-traumatic stress disorder) such as trauma/violence, racism, HIV-related discrimination/stigma, and gender-related stressors. We developed the first intervention based in cognitive behavioral therapy and culturally congruent coping for BWLWH to increase medication adherence and decrease PTSD symptoms by enhancing resilience, self-care, engagement in care, and coping for trauma, racism, HIV-related discrimination/stigma, and gender-related stressors. A pilot randomized control trial was conducted with BWLWH and histories of trauma who were at risk for their HIV viral load remaining or becoming detectable (i.e., below 80% medication adherence, detectable viral load in the past year, and/or missed HIV-related appointments). 119 BWLWH were assessed at baseline and 70 met inclusion criteria, completed one session of Life-Steps adherence counseling, and were randomized to either nine sessions of STEP-AD (Striving Towards EmPowerment and Medication Adherence) or ETAU (enhanced treatment as usual consisting of biweekly check-ins). Women completed a post intervention follow up assessment (3 months post baseline) and 3-month post intervention follow-up (6 months post baseline). Via STATA the difference-in-difference methodology with mixed models compared STEP-AD to ETAU on changes in outcomes over time. BWLWH in STEP-AD compared to E-TAU had significantly higher ART adherence (estimate = 9.36 p = 0.045) and lower likelihood of being clinically diagnosed with PTSD (OR =.07, estimate = − 2.66, p = 0.03) as well as borderline significance on higher CD4 count (estimate = 161.26, p = 0.05). Our findings suggest preliminary efficacy of STEP-AD in improving ART adherence, mental health, and immune function. [ABSTRACT FROM AUTHOR]

Disclosing one's HIV status can involve complex individual and interpersonal processes interacting with discriminatory societal norms and institutionalized biases. To support disclosure decision-making among young men who have sex with men (YMSM) living with HIV, we developed Tough Talks™, an mHealth intervention that uses artificially intelligent-facilitated role-playing disclosure scenarios and informational activities that build disclosure skills and self-efficacy. Qualitative interviews were conducted with 30 YMSM living with HIV (mean age 24 years, 50% Black) who were enrolled in a randomized controlled trial assessing Tough Talks™ to understand their experiences with HIV status disclosure. Interviews were recorded, transcribed, and thematically coded. Barriers to disclosure focused on fear, anxiety, stigma, and trauma. Facilitators to disclosure are described in the context of these barriers including how participants built comfort and confidence in disclosure decisions and ways the Tough Talks™ intervention helped them. Participants' narratives identified meaning-making within disclosure conversations including opportunities for educating others and advocacy. Findings revealed ongoing challenges to HIV status disclosure among YMSM and a need for clinical providers and others to support disclosure decision-making and affirm individuals' autonomy over their decisions to disclose. Considering disclosure as a process rather than discrete events could inform future intervention approaches. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There are over 1.4 million adolescents living with HIV in sub-Saharan Africa, the majority of whom acquired the virus through perinatal transmission (PHIV). HIV stigma is particularly high among adolescents living with HIV and is associated with several outcomes that worsen health and increase the risk of onward HIV transmission. We tested associations between internalized HIV stigma and four of these outcomes over a one-year period among a sample of adolescent boys living with PHIV in Soweto, South Africa. Participants (N = 241) answered questions about internalized HIV stigma at baseline. They completed weekly mobile surveys over the following year to answer questions about their experiences with depression, binge drinking, medication adherence, and violence victimization. Using generalized linear mixed models, we found that baseline internalized HIV stigma was associated with increased odds of depression (OR 1.74), alcohol misuse (OR 2.09), and violence victimization (OR 1.44) and decreased odds of medication adherence (OR 0.60) over the course of a year. These outcomes negatively impact the health and wellbeing of adolescents living with PHIV and increase their risk of transmitting HIV to their partners in the future. Our findings provide novel, longitudinal evidence for the deleterious effects of HIV stigma. To improve health outcomes for adolescents with PHIV, it will be crucial to develop effective HIV stigma reduction interventions that address specific developmental, gendered, and cultural experiences. [ABSTRACT FROM AUTHOR]

