When Two Become One: Exploring Identity in Marriage and Cohabitation

We examine the psychosocial impact of marital status change, and the spontaneously emerging theme of identity. In-depth interviews were conducted with 82 cohabiting, married, widowed, and divorced British adults, focusing on changes in daily routine, social relationships, and social support. We draw attention to findings of interviews with men and women who entered a married ( n = 30) or cohabiting ( n = 8) relationship for the first time. The interviews provide an insight into the complex process of identity change in marriage and cohabitation. Participants described an identity shift from “I” to “we” which was associated with social and personal changes in how they understood themselves. Marriage and cohabitation were viewed as positive transitions facilitating personal growth. However, importantly, marriage, in particular, was also associated with a process of depersonalization which posed a challenge to private identity. We conclude with a discussion of the ways in which participants managed this identity conflict. </jats:p

"We Were in a Partnership That Wasn't Recognized by Anyone Else'': Examining the Effects of Male Gay Partner Bereavement, Masculinity, and Identity

Research with older gay “widowers”1 is relatively rare and the majority focuses on the AIDS/HIV context, rather than on broader causes of death. However, drawing on studies of heterosexual spousal bereavement, we suggest that older widowers are faced with two competing challenges that impact on their identity. They are expected to grieve in a socially acceptable manner, while at the same time conform to hegemonic masculine identity. We investigate whether gay widowers face the same challenges and whether there are additional challenges compared to heterosexual widowers following the loss of their partners. We interviewed twenty older gay widowers about their experiences. We illustrate our findings with four case studies. We find that gay men, like heterosexual men, manage the challenges of normative grieving as defined by hegemonic masculinity. However, gay men also face challenges of gay identity. We discuss the ways in which these men negotiate the intersectionality of grieving, masculinity, and being gay. In addition, identities are reconstructed in response to the expectations of the gay community. Finally, gay men have to negotiate their position as grieving widower within the wider social context. </jats:p

Wellbeing in Bereavement and Widowhood

This article will examine how beveavement and widowhood affect wellbeing drawing on psychological, gerontological, and sociological research. The article will begin with an outline of what is meant by bereavement and widowhood. It will then present an overview of the effects that bereavement and widowhood has on wellbeing. In the next section, a brief history of approaches to bereavement will be presented. Next, more recent approaches will be discussed including the Dual Process Model of Bereavement (Stroebe &amp; Schut, 1999), and a discussion of the debate concerning continuing and relinquishing bonds. The focus will then turn to factors which influence wellbeing with a focus both on pre- and post-bereavement experiences, and on such factors as age and gender. Finally, there will be a discussion of factors which may enhance wellbeing, such as resilience, identity reconstruction, and coping strategies. </jats:p

Resilience amongst Older Colombians Living in Poverty: an Ecological Approach.

Older Colombians face significant adversities: poverty, violence and displacement. However, there is evidence that Latinos are often resilient. We examine resilience in older Colombians living in poverty using an ecological framework that identifies three levels: individual; community; and societal. In this paper we examine data from 16 semi-structured interviews with older Colombians that explore resilience within the context of poverty. We analyze our data using three stages: (1) modified grounded theory; (2) assignment of resilience status; (3) identification of components of the ecological framework which contribute to resilience in these participants. The most striking feature is that some participants are able to adapt to their situation, demonstrating resilience, whilst others are not. Individual characteristics such as psychological and material resources contribute to resilience. At the community level, family, social support, participation and cohesion promote resilience. Finally, at the societal level, social and welfare services, finance, religion and social policy, are important factors. These different levels of resilience are co-dependent, and we illustrate how this is so. We suggest that older Colombians living in poverty often demonstrate resilience, but that more can be done to enhance their lives. This includes interventions at the individual and community levels alongside changes in social policy

The social and healthcare professional support drawn upon by women antenatally during the COVID-19 pandemic:A recurrent, cross-sectional, thematic analysis

