Love the One You’re With: Rejection and Trait Forgiveness Predict Partner Attraction

Rejection presents a strong belonging threat, but how do individuals regain a sense of belonging? Would you be more attracted to a partner in an existing relationship if you were rejected by others? Participants completed a measure of trait forgiveness and were then asked to write either about a time they were rejected or accepted by someone other than their romantic partner. After the rejection manipulation, participants completed questionnaires regarding their feelings toward their current romantic partners. Participants reported greater attraction to their partners following the rejection manipulation, and the effect was moderated by trait forgiveness. When participants possessed low levels of trait forgiveness, rejection resulted in greater attraction toward their partners. The results suggest that existing relationships may act as a buffer for unforgiving individuals who experience an interpersonal rejection by a third party.https://scholarscompass.vcu.edu/uresposters/1002/thumbnail.jp

Chemotherapy induced liver abnormalities: an imaging perspective

Treating patients undergoing chemotherapy who display findings of liver toxicity, requires a solid understanding of these medications. It is important for any clinician to have an index of suspicion for liver toxicity and be able to recognize it, even on imaging. Cancer chemotherapy has evolved, and newer medications that target cell biology have a different pattern of liver toxicity and may differ from the more traditional cytotoxic agents. There are several hepatic conditions that can result and keen clinical as well as radiographic recognition are paramount. Conditions such as sinusoidal obstructive syndrome, steatosis, and pseudocirrhosis are more commonly associated with chemotherapy. These conditions can display clinical signs of acute hepatitis, liver cirrhosis, and even liver failure. It is important to anticipate and recognize these adverse reactions and thus appropriate clinical action can be taken. Often times, patients with these liver manifestations can be managed with supportive therapies, and liver toxicity may resolve after discontinuation of chemotherapy

Community efforts to promote vaccine uptake in a rural setting: a qualitative interview study

Vaccine hesitancy has been identified as one of the top 10 threats to global health. The causes of low vaccine uptake are many and vary at micro and macro levels. However, rural and remote coastal areas in the UK experience unique vaccine inequalities due to high levels of deprivation and their unique and complex access-related problems. This study aimed to explore community efforts to promote vaccine uptake during the COVID-19 pandemic and understand how the COVID-19 vaccination campaign was experienced by the public. We conducted an exploratory descriptive qualitative study using semi-structured interviews with decision-makers, health professionals and community members in Lincolnshire, a predominantly rural county with a long coastline, a large population of white minority ethnicities, and those living in caravan and temporary housing. Data were analysed using conventional content analysis. Overcoming the various access barriers to vaccination uptake involved working with local media stations, local communities and local community groups, translation of information, bringing vaccines closer to the people through pop-up and mobile clinics and provision of transport and ensuring confidentiality. There is a need to employ inclusive targeted non-conventional care interventions whilst dealing with complex problems as occur in rural and remote coastal regions

"I decide myself"- A qualitative exploration of end of life decision making processes of patients and caregivers through Advance Care Planning

Background The Singapore national Advance Care Planning (ACP) programme was launched in 2011 with the purpose of ensuring that healthcare professionals are fully aware of patients’ treatment preferences. There is little research assessing the performance of such programmes in ethnically diverse Asian countries; hence, the purpose of this study was to qualitatively examine patients and caregivers’ experiences with the ACP programme. Method We conducted interviews with 28 participants, thirteen of whom identified as proxy decision makers (PDMs) and the remainder as patients. Interviews focused on respondents’ experiences of chronic illness and of participating in the ACP programme. Textual data was analysed through a framework analysis approach. Results Participants’ narratives focused on four major themes with 12 subthemes: a) Engagement with Death, factors influencing respondents’ acceptance of ACP; b) Formation of Preferences, the set of concerns influencing respondents’ choice of care; c) Choice of PDM, considerations shaping respondents’ choice of nominated health spokesperson; and d) Legacy Solidification, how ACP is used to ensure the welfare of the family after the patient passes. These findings led to our development of the directive decision-making process framework, which delineates personal and sociocultural factors influencing participants’ decision-making processes. Respondents’ continual participation in the intervention were driven by their personal belief system that acted as a lens through which they interpreted religious doctrine and socio-cultural norms according to their particular needs. Conclusion The directive decision-making process framework indicated that ACP could be appropriate for the Asian context because participants displayed an awareness of the need for ACP and were able to develop a concrete treatment plan. Patients in this study made decisions based on their perceived long-term legacy for their family, who they hoped to provide with a solid financial and psychological foundation after their death

Ethnicity and risk of SARS-CoV-2 infection among the healthcare workforce: Results of a retrospective cohort study in rural United Kingdom.

