As Much As I Can - Utilizing Immersive Theatre to Reduce HIV-Related Stigma and Discrimination Toward Black Sexual Minority Men.

BACKGROUND: Despite advances in biomedical HIV prevention modalities such as pre-exposure prophylaxis to prevent the transmission of HIV, racial/ethnic and sexual/gender minority populations are disproportionately impacted by HIV epidemic. Alarming rates of HIV have persisted among Black gay and bisexual men, particularly in Southern states. METHODS: Utilizing data from the ViiV ACCELERATE! initiative, we explored the impact of As Much As I Can, an immersive theatre production, on HIV-related stigma behaviors. A self-administered post-performance survey was conducted with a cohort (n = 322) of randomly selected audience members. RESULTS: Overall, the results showed participants had a highly favorable experience, rating the performance with a mean score of 9.77/10. Respondents indicated they intended to change behaviors to promote HIV prevention education and to reduce stigma and discrimination including: (1) Say something if I hear stigmatizing language against people living with HIV (75.4%), (2) Say something if I hear anti-gay language (69.7%) and (3) Tell others about HIV prevention options (e.g., PrEP, PEP, condoms (64.1%). The findings show there is an association between HIV-related behavior intention and linkage to HIV care. Respondents who reported they were more likely to say something about HIV stigma were almost three times (O.R. 2.77; 95% C.I. 0.98-7.8) more likely to indicate they would follow up with a healthcare professional. CONCLUSIONS: This study suggests that immersive theatre is an effective method for communicating HIV prevention education and reducing HIV-related structural stigma and discrimination that increases HIV vulnerability for Black sexual minority men.

Discrimination and adherence in a cross-sectional study of Latino sexual minority men with HIV: Coping with discrimination as a mediator and coping self-efficacy as a moderator.

Discrimination is associated with antiretroviral therapy non-adherence and reduced well-being among people with HIV. We examined the potential for coping to mediate the associations between intersectional discrimination and non-adherence and coping self-efficacy (confidence in one's ability to cope with discrimination) as a moderator that may buffer the negative effects of discrimination on non-adherence in a cross-sectional convenience sample of 82 Latino sexual minority men with HIV. In bivariate linear regressions, discrimination targeting Latino ethnic origin, undocumented residency status, and sexual orientation were each significantly associated with lower self-reported antiretroviral therapy non-adherence (percentage of prescribed doses taken in the last month) and greater use of disengagement coping (denial, substance use, venting, self-blame, behavioral disengagement). Associations between discrimination targeting Latino ethnicity and non-adherence, and discrimination targeting undocumented residency status and non-adherence, were each mediated by disengagement coping responses. Moderation analyses highlighted significant discrimination by coping self-efficacy interaction effects-both coping self-efficacy for problem solving and stopping unpleasant emotions/thoughts each moderated the associations between Latino discrimination and adherence, between undocumented residency status discrimination and adherence, and between HIV discrimination and adherence. Coping self-efficacy for getting social support moderated the association between undocumented residency status discrimination and adherence. Further, the interaction coefficients across models indicated that the negative effects of discrimination on adherence were attenuated at higher levels of coping self-efficacy. Findings highlight the need for structural interventions that reduce-and ultimately eliminate-discrimination, and interventions that address the harmful effects of discrimination and adherence improvement interventions to enhance coping skills among people faced with intersectional discrimination.

Immigration-Related Discrimination and Mental Health among Latino Undocumented Students and U.S. Citizen Students with Undocumented Parents: A Mixed-Methods Investigation.

Research has consistently linked discrimination and poorer health; however, fewer studies have focused on immigration-related discrimination and mental health outcomes. Drawing on quantitative surveys (N = 1,131) and qualitative interviews (N = 63) with Latino undergraduate students who are undocumented or U.S. citizens with undocumented parents, we examine the association between perceived immigration-related discrimination and mental health outcomes and the process through which they are linked. Regression analyses identify an association between immigration-related discrimination and increased levels of depression and anxiety; this relationship did not vary by self and parental immigration status. Interview data shed light on this result as immigration-related discrimination manifested as individual discrimination as well as vicarious discrimination through family and community members. We contend that immigration-related discrimination is not limited to individual experiences but rather is shared within the family and community, with negative implications for the mental health of undocumented immigrants and mixed-status family members.