Objective: To explore antenatal experiences of social and healthcare professional support during different phases of social distancing restriction implementation in the UK. Design: Semi-structured interviews were conducted via telephone or video-conferencing software between 13 July 2020 – 2 September 2020. Interviews were transcribed and a recurrent, cross-sectional, thematic analysis was conducted. Participants: Twelve antenatal women were interviewed during UK social distancing restrictions (Timepoint 1; T1) and a separate sample of twelve women were interviewed in the initial easing of these restrictions (Timepoint 2; T2). Findings: T1 themes were: ‘Maternity care as non-essential’ and ‘Pregnancy is cancelled’. T2 themes were: ‘Technology is a polarised tool’ and ‘Clinically vulnerable, or not clinically vulnerable? That is the question’. Key conclusions: At T1, anxieties were ascribed to the exclusion of partners from routine care, and to perceived insensitivity and aggression from the public. For T2, insufficient Governmental transparency led to disillusionment, confusion, and anger. Covert workplace discrimination also caused distress at T2. Across timepoints: deteriorated mental wellbeing was attributed to depleted opportunities to interact socially and scaled back maternity care. Implications for practice: Recommendations are made to: protect maternal autonomy; improve quality of mental health and routine care signposting; prioritise parental community support in the re-opening of ‘non-essential’ services; prioritise the option for face-to-face appointments when safe and legal; and protecting the rights of working mothers.</p

Emerging Infectious Disease leads to Rapid Population Decline of Common British Birds

Emerging infectious diseases are increasingly cited as threats to wildlife, livestock and humans alike. They can threaten geographically isolated or critically endangered wildlife populations; however, relatively few studies have clearly demonstrated the extent to which emerging diseases can impact populations of common wildlife species. Here, we report the impact of an emerging protozoal disease on British populations of greenfinch Carduelis chloris and chaffinch Fringilla coelebs, two of the most common birds in Britain. Morphological and molecular analyses showed this to be due to Trichomonas gallinae. Trichomonosis emerged as a novel fatal disease of finches in Britain in 2005 and rapidly became epidemic within greenfinch, and to a lesser extent chaffinch, populations in 2006. By 2007, breeding populations of greenfinches and chaffinches in the geographic region of highest disease incidence had decreased by 35% and 21% respectively, representing mortality in excess of half a million birds. In contrast, declines were less pronounced or absent in these species in regions where the disease was found in intermediate or low incidence. Also, populations of dunnock Prunella modularis, which similarly feeds in gardens, but in which T. gallinae was rarely recorded, did not decline. This is the first trichomonosis epidemic reported in the scientific literature to negatively impact populations of free-ranging non-columbiform species, and such levels of mortality and decline due to an emerging infectious disease are unprecedented in British wild bird populations. This disease emergence event demonstrates the potential for a protozoan parasite to jump avian host taxonomic groups with dramatic effect over a short time period

Sensitive, challenging, and difficult topics: Experiences and practical considerations for qualitative researchers

Qualitative researchers often engage in work addressing challenging, difficult, or sensitive topics and are consequently exposed to the participants’ narratives which may be emotionally charged, distressing, or compromising. These narratives occasionally rest heavy on a researcher’s conscience or may linger in the mind. Much literature has assessed how best to keep participants safe, but less attention has been given to how we keep researchers safe. We therefore document the following: (1) Our experiences of the issues presented by undertaking qualitative research involving challenging, difficult, or sensitive topics; and (2) Practical principles devised to overcome these issues, ensuring safety and wellbeing amongst researchers engaging in these types of qualitative research. We provide guidance for qualitative researchers of all levels of experience and expertise on how best to protect and support themselves, their colleagues, and other collaborating research staff, when undertaking qualitative research which might otherwise feel uncomfortable or overwhelming to tackle

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p&lt;0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p&lt;0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p&lt;0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP &gt;5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification