Liability and Medico-Legal Implications in Estimating the Likelihood of Having Attained 14 Years of Age in Pediatric Clinical Practice: A Pilot Study.

Accurate methods of age estimation are more essential than ever due to the rise in undocumented individuals without proper identification, often linked to illegal immigration and criminal activities. This absence of reliable records presents challenges within the legal systems, where age thresholds in the context of children's rights vary across countries. Age 14 has global significance, as established by the UN Convention on the Rights of the Child and the EU for administrative purposes. Accurate age estimation is crucial in medical decisions, reproductive health, and forensics. This study focuses on age estimation via dental radiographs, proposing a method for estimating the likelihood of having attained the age of 14. Orthopantomograms were analyzed from two samples, 191 Italian children (aged 5-15) and 822 Chilean subjects (aged 11-22), using dental maturity indices. These indices evaluated open tooth apices and complete root development. Statistical analysis confirmed the method's reliability in identifying individuals aged 14 or older, with sex-specific cut-offs. The proposed method particularly advocates an approach based on dental mineralization, which could surpass those relying on bone growth. The collaboration between medical experts, including pediatricians and diagnostic imaging specialists, is vital for standardized age estimation strategies. Ethical concerns regarding radiation exposure and accountability are recognized, although the method's low radiation doses are deemed acceptable. The proposed method will help health professionals to accurately predict whether or not the 14-year threshold has been reached, opening up new avenues of medico-legal interest and laying the foundations for a legal framework that would allow the pediatrician, when involved, to use a valid and recognized diagnostic approach.

Do Homicide Perpetrators Have Higher Rates of Delayed-Suicide Than the Other Offenders? Data from a Sample of the Inmate Population in Italy.

Homicide-suicide can be defined as homicide followed by the suicide of the perpetrator shortly afterward. In the so-called "homicide-delayed suicide", homicide and suicide occur but within a wide and not strictly defined timeframe. This study analyzes data concerning the suicide of 667 inmates in Italy between 2002 and 2015, considering homicide perpetrators compared to all offenders. The analyses revealed that inmates who had committed homicide were more likely to commit suicide (71% versus 45%; χ2 = 10.952, p = 0.001) and the odds of suicide increase concerning 1.58 times among homicide perpetrators. The time-to-suicide interval after homicide ranges between 0 to 9.125 days (mean = 1.687,9; SD = 2.303,1). Moreover, the intimate-homicide offenders who committed suicide had a significantly shorter survival time after the offense than did the other non-intimate offenders who died by suicide (t test, t = -3.56, df = 90, p = 0.001). The link between homicide and higher suicide risk in homicide perpetrators should be highlighted because of all the homicide offenders passing through the criminal justice system. Superior knowledge about the path of homicide-delayed suicide will be of particular use to professionals in evaluating and treating homicide inmates.

Stress Impact of COVID-19 Sports Restrictions on Disabled Athletes.

The stress impact of COVID-19 restrictions has put the adapted sports community at an unprecedented level of emergency. The self-report Event Scale-Revised (IES-R) questionnaire was administered to assess the level of psychological distress and emotive reactions such as intrusion (INT), avoidance (AV) and hyperarousal (HYP) following training and competitions suspension within a sample of Italian disabled athletes. A total of 146 self-selected volunteers were included in this study: 73 disabled athletes (aged 42.11 ± 13.70) and 73 athletes (aged 40.23 ± 13.73) who served as the control group. Only 8.22% of the disabled participants vs. 30.14% of athletes were affected by subjective distress. MANOVA showed significant differences in IES-R subjective distress for age, where the emerging adults had a higher level of stress than adults (p = 0.031), and for the type of sport, where the individual sports group showed higher scores than the team sports group (p = 0.049). Regarding the IES-R subscales, significant differences were found in INT and AV for age, where the emerging adults showed higher scores than adults (p = 0.018 and p = 0.046, respectively). Significant differences were found in HYP for type of sport, where the individual sports group showed higher scores than the team sports group (p = 0.014). The results confirmed a lower distress level of disabled athletes to adverse events than that expressed by athletes. Both sports engagement and the experience of living with impairment, overcoming structural barriers, could act as a buffer effect against stress due to COVID-19 restrictions.