In this research, we examine the extent to which charitable support for the stigmatized can be enhanced by a moral claim, which occurs when a stigmatized person is attributed an unselfish (versus self-interested) motive for a socially desirable behavior. We find that prospective donors infer a more positive morality when a moral claim is made about a stigmatized person in need, which leads to a greater willingness to provide them with charitable support. The effect does not occur when the same moral claim is made for a person in equivalent need who is accepted or honored in society. We find that moral claims are effective when based on unsubstantiated statements about a mentally ill person’s morality (Study 1), when a drug thief volunteers to help flood victims, rather than helps them as part of her employment (Study 2), and when a homeless criminal returns a lost wallet to do the right thing, rather than to receive a reward (Study 3). The research contributes to our understanding of the role of moral judgments that lead to social rejection and provides insights into how the negative stereotypes that affect the stigmatized can be changed. [ABSTRACT FROM AUTHOR]

Background: This study explores how family members of individuals with mental illnesses address potential familial mental illness stigma. Previous studies have concentrated on self, social, and associative stigma and its impacts on families and persons with mental illnesses. Far less work has considered family members as perpetrators of mental illness stigma towards their loved ones with mental illnesses. Methodology/Principal findings: We conducted this study with 15 participants who were family members of persons with mental illnesses using semi-structured qualitative interviews. The in-depth interviews were followed by inductive analysis using Braun and Clarke's technique for thematic analysis. Participants' views on familial mental illness stigma and ways to reduce this were reported in five key themes. The themes included: (1) layered perspectives of social and family stigma; (2) family-related stigma; (3) complex interplay of family relationships and mental illness; (4) confronting stigma personally; and (5) envisioning a better future. The uncertainties connected with mental illnesses and the increased social stigma were conceptualized as contributors to familial mental illness stigma as ways to prevent potential associative stigma. Conclusion/Significance: Participants suggested the need for more social contact-based education and positive media reporting to correct the ongoing fallacies around mental illnesses. This study highlights how higher-order reforms to social systems and services would support both families and those living with mental illnesses to have more positive experiences. [ABSTRACT FROM AUTHOR]

A pervasive barrier to preventing, reducing, and ending homelessness is the stigmatization of and discrimination towards persons experiencing homelessness (PEH), termed "homeism." To date, there has been no systematic review of the experiences and outcomes of stigmatization and discrimination among PEH or interventions to reduce this discrimination. To fill this gap in the literature, we conducted a scoping review to identify the ways in which PEH have been stigmatized and discriminated against, the results of these experiences, and interventions that have been used to reduce stigma and discrimination. We reviewed results from 12 databases with no date restrictions; 205 studies met our inclusion criteria. Thematic data analyses resulted in the identification of 12 categories. Using community consultation, the scoping review themes were reviewed and validated with 25 PEH or service providers in the homelessness sector and their feedback integrated into our results. Thematic categories included discrimination and stigmatization in healthcare, social services, workplaces and employment, and public spaces by the general public; discrimination and stigmatization from landlords, police and security guards, informal social networks, and by PEH toward PEH; discrimination and stigmatization linked to intersectional domains; PEH feelings about discrimination and stigmatization; outcomes of discrimination and stigmatization for PEH; and interventions to reduce stigma, discrimination, and prejudice towards PEH. Based on findings from this review, we argue that homeism serves as a social determinant of health as PEH confront multiple barriers to housing, income security, and healthcare due to interpersonal, institutional, structural, and intrapersonal stigmatization and discrimination. [ABSTRACT FROM AUTHOR]