Lessons Learned from Health Disparities in Coronavirus Disease-2019 in the United States.

In the United States, the coronavirus disease-2019 (COVID-19) pandemic has disproportionally affected Black, Latinx, and Indigenous populations, immigrants, and economically disadvantaged individuals. Such historically marginalized groups are more often employed in low-wage jobs without health insurance and have higher rates of infection, hospitalization, and death from COVID-19 than non-Latinx White individuals. Mistrust in the health care system, language barriers, and limited health literacy have hindered vaccination rates in minorities, further exacerbating health disparities rooted in structural, institutional, and socioeconomic inequities. In this article, we discuss the lessons learned over the last 2 years and how to mitigate health disparities moving forward.

Predicting different dimensions of schizophrenia-related stigma in Israel: Exploring the applicability of the common sense model of illness.

The common sense model of illness is a promising conceptual framework that can promote our understanding of the predictors of schizophrenia-related public stigma. Because stigma is a multidimensional phenomenon, studies on schizophrenia-related stigma need to account for the origins of the various aspects of this phenomenon. This study explored which common sense model of illness components (cognitive and emotional) predicted three distinct indicators of stigma (stereotypes and discrimination on the individual and structural levels). A nonprobability sample of 149 students from one of the largest universities in Israel was drawn. Data were collected via a self-reported questionnaire. We found that five of the nine common sense model of illness variables predicted schizophrenia stereotypes, whereas very few predicted discrimination. Additionally, we found that greater belief in the effectiveness of schizophrenia treatment was associated with lower stereotypes and social-level discrimination. The less the perceived consequences of schizophrenia (the extent to which the illness is perceived to affect one's life), the lower the stereotypes and discrimination (individual and social). The perceived cause of schizophrenia and attribution of personal control over the illness did not predict any stigma dimension. The findings suggest that the common sense model of illness is more suitable for predicting stereotypes than discrimination. More research is needed to understand the unique drivers of different dimensions of stigma. The findings also imply the need to design separate programs to address different aspects of schizophrenia-related stigma.

Associations of Discrimination, Low Social Support, and Limited English Proficiency with Depression in South Asian Immigrants.

South Asians face stressors as a growing immigrant group in America. Work is needed to understand how these stressors impact mental health to identify those at risk of depression and design interventions. This study examined associations of three stressors (discrimination, low social support, limited English proficiency) with depressive symptoms in South Asians. Using cross-sectional data from the Mediators of Atherosclerosis in South Asians Living in America study (N = 887), we fit logistic regression models to evaluate independent/joint effects of three stressors on depression. Overall prevalence of depression was 14.8%; 69.2% of those with all three stressors had depression. The combined effect of high discrimination/low social support was significantly greater than the sum of the individual factors. Experiences of discrimination, low social support, or limited English proficiency, as well as a combination of these factors, should be considered when diagnosing/treating South Asian immigrants in a culturally appropriate manner.

Exploring the Impact of Experiences with Everyday and Major Discrimination and HIV-Related Stigma on Engagement in HIV Care Among Older African Americans Living with HIV.

OBJECTIVES: The purpose of this pilot study was to explore the effect of HIV-related stigma and everyday major experiences of discrimination on medication and clinic visit adherence among older African Americans living with HIV in Ohio. METHODS: We collected data from 53 individuals who were living with HIV in Ohio, ≥ 50 years of age, and who identified as Black or African American. We conducted logistic regression models to examine the impact of HIV-related stigma and experiences of discrimination on medication and visit adherence. Each model controlled for age, time since diagnosis, and sexual orientation. RESULTS: The average age was 53.6 ± 2.1 years and 94.3% were men. Almost half (49.1%) of the participants reported poor medication adherence and almost a third (31.4%) reported poor visit adherence. HIV-related stigma (adjusted odds ratio (aOR) = 1.39; 95% confidence interval (CI) = 1.02-1.89) and major experiences of discrimination (aOR = 1.70; 95% CI = 1.11-2.60) were associated with a greater odds of poor medication adherence. Additionally, major experiences of discrimination were associated with a threefold increase in the odds of poor visit adherence (aOR = 3.24; 95% CI = 1.38-7.64). CONCLUSIONS: HIV-related stigma and major experiences of discrimination impede optimal medication and HIV clinic visit adherence for older African Americans living with HIV. To reduce the impact of stigma and discrimination on HIV care engagement, our first step must be in understanding how intersecting forms of stigma and discrimination impact engagement among older African Americans living with HIV.