Clinical Correlates of Deliberate Self-Harm Among Migrant Trauma-Affected Subgroups.

Introduction: Studies have shown that exposure to potentially traumatic events (PTEs) during the migration process has serious consequences on mental health. Migrants with a history of PTEs are more likely to inflict deliberate self-harm (DSH), a spectrum of behavior that includes non-suicidal self-injury (NSSI). With reference to a nonclinical sample of trauma-exposed migrants, this study aims to explore the prevalence of DSH and to assess the association with sociodemographic characteristics and clinical conditions, with particular attention to post-traumatic stress disorder (PTSD) symptoms, resilience capabilities, and feelings of hopelessness. Methods: A sample of migrants underwent a baseline evaluation at an outpatient department of the National Institute for Health, Migration and Poverty (INMP). Migrants with a history of torture, rape, or other severe forms of psychological, physical, or sexual violence were invited to undergo screening at the Institute's Mental Health Unit. Trauma-exposed migrants completed a series of self-report questionnaires that assessed the presence of PTSD, depression, anxiety, suicidal ideation, resilience, and feelings of hopelessness, in addition to DSH. Univariate and multivariate log-binomial regression models were used to test the association of age and clinical characteristic of migrants with DSH. Prevalence ratio (PR) with 95% confidence intervals (95% CI) and p-values were estimated. Results: A total of 169 migrants (76.9% males), aged between 18 and 68 years, M = 28.93; SD = 8.77), were selected. Of the sample, 26.6% were frequently engaging in some form of DSH, and 30.2% were diagnosed with at least one trauma-related disorder. DSH behaviors were most common in single and unemployed migrants as well as in subjects with post-traumatic stress symptoms, feelings of anxiety, hopelessness, low capability of resilience, and suicidal ideation. Taking into account age and hopelessness, we found that PTSD and low resilience capabilities were associated with a higher risk of DSH [PR adj: 2.21; 95% CI: (1.30-3.75) and PR adj: 2.32; 95% CI: (1.16-4.62), respectively]. Conclusion: Given the association between trauma exposure and DSH among migrants, exploring the presence of DSH behavior within the immigrant community is crucial for the implementation of measures to develop intervention in a clinical setting.

Self-perceived workplace discrimination and mental health among immigrant workers in Italy: a cross-sectional study.

BACKGROUND: The process of immigration is associated with poor mental and physical health. While the workplace represents an important context of social integration, previous studies evaluating the effect of discrimination experienced in the workplace found worse mental health status among immigrants. The aim of this study was to investigate whether self-perceived workplace discrimination has any role in the mental health status of immigrants living and working in Italy, evaluating the contribution of other personal experiences, such as loneliness and life satisfaction. METHODS: A cross-sectional study was conducted on a sample of 12,408 immigrants (aged 15-64) living and working in Italy. Data were derived from the first national survey on immigrants carried out by the Italian National Institute of Statistics (Istat). Mental health status was measured through the Mental Component Summary (MCS) of the SF-12 questionnaire. A linear multivariate linear regression was carried out to evaluate the association between mental health status, self-perceived workplace discrimination, and sociodemographic factors; path analysis was used to quantify the mediation effect of self-perceived loneliness, level of life satisfaction, and the Physical Component Summary (PCS). RESULTS: Mental health status was inversely associated (p < 0.001) with self-perceived workplace discrimination (ß:-1.737), self-perceived loneliness (ß:-2.653), and physical health status (ß:-0.089); it was directly associated with level of life satisfaction (ß:1.122). As confirmed by the path analysis, the effect of self-perceived workplace discrimination on MCS was mediated by the other factors considered: self-perceived loneliness (11.9%), level of life satisfaction (20.7%), and physical health status (3.9%). CONCLUSIONS: Our study suggests that self-perceived workplace discrimination is associated with worse mental health status in immigrant workers through personal experiences in the workplace and explains the effect of the exposure to workplace discrimination on immigrants' psychological well-being. Our findings suggest that an overall public health response is needed to facilitate the social integration of immigrants and their access to health services, particularly those services that address mental health issues.