Objectives: Transgender, nonbinary, and gender expansive (TGE) persons experience pregnancies and have abortions, yet abortion care remains rooted in a gender binary, often centering the needs, experiences, and challenges of cisgender women. Despite guidance supporting gender-affirming sexual and reproductive healthcare (SRH), barriers for TGE people seeking abortions persist. We conducted an exploratory case study with key informants to understand their perception of TGE abortion seekers' needs with specific considerations for those in restrictive abortion settings. Methods: Qualitative interviews focused on gender-affirming care and abortion provision were conducted with U.S.-based key informant clinicians (n = 4) who could provide powerful insights into gaps and experiences faced by TGE individuals. Participants were eligible if they currently or previously provided abortions and had experience practicing gender-affirming care. Interviews focused on informants' perceptions of TGE patients' needs when seeking abortions. Results: Findings highlight the unique barriers TGE patients face when seeking abortions, including lack of provider knowledge, in-clinic stigmatization, and gender marginalization. It is notable that key informants who practiced in abortion-protective political environments have greater access to resources to implement gender-affirming care than those in restrictive contexts. Results are summarized in a clinical recommendations document which provides an accessible starting point for clinicians to begin building gender-inclusive abortion spaces. Conclusions: It is necessary to further understand barriers facing TGE abortion seekers and integrate recommendations and emerging evidence into abortion practice. This study contributes to a growing knowledge base which emphasizes the need for inclusive abortion spaces and highlights key considerations for improving access and quality for TGE abortions seekers. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a significant global health threat. It results in substantial mortality and may be underrecognized due to insufficient screening and diagnostic challenges. Furthermore, TB's impact is closely linked to complex socioeconomic and healthcare factors. The COVID-19 pandemic has exacerbated these challenges due to similarities in clinical presentation and transmission dynamics with TB. Socioeconomic factors such as limited access to healthcare services, resource constraints, and social stigma further complicate TB management. Historically, TB faced increased burdens during natural disasters, wars, and pandemics. This study analyzes TB incidence changes, emphasizing the crucial need for timely diagnosis within the context of COVID-19 measures. Method: This cross-sectional study, conducted at Shiraz's TB referral center in Southern Iran, covered the period from January 1, 2018, to December 31, 2022. We analyzed patient data, including epidemiological and demographic factors, clinical and radiological features, and treatment outcomes. Data were compared between the pre-COVID-19 pandemic era and the COVID-19 pandemic era (from March 2020), using standard and regression analyses. A P-value of less than 0.05 was considered statistically significant. Results: We analyzed 388 TB patients with a mean age of 48.38 ± 20.53 years, including 264 pulmonary cases (68.0%). The highest incidence of TB was recorded in 2019, representing 27.6% of the cases. During the COVID-19 era, logistic regression analysis identified significant associations with higher education levels (P = 0.032; OR = 1.380; 95% CI: 1.028–1.851), a decrease in symptoms such as sputum production (P = 0.004; OR = 0.342; 95% CI: 0.166–0.705) and chills (P = 0.036; OR = 0.282; 95% CI: 0.087–0.919), and an increase in symptoms of fatigue (P = 0.006; OR = 2.856; 95% CI: 1.358–6.005). Conclusion: The COVID-19 pandemic has had a prolonged impact on TB cases in our country, resulting in a reduction in reported cases due to challenges in quarantine and screening. However, it has also led to a shift in TB patterns and a potential increase in latent TB cases and future mortality rates. Addressing the repercussions requires enhanced control strategies, prioritized service delivery, and secured funding for intensified case finding, expanded contact-tracing, community engagement, digital health tools, and uninterrupted access to medications. [ABSTRACT FROM AUTHOR]

Background: Attitudes toward suicide are essential in suicide prevention, as suicide is socio-culturally nuanced. Although the relationship between individual attitudes and suicidal behavior has been extensively studied, the effect of community attitudes--aggregated by region--on suicide mortality remains ambiguous. This study explored the association between community attitudes and real-world suicide mortality. Methods: Data on attitudes toward suicide from the 2018 Korea National Suicide Survey (N = 1500) and individual mortality data from the MicroData Integrated System were obtained. Confirmatory factor analysis supported a factor structure with three factors: "Permissiveness," "Unjustified behavior," and "Readiness to help/Preventability." Thirty regional units in South Korea aggregated the data for ecological analysis. We used negative binomial models to examine the association at the regional level, and stratified analysis by gender and age group was conducted. Results: "Permissiveness" was associated with reduced suicide rates in a univariate model (P < 0.001). Adjusting for gender, age, and additional sociodemographics did not alter the association. Additionally, this relationship was observed in males and individuals under 60 years of age after stratification. However, "Unjustified Behavior" and "Readiness to help/Preventability" exhibited no significant association with suicide in any model or stratum. Conclusion: The observed inverse association between permissive community attitudes and suicide contradicts the findings of previous research that links permissive individual attitudes to increased suicidal behavior. Our findings suggest that attitudes may operate differently at the individual and group levels. Although the cross-sectional design and single-country focus of this study warrant further investigation, our findings indicate that attitudes are significant contextual factors in the process of suicide, which could lead to novel approaches in suicide prevention. [ABSTRACT FROM AUTHOR]