Daily discrimination, church support, personal mastery, and psychological distress in black people in the United States.

OBJECTIVE: This study used the stress process model to test the mediating effects of personal mastery and moderating effects of church-based social support on the relationship between daily discrimination and psychological distress across three age groups of African American and Afro-Caribbean adults. METHODS: Using a national sample of 5008 African Americans and Afro-Caribbean adults from the National Survey of American Life Study, this study employs structural equation modeling to investigate the relationships between daily discrimination, personal mastery, church-based social support, and psychological distress. RESULTS: Daily discrimination was an independent predictor of psychological distress across all groups. Group- and age-specific comparisons revealed significant differences in the experience of daily discrimination and psychological distress. Mastery was a partial mediator of the relationship between discrimination and psychological distress among Afro-Caribbeans while church support was a significant moderator only among the young and older African Americans. IMPLICATIONS: Together, our study findings provide useful first steps towards developing interventions to reduce the adverse psychological impacts of daily discrimination on African Americans and Afro-Caribbeans. Intervention efforts such as individual psychotherapy aimed to improve Afro-Caribbean individuals' sense of mastery would be a partial solution to alleviating the adverse effects of discrimination on their psychological health.

Análisis bifactorial y validez de constructo de la Escala de Percepción de Amenaza exogrupal frente a los inmigrantes VIH positivos en una muestra de adultos peruanos / Bifactorial analysis and construct validity of the Out-group Threat Perception Scale against HIV-positive immigrants in a sample of Peruvian adults

En la actualidad se evidenciado aumento de los desplazamientos provocados por conflictos, persecuciones, falta de oportunidades, seguridad, entre otras razones, inscrementando la población de migrante en países de América Latina. Se destaca los desplazados venezolanos, siendo Perú el segundo país de Latinoamérica con más de esta población de migrantes. Estudios han alertado sobre la desvalorización de los migrantes y especialmente aquellos que vivan con enfermedades infectocontagiosas como es el VIH. Los ciudadanos autóctonos del país receptor, percirbe la presencia del exogrupo como amenazas a sus derechos sociales relacionándose con actitudes negativas, que se ha ido poteciando por los medios de comunicación. Por tanto, es importante realizar estudios que estimen el discernimiento de amenazas exogrupal estrechamente hacia los migrantes. El objetivo evaluar las evidencias psicométricas del instrumento de medición EPAE en una muestra de adultos peruanos frente a los inmigrantes VIH. El análisis de los ítems y de confiabilidad demostró un adecuado funcionamiento a excepción de los ítems 4, 5, 11 y 12. Se propone utilizar el modelo 2, el cual consta de 9 agregados, confirmado por los diferentes índices estadísticos (X2/gl=3.49; WMRM=1.124; NFI=0.993; CFI=0.995; GFI=0.997; RMSEA=0.045; SRMR=0.035). Según los valores del análisis bifactor no existe suficiente evidencia para asumir un factor general, se recomienda trabajar con dimensiones independientes. Es importante la identificación de percepción de amenazas reales, debido a que investigaciones han evidenciado que el estigma asociado con el VIH constituye uno de los mayores obstáculos para la prevención de nuevas infecciones(AU)