Psychological Impact of the Quarantine-Induced Stress during the Coronavirus (COVID-19) Outbreak among Italian Athletes.

The 2019 Coronavirus (COVID-19) outbreak caused home confinement, as well as training and sport competitions withdrawals. The prolonged inactivity impact, and lack of in-person interactions among teammates-coaches, could negatively affect athletes. Total of 1508 self-selected Italian athletes, 338 children (aged 10.52 ± 1.31), 499 adolescents (aged 14.17 ± 1.13), and 671 adults (aged 27.59 ± 10.73), completed the Impact of Event Scale (IES-8, IES-15, and IES-R, respectively). Differences by gender, type of sport (individual vs. team), and competitive level (elite vs. amateur) were examined. One-way ANOVAs showed, in adults, significant differences between genders for perceived stress impact total score (TS; p = 0.017) and avoidance behavior, with higher scores in women (p = 0.045). Between individual and team sport, significant differences were found in TS (p = 0.038) and hyperarousal (p = 0.030), with higher results in individual. Adult elite athletes showed significantly higher scores in hyperarousal (p = 0.020) than amateurs. Significant differences were found between gender in adolescents for avoidance (p = 0.011), and between competitive levels in children, for intrusion (p = 0.020). These evidences may raise awareness on distress effects of COVID-19 lockdown among athletes and suggested applying specific well-being protocols during the activity resumption, considering gender, type of sport, and competitive level.

Resilience, trauma, and hopelessness: protective or triggering factor for the development of psychopathology among migrants?

BACKGROUND: Recently, many studies have investigated the role of migration on mental health. Nonetheless, only few focused on the consequences of childhood trauma, hopelessness, and resilience on migrants' psychopathology, including psychiatric disorders and symptoms. METHOD: 119 migrants were recruited between May 2017 and April 2018, among those applying for assessment to the Mental Health Operational Unit of the National Institute for Health, Migration and Poverty (NIHMP) in Rome, Italy. Assessment included the following: Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS), Connor-Davidson Resilience Scale (CD-RISC), Childhood Trauma Questionnaire (CTQ), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), Beck Hopelessness Scale (BHS), Beck's Suicide Intent Scale (SIS), Brief Aggression Questionnaire (BAQ), Deliberate Self-Harm Inventory (DSHI). RESULTS: 53.39% of migrants scored above the PCL-5 cut-off score (mean score was 39.45). SDS scores below the cutoff suggested the presence of depression in 42.37%, while According to SAS scores anxiety levels were low in 38.98% of migrants. During childhood, physical abuse and neglect were reported respectively by 56.78 and 69.49% of migrants. CONCLUSION: We found that Post Traumatic Stress Disorders play the role of mediators for the relation between the childhood traumatic experiences and aggressiveness, anxious and depressive symptomatology, while hopelessness is a mediator between the childhood traumatic experiences and the development of depression in adulthood. Hopelessness seems to influence the strength of the relation between childhood traumatic experiences and the individual's current intensity of suicidal attitudes, plans, and behaviors. Further developments and future perspectives of the research project are to address key gaps in the field of resilience by means of a longitudinal evaluation study in migrants, including a native population control group, acceding to NIHMP.

Influence of coping strategies on the efficacy of YAM (Youth Aware of Mental Health): a universal school-based suicide preventive program.

The school-based mental health promotion and suicide prevention universal program Youth Aware of Mental Health (YAM) significantly reduces incident suicide attempts and severe suicidal ideation. This paper aims at elucidating psychological mechanisms underlying YAM's efficacy. Our hypothesis is that YAM operates through interactions with coping strategies (CS) on the reduction of suicidal ideation (SI). In the Saving and Empowering Young Lives in Europe (SEYLE) study, five coping strategies were assessed at baseline (T0) and 12-month follow-up (T12): "learning", "help-seeking", "arts", "sports" and "fight". We analyzed interactions between the YAM intervention, coping strategies and SI in the YAM group (N = 1693) and the minimal intervention group (N = 1909), after excluding prevalent cases with SI and previous suicide attempts from our total sample (N = 5654). General Linear Mixed Model regressions were performed. The present study confirms that coping strategies play an influential role on suicidal ideation. Our results showed that YAM acts whatever the prevailing coping strategies used. It is particularly efficient for pupils insufficiently using adaptive coping strategies such as LEARN and HELP-SEEKING or using maladaptive coping strategies, such as ARTS and FIGHT. The socialization induced by the YAM intervention seems to be a strong component of its efficiency.