Objectives: Considering the importance of mental health help-seeking, researchers have closely examined the relationship between mental health literacy (MHL) and help-seeking intention (HSI). Furthermore, the high impact of stigma and the potential value of social support on HSI have been recognised. However, the relationship between these variables has not been fully tested within the context of Chinese elite athletes. This study addressed this gap by examining the relationship between MHL and HSI. Furthermore, it explored the mediating effects of public stigma, self-stigma, and social support on the relationship between MHL and HSI among Chinese elite athletes. Methods: 450 Chinese elite athletes (Mage = 18.12, SD = 3.20, 46.2% female) selfreported their MHL, public stigma, self-stigma, social support, and HSI. Mediation analysis was conducted using the bootstrap approach of the PROCESS macro version 3.3 of SPSS 25. Results: The results showed a significant positive correlation between MHL and HSI (r = 0.348). The results also demonstrated that MHL was a predictor of HSI (ß = 0.337, 95%CI [0.249, 0.425], p < 0.001). Furthermore, 1) the indirect effect of MHL public stigma HSI was 0.024 and a 95%CI [0.003, 0.053]. Specifically, MHL predicted public stigma (Estimate = -0.151, 95%CI [-0.187, -0.045], p < 0.001), and public stigma predicted HSI (Estimate = -0.161, 95%CI [- 0.549, -0.164], p < 0.001); 2) the indirect effect of MHL→self-stigma→HSI was 0.016 and 95%CI [0.002, 0.038]. Specifically, MHL predicted self-stigma (Estimate = -0.137, 95%CI [-0.069, -0.013], p < 0.01), and self-stigma predicted HSI (Estimate = -0.120, 95%CI [-1.181, -0.186], p < 0.01); as well as 3) the indirect effect of MHL social support HSI was 0.029 and a 95%CI [0.009, 0.055]. Specifically, MHL predicted social support (Estimate = 0.208, 95%CI [0.018, 0.047], p < 0.001), and social support predicted HSI (Estimate = 0.141, 95%CI [0.578, 2.442], p < 0.01). Additionally, the direct effects from MHL to HSI is (ß = 0.452, 95%CI [0.304, 0.600], p < 0.001). Conclusion: Our findings provide empirical support for the roles of public stigma, self-stigma, and social support as mechanisms of behavioural change in MHL interventions. These factors increase HSI among elite athletes. Future studies should further test these mediating effects using experimental designs. [ABSTRACT FROM AUTHOR]

ABSTRACT During the Lebanese 2019 uprising, the country's second‐largest city, Tripoli, became portrayed as the “bride of the revolution.” This portrayal was seen to break with the city's former stigma as a hotbed of extremism. However, as this article shows, local protesters were not unambiguously happy with this portrayal. Based on interviews with 30 protesters and fieldwork observations, the article seeks to understand the critical views of this narrative. It shows that there was a widespread perception among Tripoli protesters that the narrative of their city as the “bride of the revolution,” as presented by the media, represented a distorted image that romanticized, depoliticized, and de‐contextualized the uprising. This narrative was believed to serve a political purpose. These findings provide two main contributions to scholarly debates concerning identity narratives and the role of media for social movements in societies like Lebanon, characterized by hybrid regimes and a complex media‐politics nexus. First, it points to the complexity of breaking stigma and changing geography‐based identities. Second, it shows how the political ownership of media fuels the understanding of media frames as being politically motivated, even when they seem sympathetic to protests. [ABSTRACT FROM AUTHOR]

The growing popularity of frisbee sport in China has brought both recognition and stigmatisation. Rooted in the social identity perspective, this study employs in-depth interviews and participatory observation to explore this phenomenon, creating a multifaceted analytical framework that includes affective commitment, self-categorisation, group self-esteem and self-expansion. The study finds that the primary manifestations of frisbee stigmatisation encompass the heightened online attention and scrutiny, conflicts due to limited playing venues, misconceptions from one-sided sport perceptions, and controversies around its use for blind dates. Moreover, the study reveals that frisbee community members employ diverse strategies to counteract stigma, such as positive confrontation, ignoring or humorously resolving stigmatisation, selective online self-presentation, and converting opponents into supporters. This research contributes to the field of leisure studies by offering a deeper understanding of how leisure sports identities are negotiated in the context of societal prejudices. Furthermore, it provides practical insights for fostering resilience, promoting a positive sports culture, and encouraging a healthier approach to leisure sports among youth, potentially minimising the negative impact of stigma on emerging leisure sports activities. [ABSTRACT FROM AUTHOR]