Currently, there is evidence of an increase in displacement caused by conflicts, persecution, lack of opportunities, security, among other reasons, increasing the migrant population in Latin American countries. The displaced Venezuelans stand out, with Peru being the second country in Latin America with more than this population of migrants. Studies have warned about the devaluation of migrants and especially those who live with infectious diseases such as HIV. The autochthonous citizens of the receiving country perceive the presence of the outgroup as threats to their social rights, related to negative attitudes, which has been promoted by the media. Therefore, it is important to carry out studies that estimate the discernment of out-group threats closely towards migrants. The objective is to evaluate the psychometric evidence of the EPAE measurement instrument in a sample of Peruvian adults compared to HIV immigrants. The analysis of the items and reliability showed an adequate functioning with the exception of items 4, 5, 11 and 12. It is proposed to use model 2, which consists of 9 aggregates, confirmed by the different statistical indices (X2/df= 3.49; WMRM=1.124; NFI=0.993; CFI=0.995; GFI=0.997; RMSEA=0.045; SRMR=0.035). Given the values of the bifactor analysis, there is not enough evidence to assume a general factor, it is recommended to work with independent dimensions. It is important to identify the perception of real threats, since research has shown that the stigma associated with HIV constitutes one of the greatest obstacles to the prevention of new infections(AU)

Discrimination in an "equal country"-a survey amongst Swedish final-year medical students.

BACKGROUND: Discrimination due to gender and ethnicity has been found to be widespread in medicine and healthcare. Swedish and European legislation list seven discrimination grounds (age, sex, ethnicity, religion, sexuality, non-binary gender identity, and disability) which may intersect with each other; yet these have only been sparsely researched. The aim of this study was to assess the extent of discrimination, based on these seven discrimination grounds, amongst final-year medical students in Sweden. METHODS: A web-based survey, based on the CHERRIES-checklist, was disseminated to course coordinators and program directors in charge of final year medical students at all seven medical schools in Sweden. Quantitative data were analyzed using descriptive statistics, Fisher's exact test, and logistic regression. Free-text answers were analyzed thematically using the "Master Suppression techniques" conceptual framework. RESULTS: Of the 1298 medical students contacted, 247 (19%) took part in the survey. Almost half (n = 103, 42%) had experienced some form of discrimination, and this difference was statistically significant by gender (p = 0.012), self-perceived ethnicity (p < 0.001), country of birth other than Scandinavia (p < 0.001) and visible religious signs (p = 0.037). The most common type of discrimination was gender-based (in 83% of students who had experienced discrimination), followed by age (48%), and ethnicity (42%). In the logistic regression, women/non-binary gender (p = 0.001, OR 2.44 [95% CI 1.41-4.22]), country of birth not in Scandinavia (p < 0.001, OR 8.05 [2.69-24.03]), non-Caucasian ethnicity (p = 0.04, OR 2.70 [1.39-5.27]), and disability (p = 0.02, OR 13.8 [1.58-12040]) were independently associated with discrimination. Half of those who had experienced religion-based discrimination and nearly one-third of victims of ethnicity-based discrimination reported "large" or "extreme" impact of this. Clinical staff or supervisors were the most common offenders (34%), closely followed by patients and their relatives (30%), with non-Caucasian respondents significantly more likely to experience discrimination by patients (p < 0.001). CONCLUSIONS: Discrimination appears to be frequent in medical school, even in one of the world's "most equal countries". Discrimination is most commonly gender- or ethnicity-based, with ethnicity- and religion-based discrimination appearing to have the largest impact. Future research should continue to evaluate discrimination from an intersectional perspective, adapted for local contexts and legislations.

Personal attributes and attitudes to substance use disorder: A study among Jordanian undergraduate medical majors students.

BACKGROUND: Emerging health professionals in undergraduate programs should be equipped to provide care to people with substance use disorder (SUD). The students' personal attributes may impact their attitude toward those with SUD. This study aims to evaluate the impact of personal attributes of Jordanian undergraduate health students on their attitudes toward SUD and examine the relationship between the personal attributes and their devaluation and discriminatory (stigmatory) behaviour toward those with SUD. METHOD: A cross-sectional descriptive design was used to examine the attitudes and stigmatory behaviours. The data were collected between May to October 2017 with a structured questionnaire that consisted of three parts: 1) a data sheet to collect the socio-demographic characteristics of the participants, 2) the Acute Mental Health Scale (ATAMHS), and 3) the Devaluation-Discrimination Scale (DDS). FINDINGS: Younger and females demonstrated a positive attitude toward those with SUD compared to older or male students. Age, gender, and previous experience with SUD are significant factors that affect their attitude. CONCLUSION: Identifying the attitude to people with SUD and personal attributes of emerging health professionals in Jordan will help identify the need to educate them prior to their entry into practice.

