A Workbook to Promote Forgiveness for Ingroup Congregational Offenses

Since research on forgiveness has flourished over the past three decades, multiple interventions have been developed to aid individuals in this arduous process. Two interventions in particular have been most-widely studied with diverse groups: Enright’s process model (Enright & Fitzgibbons, 2000) and Worthington’s REACH Forgiveness model (2006). Thus far, these forgiveness interventions have been led by trained professionals in an in-person group. In-person interventions pose issues of cost and attendance. In the current study, I adapted Worthington’s Christian-adapted REACH Forgiveness intervention into a self-directed workbook for Christians who have experienced an offense within a religious community. Participants (N = 52) voluntarily completed the workbook for partial course credit, taking an average of 6.66 hours of time, and assessments at three time points. I found a significant treatment condition x time interaction, Wilks’ ë = .31, F(6,31) = 11.57, p \u3c .001, partial ç² = .69, which indicates that the effect of time depended upon the treatment condition to which participants were assigned. In addition, the current study produced a larger effect size comparable to benchmarks of previous in-person REACH Forgiveness interventions (d = 1.63), and fell within the upper limit of the standard of change. The current findings encourage further analysis of this self-directed intervention which is cost-effective, easily disseminated, and found effective in this initial study

Violations of the Divine: Forgiveness of Ingroup Transgressors within Church Congregations of the Christian Faith

Research on forgiveness has been expanding rapidly in the last decade with a subset of studies looking at how religious people forgive. A discrepancy persists between Christians’ level of valuing forgiveness and forgiveness of actual transgressions. Several methodological issues and offense-specific variables have been presented as explanations. This present thesis examines the role of the congregation as a group identity, and applies it to a theory of relational spirituality, as a measure of the relationship between a victim and the Sacred. No existing research has polled congregants about offense-specific forgiveness of church peers. I collected data from members of Christian congregations throughout the United States (Study 1, N = 63) and college students belonging to Christian congregations (Study 2, N = 387) concerning group identity and within group forgiveness. In the present studies, group identification with a congregation predicted lower unforgiving and higher forgiving motivations towards an in-group offender

Student Engagement in an Online Engineering Afterschool Program During the COVID-19 Pandemic

The COVID-19 pandemic forced much of schooling online and limited students’ access to informal learning opportunities such as afterschool programs. The purpose of this study was to investigate how fourth- and fifth-grade students engaged in an online engineering program and what factors influenced their engagement. We drew on a four-dimensional model of student engagement to describe how students engaged in the afterschool engineering program and to identify the factors that enhanced or inhibited engagement. Using a case study design, we drew on interviews with six program mentors and ten students and observation data from weekly Zoom sessions throughout the 2020–2021 school year. We found examples of all four dimensions of engagement, but also of disengagement. The program influenced student engagement in multiple ways, including through the program mentors’ social, pedagogical, and managerial roles, students’ interest in and enjoyment of engineering, the drawbacks and benefits of the online learning environment and Zoom’s affordances, and the nature of the program’s activities. We connect these factors to the different dimensions of engagement. We conclude with a discussion of how our findings add to research on engineering education in informal online settings and offer implications for practitioners

Efficacy of a Workbook to Promote Forgiveness: A Randomized Controlled Trial with University Students

Objective The present study investigated the efficacy of a 6-hour self-directed workbook adapted from the REACH Forgiveness intervention. Method Undergraduates (N = 41) were randomly assigned to either an immediate treatment or waitlist control condition. Participants were assessed across 3 time periods using a variety of forgiveness outcome measures. Results The 6-hour workbook intervention increased forgiveness, as indicated by positive changes in participants’ forgiveness ratings that differed by condition. In addition, benchmarking analysis showed that the self-directed workbook intervention is at least as efficacious as the delivery of the REACH Forgiveness model via group therapy. Conclusion A self-directed workbook intervention adapted from the REACH Forgiveness intervention provides an adjunct to traditional psychotherapy that could assist the mental health community to manage the burden of unforgiveness among victims of interpersonal harm

Efficacy of REACH Forgiveness across Cultures

Across cultures, most people agree that forgiveness is a virtue. However, culture may influence how willing one should be to forgive and how one might express forgiveness. At a university in the United States, we recruited both foreign-extraction students and domestic students (N = 102) to participate in a six-hour REACH Forgiveness intervention. We investigated the efficacy of the intervention overall as well as whether foreign-extraction and domestic students responded differently to treatment. Forgiveness was assessed using two measures—decisional forgiveness and emotional forgiveness. The six-hour REACH Forgiveness intervention improved participants’ ratings of emotional forgiveness, but not decisional forgiveness, regardless of their culture. Thus, the REACH Forgiveness intervention appears equally efficacious for participants from different cultural backgrounds when conducted in the United States with college students

Forgiveness of In-group Offenders in Christian Congregations

Religious communities, like other communities, are ripe for interpersonal offenses. We examined the degree to which group identification predicted forgiveness of an in-group offender. We examined the effects of a victim’s perception of his or her religious group identification as a state-specific personal variable on forgiveness by integrating Social Identity Theory into a model of Relational Spirituality (Davis, Hook, & Worthington, 2008) to help explain victim’s responses to transgressions within a religious context. Data were collected from members of Christian congregations from the mid-west region of the United States (Study 1, N = 63), and college students belonging to Christian congregations (Study 2, N = 376). Regression analyses demonstrated that even after statistically controlling for many religious and transgression-related variables, group identification with a congregation still predicted variance in revenge and benevolence toward an in-group offender after a transgression. Additionally, mediation analyses suggest group identification as one mechanism through which trait forgivingness relates to forgiveness of specific offenses. We discuss the importance of group identity in forgiving other in-group members in a religious community