Background The reason why Black and South Asian healthcare workers are at a higher risk of SARS-CoV-2 infection remain unclear. We aim to quantify risk of SARS-CoV-2 infection among ethnic minority healthcare staff and elucidate pathways of infection. Methods A one-year-follow-up retrospective cohort study has been conducted among NHS employees working at 123 facilities in Lincolnshire, UK. Results Overall, 13,366 professionals were included. SARS-CoV-2 incidence per person-year was 5.2% [95%CI: 3.6%–7.6%] during the first COVID-19 wave (Jan-Aug 2020) and 17.2% [13.5%–22.0%] during the second wave (Sep 2020-Feb 2021). Compared to White staff, Black and South Asian employees were at higher risk of SARS-CoV-2 infection during both the first wave (HR, 1.58 [0.91-2.75] and 1.69 [1.07-2.66] respectively) and the second wave (HR 2.09 [1.57-2.76] and 1.46 [1.24-1.71]). Higher risk of SARS-CoV-2 infection persisted even after controlling for age, gender, pay grade, residence environment, type of work and time exposure at work. Higher adjusted risk of SARS-CoV-2 infection were also found among lower-paid health professionals. Conclusions Black and South Asian health workers continue to be more at risk of SARS-CoV-2 infection compared to their White counterparts. Urgent interventions are required to reduce SARS-CoV-2 infection in these ethnic groups

A Matter of Trust: Building COVID-19 Vaccine Confidence among Diverse Communities in Canada and the United Kingdom - Final Full Report to The British Academy

Over the course of the COVID-19 pandemic, the virus has undergone many mutations. Governments must continually update their health policies – often in seemingly contradictory terms – to protect the public from illness and death, and health systems from collapsing. This means persuading millions of people, not just once, but twice and three times each, to be vaccinated, while the virus and the messaging about it are in flux. The purpose of our ongoing research, in Canada and the United Kingdom (UK), is to learn what methods to date have worked to improve COVID-19 vaccine confidence among the public throughout the pandemic and to share this information with policymakers, public health officials, community decision-makers and contributors to public discourse. Our goal is to better understand how policy changes and mis/disinformation are experienced in communities with low vaccine confidence and to identify community level interventions that can be used to develop vaccine confidence. For this multiple methods study, our teams analysed and compared societal reception to COVID-19 vaccination policies, in particular the communication of those policies, across two distinct areas and populations, one in the UK and the other in Canada. Both areas studied had areas with lower vaccination rates and similar kinds of demographic subpopulations. We have characterized the evolution of relevant public health policies in terms of their content, context, actors and processes, seeking to learn more about how people understood and acted – or not – on COVID-19 health policy changes over time. We wanted to study which communication channels were used and how various populations responded to public health information and regulations; what other “unofficial” channels they may have used, for better or worse; and what community efforts might have built vaccine confidence among rural and urban communities. We, firstly, examined the policy evolution through a desk review. Our data sources included government websites and official social media, which were used to identify operational COVID-19 policy documents, guidelines, laws and regulations. Search results were indexed, extracted and inserted into a spreadsheet for each country, then policy categories were devised based on how the policies were framed. Secondly, we characterised response to these policies through a series of individual interviews conducted in the East Midlands region of England and in Waterloo, a small, southern-Ontario city in central Canada. Finally, we compared our policy review to our qualitative analysis to gain insights into the influence of policy on vaccine programme equity and coordination. Findings from the desk review indicated that Canada and the UK were able withstand uncertainty and fluctuations created by the global COVID-19 pandemic through adopting a proactive stance. They ensured that their respective populations were able to access vaccines through creating actors dedicated to overseeing vaccine specific policy, such as the vaccine task forces, and by adopting a multisectoral response with targeted funding. However, our findings also indicate that both Canada and the UK would have benefitted from more co-ordinated, consistent, and clear vaccine communications. When health policy makers tried to find the “perfect” way to communicate complex, changing information to the public, they tended to sow confusion and mistrust, creating vaccine hesitancy. Communicating evidence and data in widely accessible ways was important for engendering trust in the policies and processes. The believability of vaccine messages depended on the level of trust in who the messenger was. This varied between Canada and the UK and among different population groups, depending on the level of trust that was shown for politicians vs scientists vs public health doctors. Messaging had to be adapted and targeted for different communities, considering cultural and language differences. While community understanding mattered, approaches that explained the evidence and adopted a compassionate approach that emphasized individual benefits, as well as benefits for those close to an individual, were perceived as being more effective over the longer term than emphasizing community benefits to vaccination. In both countries, adopting an approach that was open, responsive, shared information and created autonomy was seen as more effective than handing policies down from a traditional, rigid hierarchy. In the UK, the framing of vaccination policy as “protect the NHS” had the unintended consequence of worsening access to health care in already deprived communities; doctors abandoned routine activities to prioritise the vaccination programme. Funding of “community championship” schemes in the UK was not proactive, undermining the effort needed to keep vaccine acceptance levels high. At the same time, the UK commissioned key studies that were very valuable in informing vaccine schedules, booster programmes and vaccination of pregnant people, among others, including in other countries such as Canada. With trust for the source and spokesperson at the centre of whether an individual would accept vaccine advice, we see a need for investment in public health outreach work that promotes good relationships with, and among, communities that may have low engagement with vaccination and other health care opportunities. Governments need to have transparent policies on vaccine approval processes that lay people can access and understand. Authentic, ethical statements about what vaccines can and cannot deliver need to be conceived and delivered in good faith. Transparency and open dialogue between the government and historically excluded groups must also be ongoing, as the sudden prioritizing of vaccination raised worries and mistrust in some. We suggest that further study is needed to interrogate the role of trust, especially trust in policy actors. Specifically, how can we expand our understanding of who is a trustworthy leader, especially if they are not in health care, the civil service or elected government? Which potentially important community actors are missing from the COVID-19 story? We have seen in this study that religious leaders can be trusted by many, for example, but what about the influence of women on health care action in communities? And at what point do people switch from wanting to do their duty as citizens of a country, to making a vaccine decision about themselves as individuals? We also suggest that health policy makers prioritise the widest possible global sharing of the best, clearest and most up-to-date scientific information about COVID-19 – and whatever virus comes next – to help reduce the mis/disinformation that spreads like wildfire on social media, creates mistrust and limits vaccine uptake. COVID-19 continues to show us that no individual is immune, even if they are vaccinated