Discriminações e preconceitos: temas que precisam de muito debate na formação dos profissionais de saúde / Discrimination and prejudice: topics that require extensive debate in the training of healthcare professionals

Conteúdos curriculares relativos às Ciências Humanas e Sociais têm muita importância no desenvolvimento de habilidades que vão construir competências relacionadas ao comportamento dos egressos. O curso de Odontologia da Univates aborda, desde o início da formação temáticas relacionadas a discriminação e ao preconceito de forma integrada no seu currículo. O trabalho apresenta relatos de experiências de quatro estudantes durante os estágios com o objetivo de identificar, reconhecer e discutir questões relacionadas ao preconceito e discriminação no desenvolvimento do estágio extramuros, apresentando os desafios e dificuldades encontradas nesse processo. Através de relatos subjetivos podemos perceber os diferentes itinerários de formação que os estudantes percorrem, além da ampliação das oportunidades de contato com essas temáticas. Nos relatos são descritas atividades de aprendizagem realizadas durante o curso e que são retomadas no enfrentamento das situações vivenciadas nos estágios. Dramatizações, leitura de materiais, desafios propostos no CBL (Challenge Based Learning), produções de resumoseparticipações em congressos vão sendo elencadas como referências importantes no atendimento de populações específicas como indígenas, imigrantes, pessoas com pele preta e que fazem uso de tornozeleiras eletrônicas, além de contatos com pessoas transexuaise portadores de necessidades especiais. Essas experiências, muitas vezes, são possíveis pela presença dos estudantes nas redes de saúde. O estágio extramuros amplia as experiências de atendimento aos estudantes, contribuindo para uma formação mais generalista e humanista. O contato dos estudantes com diferentes realidades é benéfico para o desenvolvimento de novas perspectivas a partir dos conteúdos trabalhados de forma teórica e, quando integrados, podem contribuir para uma formação mais cidadã (AU).

Curriculum subjects related to Human and Social Sciences are important to the development of skills that will build the abilities related to the behavior of graduates. From the beginning of training, the Univates Dentistry course addresses themes related to discrimination and prejudice in an integrated way in its curriculum. This academic project features reports of four students during their internships, aiming to identify, recognize and discuss issues related to prejudice and discrimination in the development of the internship, presenting the challenges encountered in this process. Through subjective reports it is possible to understand the different paths that graduation students go through, and the expansion of opportunities to get in touch with these themes. In the reports, the students describe many learning activities applied during the course that later were used in situations experienced in the internships. Acting, relevant paper reading, challenges proposed in the CBL (Challenge Based Learning), production of overviews and reports and participation in conferences are some of the important references in the care of specific populations such as indigenous people, immigrants, people with black skin, convicted people with electronic anklets, transsexuals and individuals with special needs. These experiences are often only possible due to the presence of students in the public health and care systems. The internship expands the student service experiences, contributing for a more humanized and real graduation. The contact of students with different realities is beneficial for the development of new perspectives from the content learned theoretically and, when combined, can build up to a more humanized graduation (AU).

Recovered but Constrained: Narratives of Ghanaian COVID-19 Survivors Experiences and Coping Pathways of Stigma, Discrimination, Social Exclusion and Their Sequels.

BACKGROUND: Research about the coronavirus disease 2019 (COVID-19), its epidemiology and socio-economic impact on populations worldwide has gained attention. However, there is dearth of empirical knowledge in low- and middle-income settings about the pandemic's impact on survivors, particularly the tension of their everyday life arising from the experiences and consequences of stigma, discrimination and social exclusion, and how they cope with these behavioral adversities. METHODS: Realist qualitative approach drawing data from people clinically diagnosed positive of COVID-19, admitted into therapy in a designated treatment facility, and subsequently recovered and discharged for or without follow-up domiciliary care. In-depth interviews were conducted by maintaining a code book for identifying and documenting thematic categories in a progression leading to thematic saturation with 45 participants. Data were transcribed and coded deductively for broad themes at the start before systematically nesting emerging themes into the broad ones with the aid of NVivo 12 software. RESULTS: Everyday lived experiences of the participants were disrupted with acts of indirect stigmatization (against relatives and family members), direct stigmatization (labeling, prejudices and stereotyping), barriers to realizing full social life and discriminatory behaviors across socio-ecological structures (workplace, community, family, and social institutions). These behavioral adversities were associated with self-reported poor health, anxiety and psychological disorders, and frustrations among others. Consequently, supplicatory prayers, societal and organizational withdrawal, aggressive behaviors, supportive counseling, and self-assertive behaviors were adopted to cope and modify the adverse behaviors driven by misinformation and fearful perceptions of the COVID-19 and its contagious proportions. CONCLUSION: In the face of the analysis, social campaigns and dissemination of toolkits that can trigger behavior change and responsible behaviors toward COVID-19 survivors are proposed to be implemented by health stakeholders, policy and decision makers in partnership with social influencers, the media, and telecoms.

Processo transexualizador no sus: questões para a psicologia a partir de itinerários terapêuticos e despatologização / Proceso transexualizador en el sus: cuestiones para la psicología desde itinerarios terapêuticos y despatologización / Transexualizing process in the sus: questions for psychology from therapeutic itinetaries and depathologization

RESUMO. Trata-se de uma pesquisa qualitativa, des critiva e exploratória, realizada no Tratamento Fora de Domicílio, na cidade de Cuiabá-MT, Brasil, que objetivou levantar reflexões sobre os itinerários terapêuticos de pessoas trans, na busca pelo Processo Transexualizador. Participaram três homens trans, duas mulheres trans e uma mulher travesti, com faixa etária de 21 a 32 anos. Os da dos foram coletados por entrevistas semiestruturadas e analisados mediante análise de conteúdo. Os resultados mostram que essas pessoas trans seguem trajetórias diver sas, procurando serviços institucionalizados ou informais (redes de socialidade trans), para a afirmação de suas identidades de gênero. Destacam-se entraves atinentes à patologização, ao acolhimento, à continuidade do cuidado, à resolutividade e à referência na rede de atenção do processo transexualizador. Observaram-se importantes pontos críticos na assistência social, endocrinológica e para a psicologia, sendo a peregrinação pelos serviços de saúde demarcada por constantes discriminações institucionais, permitindo a compreensão de como o sistema de saúde se organiza em relação ao atendimento dessas pessoas, elencando questões para o trabalho da psicologia, nesse campo, a partir de uma perspectiva da experiência e materialidade do gênero.

RESUMEN. Esta es una investigación cualitativa, descriptiva y exploratoria realizada en el tratamiento fuera del domicilio en la ciudad de Cuiabá, Brasil, que tuvo como objetivo plantear reflexiones sobre los itinerarios terapéuticos de las personas trans en la búsqueda del proceso transexual. Participaron tres hombres trans, 2 mujeres trans y 1 mujer travesti de 21 a 32 años. Los datos fueron recogidos a través de entrevistas semiestructuradas y fueron analizados mediante el Análisis de Contenido. Los resultados muestran que estas personas trans siguen caminos divergentes en busca de servicios institucionalizados o informales (redes sociales trans) para afirmar sus identidades de género. Se destacan los obstáculos relacionados con la patologización, acogida, la continuidad de la atención, la resolución y la referencia en la red de atención del Proceso Transexualizador. Se observaron puntos críticos importantes en la asistencia social, la endocrinología y la psicología, em que la peregrinación por los servicios de salud es delimitada por la constante discriminación institucional que permite comprender cómo se organiza el sistema de salud en relación con la atención de estas personas que señalan los problemas para el trabajo de la Psicología en este campo desde una perspectiva de experiencia y materialidad de género

ABSTRACT. This qualitative, descriptive and exploratory research conducted in the Away from Home Treatment (Tratamento Fora de Domicílio [TFD]), in Cuiabá, Brazil, aimed to raise reflections on the therapeutic process itineraries of trans people in the search for the Transsexualizer Process (Processo Transexual [PT]). Three transgender men, two transgender women and one transvestite woman participated. They were aged between 21 and 32 years. Data were collected through semi-structured interviews and analyzed using Content Analysis. The results show that trans people follow different itineraries, looking for institutionalized or informal services (trans sociality networks) to affirm their gender identities. Obstacles related to pathologization, reception, continuity of care, resolution and reference in the care network of the Transsexualizer Process stand out. Important critical points were observed in social, endocrinological and psychological care. The pilgrimage by health services was marked by constant institutional discrimination, allowing for the understanding of how the health system is organized concerning the care of these people, listing issues for the work of Psychology, in this field, from a perspective of the experience and materiality of gender.