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice

How Internal and External Collaborations Launched a System-wide Social Health Screening and Referral Initiative

Background In 2019, addressing the social health needs of patients was identified as a top priority for the health system through the Community Heatlh Needs Assessment. As plans were underway to implement a social health screening, the pandemic occurred and amplified more pressing priorities for the health system. The COVID-19 pandemic, however, exacerbated social needs and worsened disparities for patients. This elicited a refocus on implementing a system-wide social determinants of health (SDOH) screening and referral process. Methods This initiative utilized both internal and external collaborations. Internal collaborations included the development of a leadership committee with various departments to inform the SDOH rollout. The primary grant project site, provided feedback to refine the SDOH process. A key external collaboration included a care coordination platform\u27s Team. This platform provides patient connectivity to community organizations that support their social health needs identified through screening. Results From April through November 2022, the health system has successfully conducted over 8,000 social health assessments and over 2,500 community referrals through the care coordination platform. Conclusion The leadership committee collaboration informed tactics to streamline the screening process. This included technical updates in our electronic medical records system, screening requirements, an appropriate timeline for onboarding outpatient clinics. The feedback provided by the clinic team facilitated the development of an online, self-paced training module to prepare clinic teams for SDOH implementation. These findings demonstrate the successful implementation of a new initiative through internal and external collaborative efforts within a health syste

Study protocol for a randomised controlled feasibility trial of a virtual intervention (STRIDE) for symptom management, distress and adherence to adjuvant endocrine therapy after breast cancer

Introduction Patient adherence to adjuvant endocrine therapy (AET) after a diagnosis of hormone-sensitive breast cancer is poor. Previous interventions have failed to produce changes in adherence, address patient preferences or include theoretically informed and evidence-based components. Therefore, we iteratively developed a patient-centred, evidence-based, small-group, videoconference intervention to improve adherence and symptom management as well as reduce distress for patients taking AET after breast cancer (Symptom-Targeted Randomised Intervention for Distress and Adherence to Adjuvant Endocrine Therapy, STRIDE).Methods and analysis The current study is a non-blinded, randomised, controlled, feasibility trial of STRIDE compared with a medication monitoring control group. The primary objective is to examine the feasibility and acceptability of STRIDE, while secondary objectives are to assess changes in objective and subjective adherence, symptom distress and satisfaction with AET. Patients will be recruited from the Massachusetts General Hospital Cancer Center in Boston, Massachusetts. The total number of patients accrued will be 75, with ≥60 patients completing the study. All patients will store their AET in an electronic pill bottle for objective adherence monitoring. Patients randomly assigned to the STRIDE intervention will receive 6 weekly 1-hour sessions, in small groups of two, delivered via videoconferencing by a trained mental health professional. Patients assigned to the control group will store their medication in the electronic pill bottle and receive follow-up oncology care as usual. All participants will complete self-report psychosocial measures at baseline, 12 weeks and 24 weeks postbaseline.Ethics and dissemination The study is funded by the National Cancer Institute of the National Institutes of Health and is approved by the Dana-Farber/Harvard Cancer Center Institutional Review Board (Protocol #18–603, V.1.2, first approval date 1 February 2019). The study will be reported in accordance with the Consolidated Standards of Reporting Trials statement for non-pharmacological trials. Results will be published in peer-reviewed academic journals, presented at scientific meetings and disseminated to patient organisations and media outlets.Trial registration numberNCT03837496; Pre-results

NLRP3 inflammasome inhibition attenuates sepsis-induced platelet activation and prevents multi-organ injury in cecal-ligation puncture.

Sepsis is characterized by organ dysfunction due to a dysregulated immune response to infection. Currently, no effective treatment for sepsis exists. Platelets are recognized as mediators of the immune response and may be a potential therapeutic target for the treatment of sepsis. We previously demonstrated that NLRP3 inflammasome activation in sepsis-induced activated platelets was associated with multi-organ injury in the cecal-ligation puncture (CLP) rat model of sepsis. In this study, we tested the hypothesis that inhibition of NLRP3 would inhibit platelet activation and attenuate multi-organ injury in the CLP rat. CLP (n = 10) or Sham (n = 10) surgery were performed in male and female Sprague-Dawley rats. A subset of CLP rats were treated with MCC950 (50mg/kg/d), a specific NLRP3 inhibitor (CLP+MCC950, n = 10). At 72 hrs. post-CLP, blood and organs were harvested for analysis of platelet activation, NLRP3 activation, inflammation and end organ damage. Platelet activation increased from 8±0.8% in Sham to 16±1% in CLP, and was reduced to 9±1% in CLP+M rats (p<0.05). NLRP3 activation was also increased in platelets of CLP vs Sham. NLRP3 expression was unchanged in kidney and lung after CLP, but Caspase 1 expression and IL-1β were increased. MCC950 treatment attenuated NLRP3 activation in platelets. Plasma, kidney, and lung levels of NLRP3 inflammasome associated cytokines, IL-1ß and IL-18, were significantly increased in CLP compared to Sham rats. Inhibition of NLRP3 normalized cytokine levels. Glomerular injury, pulmonary edema, and endothelial dysfunction markers were increased in CLP rats vs Sham. MCC950 treatment significantly decreased renal and pulmonary injury and endothelial dysfunction in CLP+M. Our results demonstrate a role for NLRP3 in contributing to platelet activation and multi-organ injury in sepsis