Neural Correlates of Simulated Driving While Performing a Secondary Task: A Review.

Distracted driving consists in performing a secondary task while driving, such as cell-phone conversation. Given the limited resources of the attentional system, engaging in a secondary task while driving increases the risk to have car accidents. The secondary task engagement while driving can depend on or be affected by different factors, including driver's individual characteristics, necessities, environmental conditions, and so forth. In the present work, the neuroimaging studies that investigated the brain areas involved in simulated driving during the execution of a secondary task (visual and overall auditory tasks) were reviewed in light of driving settings. In general, although there are also differences in decrease and increase brain activations across studies, due to the varieties of paradigms used (simulators, secondary tasks and neuroimaging techniques), the dual-task condition (simulated driving plus secondary task), as compared to the simulated driving-alone condition, was generally found to yield a significant shift in activations from occipital to fronto-parietal brain regions. These findings show that when a secondary task is added during driving the neural system redirects attentional resources away from visual processing, increasing the possibility of incorrect, dangerous or risky behavioral responses. The shift of the attentional resources can occur even if driving behavior is not explicitly affected. Limits of the neuroimaging studies reviewed and future research directions, including the need to explore the role of personality factors in the modulation of the neural programs while engaging distracted driving, are briefly discussed.

Continuous Environmental Changes May Enhance Topographic Memory Skills. Evidence From L'Aquila Earthquake-Exposed Survivors.

Exposure to environmental contextual changes, such as those occurring after an earthquake, requires individuals to learn novel routes around their environment, landmarks and spatial layout. In this study, we aimed to uncover whether contextual changes that occurred after the 2009 L'Aquila earthquake affected topographic memory in exposed survivors. We hypothesized that individuals exposed to environmental changes-individuals living in L'Aquila before, during and after the earthquake (hereafter called exposed participants, EPs)-improved their topographic memory skills compared with non-exposed participants (NEPs) who moved to L'Aquila after the earthquake, as only EPs had to modify their previous cognitive map of L'Aquila. We also hypothesized that memory improvement was selective for the navigational space and did not generalize across other spatial and verbal domains. To test these hypotheses, we compared the topographic and spatial memory skills of 56 EPs without post-traumatic stress disorder (PTSD) symptoms to the skills of 47 NEPs using the Walking Corsi Test (WalCT; memory test in the navigational space) and the Corsi Block-Tapping Test (CBT; visuospatial memory test in the reaching space); EPs and NEPs were matched for gender, education and general navigational skills. A sub-group of participants also underwent the Rey-Auditory Verbal Learning Test (RAVLT; verbal memory test). The results showed that only EPs had better performances on topographic learning (TL) assessed using the WalCT rather than spatial learning assessed by the CBT. This outcome suggests the possibility that EPs specifically improved topographic memory. This effect may be due to continuous exposure to environmental changes that have required individuals to learn novel paths within the city and integrate novel information, such as "new towns," into their pre-existing mental representation of the city. Implications and limitations of the study are discussed.

Gender Effects in Young Road Users on Road Safety Attitudes, Behaviors and Risk Perception.

In the present study, we investigated gender-related effects on road safety attitudes in 2681 young drivers (1458 males, 54.4%; aged 18-22) who filled out several scales assessing attitudes toward road safety issues, driving behavior in specific hypothetical situations, accident risk perception, and concerns about such a risk. We focused only on young drivers to better understand the role of gender in road safety attitudes in a period of life in which risky behaviors are widespread for males and females. Indeed, there is still no agreement as to the nature of these gender differences. According to some authors, the effects of gender on being involved in a crash due to driving skills are either non-existent or largely explained by differences in alcohol consumption. In our study, we found gender differences in road safety attitudes (i.e., "negative attitude toward traffic rules and risky driving"; "negative attitude toward drugs and alcohol" and "tolerance toward speeding") and in driver behavior (i.e., "errors in inattentive driving" and "driving violations"). This result is consistent in all drivers coming from nine different European countries. Our analyses yielded an important finding concerning risk perception. The results indicate that the level of risk perception during driving is the same for males and females. However, these two groups differ in the level of concern about this risk, with males being less concerned about the risk of a road accident. This suggests that the main difference between these two groups is not strictly related to judgment of the perceived risk probability but rather to the level of concern experienced about the consequences of the risk. This difference between risk perception and worry could explain differences in the frequency of car accidents in the two groups. The present findings may provide new insights for the development of gender-based prevention programs.

Participation in a 9-month selected physical exercise programme enhances psychological well-being in a prison population.

BACKGROUND: There is general population evidence that physical exercise is effective in reducing the risk of depression and has positive effects on mood. Some prisons encourage exercise, but there is no evidence specific to this group on its benefits or the relative merits of different programmes. AIMS: To test the effect of physical exercise on the psychological well-being of prisoners and to determine which mental disorders are most affected by physical activity. METHODS: Sixty-four participants were randomly assigned across three groups: cardiovascular plus resistance training (CRT), high-intensity strength training (HIST) and no exercise. Before and after the 9-month experimental period, all participants completed the Symptom Checklist-90-Revised. RESULTS: Each form of exercise significantly reduced depression scale scores compared with those in the control group, in which average depression scale scores actually increased. The CRT group also showed a significant decrease in GSI scores on the Symptom Checklist-90 and on its interpersonal sensitivity scale, whereas the HIST group also significantly improved on the anxiety, phobic anxiety and hostility scale scores. CONCLUSIONS: Our evidence, taken together with general population studies, supports introduction of supervised, moderately intense exercise for at least 1 h per week for men in prison. They form a high risk group for mental disorders, and such exercise reduces depression and anxiety. Minimal special equipment is needed for CRT. Further research should replicate the study in a larger, multi-centre trial, and examine impact on shorter-term and longer-term prisoners, female prisoners and effects on recidivism.

The use of videos in road safety training: cognitive and emotional effects.

The aim of the study was to evaluate the use of videos in educational programs for improving road safety. Particularly, we evaluated the cognitive and emotional effects of viewing videos taken from cameras placed along Italian highways and showing car crashes or traffic flow images. One hundred and seventy students from the Sapienza University of Rome participated in the study as volunteers. Each participant was randomly assigned to one of three experimental groups ("Video", "Video plus commentary", "Written Description"). Results showed that the overall emotional activation was significantly higher in the two conditions that employed live video (both with and without verbal explanations). However, scores on the Information dimension were significantly higher in the conditions that contained only verbal descriptions or that combined video and verbal explanations. Results of this experiment suggest that live videos of car crashes have the primary feature of inducing a high emotional activation (especially when they represent action scenes, as car crashes) that can be modulated by co-occurring verbal explanations. When these videos are not integrated by an appropriate verbal explanation, they can be experienced as not fully instructive.

Self-harm in prisoners.

UNLABELLED: IntroductionSelf-harm is a direct, socially unacceptable,repetitive behavior that causes minor to moderate physical injury without suicidal intent. It is also a significant and growing concern among prison inmates, although it has been rarely studied. In the present study, we aimed to investigate demographic, psychosocial, and clinical variables associated to this critical bahaviour in a high risk sample of 1,555 male prisoners. METHODS: Prisoners were interviewed about their history of self-mutilation, psychiatric history,and forensic history. The prisoners completed the Barratt Impulsivity Scale, Buss-Durkee Hostility Inventory, Eysenck Personality Questionnaire, and Childhood Trauma Questionnaire. RESULTS: Eighteen percent of prisoners had a history of self-harm. They more frequently reported childhood traumas, were more likely to be unmarried, previously imprisoned, tested positive for substance abuse, had a history of suicide attempt, and more likely showed violent tendencies.DiscussionSelf-harm among prisoners is common, being found in almost 20% of the subjects in our sample. Self-mutilation among prisoners appears to be multi-factorial with developmental, socio-demographic, psychiatric, and personality determinants. CONCLUSION: Self-harm is associated with critical behaviors such as violence, substance abuse and suicide attempts, which represent major critical problems in contention environments.