Parâmetros de dificuldade e discriminação das tarefas motoras do instrumento KTK: uma análise a partir da teoria de resposta ao item / Difficulty and discrimination parameters of the KTK instrument motor tasks: an analysis from item response theory

RESUMO Nas últimas décadas o uso da Teoria de Resposta ao Item (TRI) tem sido implementada devido à complexidade dos cálculos estatísticos que permite analisar com profundidade testes educacionais, questionários e listas de itens aplicados em diferentes áreas como a psicometria, ranking esportivo e pedagogia. A partir dessa premissa este estudo teve como objetivo verificar a adequabilidade das tarefas motoras do KTK analisando o grau de dificuldade e parâmetro de discriminação de cada tarefa motora. Participaram do estudo 385 crianças de 5 a 14 anos. O instrumento avaliado foi o KTK (Körperkoordinationstest für Kinder), composto por quatro tarefas motoras: trave de equilíbrio, saltos monopedais, saltos laterais e transposição de plataformas. As análises foram conduzidas a partir dos dados brutos adquiridos em cada tarefa motora. A fim de verificar a estrutura fatorial da matriz teórica subjacente ao teste, foi realizada uma análise fatorial exploratória seguida da análise fatorial confirmatória. Os parâmetros de dificuldade e discriminação de cada tarefa motora foram analisados a partir do modelo de resposta gradual, fundamentado na teoria de resposta ao item (TRI). Os resultados corroboram com a estrutura fatorial sugerida na versão original do KTK, apresentando apenas um fator, chamado de coordenação motora. Os indicadores da Análise Fatorial Confirmatória (AFC) foram aceitáveis, indicando boa qualidade do modelo ajustado para a amostra. Conclui-se que a análise de TRI evidenciou diferenças nos parâmetros de dificuldade e de discriminação entre as tarefas motoras do KTK, demonstrando a importância de considerar uma ponderação na criação de tabelas normativas de avaliações motoras.

ABSTRACT In the last decades, the use of Item Response Theory (IRT) has been implemented due to the complexity of statistical calculations that allows for in-depth analysis of educational tests, questionnaires and lists of items applied in different areas such as psychometry, sports ranking and pedagogy. Based on this premise, this study aimed to verify the suitability of the KTK motor tasks analyzing the degree of difficulty and discrimination parameters of each motor task. A total of 385 children aged 5 to 14 years participated in the study. The instrument evaluated was the KTK (Körperkoordinationstest für Kinder), consisting of four motor tasks: balance beam, single-pedal jumps, side jumps and platform transposition. Analyzes were conducted from the raw data acquired in each motor task. In order to verify the factor structure of the theoretical matrix underlying the test, an exploratory factor analysis was performed, followed by a confirmatory factor analysis. The difficulty and discrimination parameters of each motor task were analyzed using the gradual response model, based on the Item Response Theory (IRT). The results corroborate the factor structure suggested in the original version of the KTK, presenting only one factor, called motor coordination. The AFC indicators were acceptable, indicating good quality of the model adjusted for the sample. It is concluded that the IRT analysis evidenced differences in the parameters of difficulty and discrimination between the KTK motor tasks, demonstrating the importance of considering a weighting in the creation of normative tables of motor assessments.

Commentary on the special issue on disproportionate exposure to trauma: Trauma, stress, and adversities and health disparities among disenfranchised groups globally during the COVID pandemic.

The papers in this Journal of Traumatic Stress special issue on disproportionate adversity cover the gamut of discrimination traumas and stressors, including microaggressions, a more insidious forms of discrimination, and their often-devastating and wide-ranging mental health sequelae, in disproportionately affected disenfranchised groups. Discrimination based on race, ethnicity, gender, and sexual orientation commonly confers cumulative and chronic effects. In the field of traumatic stress studies, several types of identity-linked traumatic events have been identified and empirically investigated as posttraumatic stress disorder (PTSD)-producing experiences. Collectively, the 13 papers included in this special issue raise questions about the definition, conceptualization, and categorization of various forms of explicit and implicit identity-linked trauma. These papers highlight the need for acceptance of a shared nomenclature and better differentiation of both causal and correlational associations with acute and chronic PTSD, depression, suicide risk, alcohol misuse, and other mental health outcomes. In this commentary, the discussion is extended to COVID-19, a disease that has been globally devastating for many. On multiple levels (i.e., physical, mental, emotional, economic, and social), COVID-19 has magnified the prepandemic fault lines of race, ethnicity, gender, gender identity, and sexual orientation. Applying a syndemic framework to the health impact of COVID-19 and, arguably, the most pervasive identity linked epidemic worldwide-systemic racism-brings perspective to the biological and social forces that are likely to be driving the convergence of COVID-19, systemic racism, and chronic health inequities, and may be informative in guiding evidence-based strategies for managing racial trauma in the context of COVID-19.

Disclosing Genetic Risk of Alzheimer's Disease to Cognitively Unimpaired Older Adults: Findings from the Study of Knowledge and Reactions to APOE Testing (SOKRATES II).

BACKGROUND: Current practice guidelines recommend against Apolipoprotein E (APOE) testing. However, advances in Alzheimer's disease (AD) research and care may soon change this. OBJECTIVE: To examine longitudinally the experience of learning an APOE result and, if an ɛ4 carrier, taking a disease-specific treatment to reduce one's risk of AD. METHODS: Fifty ɛ4 carriers and 20 non-carriers completed semi-structured interviews 3 months and 15 months after APOE disclosure. RESULTS: Individuals generally understand their APOE results. While non-carriers felt relief, ɛ4 carriers often described themselves as disappointed by their result but nevertheless glad to know. Carriers expressed concerns about stigma and discrimination, including in the workplace. Carriers adopted new health behaviors at higher rates than non-carriers and revised their future plans to account for their increased risk of AD. Individuals participating in research were hopeful that their participation would help them or others; individuals who learned they were at increased risk for AD but who could not participate in research were disappointed. CONCLUSION: Providers disclosing APOE results should be sensitive to how APOE results shape emotions, self-perceptions, and attitudes about memory; raise concerns about stigma and discrimination in personal and professional relationships; influence health behaviors and decision-making; and can have follow-on effects on family members.

Public opinions and gender issue.

OBJECTIVE: Gender is an aspect of the natural identity of a person that has been given ample attention in socio-cultural, psychological, and political studies worldwide. Transgender, which is a part of gender issues, is still lacking in information on definitions of transgender, its causes, society's perceptions toward it, and interpretations on transgender action. Transgender is an umbrella term that describes people whose gender identity or expression does not match the sex they have been assigned at birth. It is one of the most important signs of progress produced by scientific advancement in the field of medicine, which is a relatively new phenomenon. Due to the lack of research on transgender, researchers study this issue at the theoretical and public opinion levels and from different perspectives. The objectives are to provide insights into the landscape of gender issues, instill awareness among communities and make them understand the psychological pains and the emotional difficulties that the transgender go through. Transgender issues must be analyzed from the perspectives of humanity, ethics, and culture. MATERIALS AND METHODS: Data were gathered through open-ended interviews among nine participants. And to complement the data, particularly about the public's opinions toward the transgender, a focus group discussion (FGD) was held among four participants. RESULTS: The findings indicate that the transgender community often faces social discrimination due to the social stigma towards them. Thus, the treatment should be more on psychological therapies, family education, community awareness, and social activism that are needed to realign the transgender to the right track. CONCLUSIONS: This study provides insights into the landscape of gender equality and ways to support those with gender identity issues. Hence, this research carries values to the Sustainable Development Goals (SDG) in enhancing the policy on gender equality.