Background: Voiding dysfunction (VD) is a frequent reason for primary care referrals to urologists and pediatric urologists. VD symptoms include urine incontinence (UI), urinary tract infection (UTI), hyperactive bladder, and constipation. Early detection of Nocturnal enuresis is critical due to its high frequency and the consequences for families and children regarding psychological and behavioral aspects. Objectives: This study aims to determine the prevalence of voiding disorder in Palestine and its relationship to demographic, family, and behavioral risk factors. Design: A cross-sectional study. Methods: This study administered a 2-part validated questionnaire to the mothers of primary school-age children who had no history of urological disease between December 2022 and March 2023. Results: Out of 169 children; daytime incontinence was found in 39 (23.2%) of the sample, whereas nocturnal enuresis was found in 49 (28.4%). Age was significantly correlated with voiding dysfunction, in which 25 (55.6%) were under the age of 7 years (P =.025). Conclusion: According to our data, VD is a widespread health issue in primary school. Expanding our understanding of voiding dysfunction is important to eliminate the social stigma associated with voiding disorder and encourage parents and children to seek treatments and therapies. Furthermore, raising awareness will aid in early diagnosis, resulting in fewer long-term problems and earlier treatments. Raising awareness can be accomplished through educational programs focusing on primary care screening. [ABSTRACT FROM AUTHOR]

Background: Lifestyle modifications (LM) are crucial in managing comorbid Tuberculosis (TB) and Diabetes Mellitus (DM) patients, significantly impacting treatment outcomes and overall health. In view of this, a study was conducted to clarify sociocultural features associated with LM among TB–diabetes comorbid patients. Methods: A cross-sectional descriptive study among randomly selected 180 adult TB–diabetes-comorbid-patients was conducted using a semi-structured interview schedule. Mann–Whitney-U-test was used to examine differences in means between patterns of distress (PDs) and perceived causes (PCs) regarding TB and Diabetes for two identified LM strategies among comorbid patients. Stepwise logistic regression was used to study factors associated with these LM strategies. Results: TB–diabetes-comorbid-patients reporting physical symptoms as PDs preferred to follow the LM-1 strategy for TB and LM-2 for Diabetes. In contrast, patients reporting health-illness-injury-related causes follow LM-2 for TB and LM-1 for Diabetes. Further patients reporting hypertension for Diabetes (AOR = 2.916, 95% CI 0.9262–9.1788) and concerns-about-the-course-of-TB-illness (AOR = 3.746, 95% CI 1.4683–9.5593) as PDs were 3–4 times more likely to follow LM-1. While those reporting prior illnesses (AOR = 4.255, 95% CI 1.3941–12.9837) and sanitation (AOR = 5.242, 95% CI 1.2028–22.8446) as PCs for TB were 4–5 times follow LM-2. Patients who perceived consumption of alcohol as PCs of Diabetes were 10 times more likely to stop addictions (AOR = 9.680, 95% CI 2.5555–36.6639) and follow the LM-2 strategy. Conclusion: Given significant associations of sociocultural features with LM strategies, consideration of sociocultural features vis-à-vis these strategies is indispensable for managing TBDM comorbidity, emphasizing the need for developing comprehensive, patient-centred self-management interventions to enhance adherence and improve health outcomes. [ABSTRACT FROM AUTHOR]