A Matter of Trust: Building COVID-19 Vaccine Confidence Among Diverse Communities in Canada and the United Kingdom

COVID-19 infections are over-represented in ethnic minority groups and other deprived communities while low uptake levels for COVID-19 vaccines are observed in the same groups. The uptake of a vaccine depends not only on its perceived safety and effectiveness profile but also on how well vaccination policies are communicated by policy makers and subsequently implemented by practitioners. Scarcity of what was known about COVID-19 and its novel vaccines meant COVID-19 vaccination policies evolved quickly. We analysed how changes in government policies on COVID-19 vaccination in the UK (England) and Canada (Ontario) were communicated and experienced by diverse communities

HIV and adolescents: focus on young key populations

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138345/1/jia20076.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138345/2/jia20076-sup-0001.pd

Acceptability of a microfinance-based empowerment intervention for transgender and cisgender women sex workers in Greater Kuala Lumpur, Malaysia

Introduction: Cisgender and transgender woman sex workers (CWSWs and TWSWs, respectively) are key populations in Malaysia with higher HIV‐prevalence than that of the general population. Given the impact economic instability can have on HIV transmission in these populations, novel HIV prevention interventions that reduce poverty may reduce HIV incidence and improve linkage and retention to care for those already living with HIV. We examine the feasibility of a microfinance‐based HIV prevention intervention among CWSW and TWSWs in Greater Kuala Lumpur, Malaysia. Methods: We conducted 35 in‐depth interviews to examine the acceptability of a microfinance‐based HIV prevention intervention, focusing on: (1) participants’ readiness to engage in other occupations and the types of jobs in which they were interested in; (2) their level of interest in the components of the potential intervention, including training on financial literacy and vocational education; and (3) possible barriers and facilitators to the successful completion of the intervention. Using grounded theory as a framework of analysis, transcripts were analysed through Nvivo 11. Results: Participants were on average 41 years old, slightly less than half (48%) were married, and more than half (52%) identified as Muslim. Participants express high motivation to seek employment in other professions as they perceived sex work as not a “proper job” with opportunities for career growth but rather as a short‐term option offering an unstable form of income. Participants wanted to develop their own small enterprise. Most participants expressed a high level of interest in microfinance intervention and training to enable them to enter a new profession. Possible barriers to intervention participation included time, stigma, and a lack of resources. Conclusion: Findings indicate that a microfinance intervention is acceptable and desirable for CWSWs and TWSWs in urban Malaysian contexts as participants reported that they were ready to engage in alternative forms of income generation