Midlife, beginning at 40 years and extending to 65 years, a range that encompasses the late reproductive to late menopausal stages, is a unique time in women's lives, when hormonal and physical changes are often accompanied by psychological and social evolution. Access to sexual health and sexual well-being (SHSW) services, which include the prevention and management of sexually transmitted infections, contraception and the support of sexual function, pleasure and safety, is important for the health of midlife women, their relationships and community cohesion. The objective was to use the socio-ecological model to synthesise the barriers and enablers to SHSW services for midlife women in high-income countries. A systematic review of the enablers and barriers to women (including trans-gender and non-binary people) aged 40–65 years accessing SHSW services in high-income countries was undertaken. Four databases (PubMed, PsycINFO, Web of Science and Google Scholar) were searched for peer-reviewed publications. Findings were thematically extracted and reported in a narrative synthesis. Eighty-one studies were included; a minority specifically set out to study SHSW care for midlife women. The key barriers that emerged were the intersecting disadvantage of under-served groups, poor knowledge, about SHSW, and SHSW services, among women and their healthcare professionals (HCPs), and the over-arching effect of stigma, social connections and psychological factors on access to care. Enablers included intergenerational learning, interdisciplinary and one-stop women-only services, integration of SHSW into other services, peer support programmes, representation of minoritised midlife women working in SHSW, local and free facilities and financial incentives to access services for under-served groups. Efforts are needed to enhance education about SHSW and related services among midlife women and their healthcare providers. This increased education should be leveraged to improve research, public health messaging, interventions, policy development and access to comprehensive services, especially for midlife women from underserved groups. Plain language summary: Sexual health and sexual wellbeing services for midlife women in high income countries Midlife, beginning at 40 years and extending to 65 years, a range that encompasses the late reproductive to late menopausal stages, is a unique time in women's lives. Access to Sexual Health and Sexual Wellbeing (SHSW) services, which include the prevention and management of sexually transmitted infections, contraception and the support of sexual function, pleasure and safety, is important for the health of midlife women, their relationships and community cohesion. The objective of this systematic review was to use the socio-ecological model to synthesise the barriers and enablers to SHSW services for midlife women in high income countries. Eighty-one studies were included; a minority specifically set out to study SHSW care for midlife women. The key barriers that emerged were the intersecting disadvantage of under-served groups, poor knowledge, about SHSW, and SHSW services, among women and their HealthCare Professionals (HCPs), and the over-arching effect of stigma, social connections, and psychological factors on access to care. Enablers included intergenerational learning, interdisciplinary and one-stop women-only services, integration of SHSW into other services, peer support programmes, representation of minoritised midlife women working in SHSW, local and free facilities, and financial incentives for under-served groups to access services. The appetite for education about SHSW and SHSW services among midlife women and their HCPs should be capitalised upon, and utilised to improve research, public health messaging, interventions and access to holistic services, particularly for midlife women from under-served groups. [ABSTRACT FROM AUTHOR]

Introduction: The employment landscape for multiply marginalized people with disabilities presents significant challenges, exacerbated by intersecting identities such as race/ethnicity, sexual orientation, gender identity, poverty, and geography. Recent studies highlight the compounded employment disparities faced by this group, including discriminatory hiring practices, inadequate accommodations, and uneven gains in employment during the COVID-19 public health emergency. Methods: Our study employed a three-round Delphi process with 20 diverse experts across 14 states across the United States (U.S.) to formulate recommendations for improving employment experiences for multiply marginalized people with disabilities. The panel's insights were gathered through surveys administered online, with each round designed to refine the collective recommendations. This iterative process aimed to build a consensus on the most effective policy and practice recommendations for improving employment outcomes within this population. Results: The Delphi study identified key areas for strategic focus, including emergency preparedness, education and training, transportation, assistive technology, workplace accommodations, and combating discrimination and stigma. Notable recommendations included improving emergency preparedness training, enhancing employment education, increasing funding for accessible transportation and assistive technology, and promoting inclusive hiring practices. The study also emphasized the need for policies supporting telework and simplifying disability-related benefits. Discussion: The findings highlight the critical role of tailored strategies to address employment challenges faced by people with disabilities from marginalized communities. Meaningfully and fully implementing these recommendations would create a more inclusive environment that improves employment outcomes for multiply marginalized people with disabilities. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionWhile the stigma experienced by non-drinkers is well-documented, little is known about the factors that influence it. This study aims to test a sequential mediation model in which the amount of alcohol consumed by a drinker, predicts their experienced alcohol-related harm, which in turn predicts the concern they have for drinking and their negative attitudes towards non-drinkers.A sample of 787 Australian drinkers (Mage = 38.4 years, SD = 11.4) completed online measures of alcohol consumption, alcohol-related harms, concern for drinking and the Cheers Attitudes towards Non-drinker Scale (CANS): a scale that measures the negative attitudes toward non-drinkers via three threats non-drinkers are perceived to pose to drinkers (Threat to Fun, Connection, and Self).The model was shown to be a good fit and demonstrated a sequential mediation with significant indirect effects from alcohol consumption via experienced alcohol-related harms and concern, to each CANS subscale: Threat to Self (β = 0.402, p < 0.001), Fun (β = 0.096, p = 0.006) and Connection (β = 0.165, p < 0.001).The findings suggest that the stigma directed at non-drinkers may be enacted as a defence against an unwanted self-reflection from a drinker’s concern for their own drinking. [ABSTRACT FROM AUTHOR]