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A growing body of research has demonstrated that teachers' judgements may be biased by the demographics and characteristics of the students they teach. However, less work has investigated the contexts in which teachers may be most vulnerable to bias. In two pre-registered experimental studies we explored whether the quality of students' work, and the cognitive load placed on the grader, would influence the emergence of biases relating to socioeconomic status (SES) and ethnicity. In Study 1, teachers (N = 397) graded work of either high or low quality that had ostensibly been written by a student who varied in terms of SES and ethnicity. We found that SES and--to a lesser extent--ethnicity biases were more likely to manifest when the standard of work was below average, largely favouring a student from an affluent White background. In Study 2, an undergraduate sample (N = 334) provided judgements based on an identical piece of work written by a student who varied by SES and ethnicity. Importantly, they formulated these judgements whilst working under high or low cognitive load, which was manipulated via a simultaneous listening task. Results showed that under high cognitive load, a student from an affluent White British background was afforded a boost in grading that was not afforded to Black Caribbean and/or lower SES students. These findings highlight contexts in which teachers may be most prone to biased judgements and should be used by educational institutions to de-bias their workflows, workloads and workforces.

Previous research indicates that discipline identification -- the level of integration of one's discipline of study into the self-concept -- is associated with deep approaches to learning and academic self-efficacy. However, it is not known whether these relationships would hold in the context of learning during the COVID-19 pandemic. The present study investigates this, as well as exploring whether belonging, identity incompatibility, and virtual and in-person time spent with fellow students and with faculty act as potential antecedents of discipline identification. A cross-sectional online survey with n = 385 students in the UK was conducted during the spring term (February-May) of the 2019-2020 academic year, when UK universities were under COVID-19 restrictions. Of those students, n = 109 completed a follow-up survey during the autumn term (September-December) of the 2020-2021 academic year. Due to pandemic-related changes, the two waves of data were analysed separately using path analysis. During the spring term, identity incompatibility and discipline identification were significantly associated with both deep approaches to learning and academic self-efficacy. There were also significant indirect effects of belonging on both deep approaches to learning and academic self-efficacy via discipline identification. During the autumn term, discipline identification was again significantly associated with both academic outcomes. Identity incompatibility was significantly associated with academic self-efficacy. There were also indirect effects of identity incompatibility and belonging on deep approaches to learning via discipline identification. These results add to the literature on the importance of discipline identification and associated social-psychological processes in predicting important higher education outcomes during the COVID-19 pandemic.

Teachers' judgements and interactions may be influenced by the backgrounds of their students, yet research shows that they may be reluctant to accept evidence relating to such biases. We investigated teachers' perceptions of their own and others' biases and explored whether a brief self-affirmation manipulation--which tends to reduce defensive responding-- could increase their acknowledgement of personal and institutional bias. UK-based teachers (N = 288) completed either a values affirmation or control task before reading a mildly threatening research-based article about unconscious bias in education. Overall, teachers exhibited a "bias blind spot," whereby they were more likely to perceive unconscious bias as an issue for other teachers to contend with rather than as a concern for themselves. Self-affirmed teachers were more likely to agree to have their teaching filmed to explore if/where personal biases may exist. Nevertheless, the self-affirmation did not alter levels of overall acceptance of the issue or perceptions of personal relevance. Exploratory analyses suggested that greater support for equity-enhancing teaching practices among teachers was associated with increased acknowledgement of bias and support for anti-bias initiatives. The findings suggest that self-affirmation may offer limited scope for improving acknowledgement of biases and that more work needs to be done to challenge and change the narrative of prejudice in schooling, from one that concerns only a few 'bad apples' to one that is accepted as an issue for all educators to be aware of and responsible for.

ABSTRACTBackground: Healthcare workers (HCWs) across the globe have reported symptoms of Post-Traumatic Stress Disorder (PTSD) during the COVID-19 pandemic. Moral Injury (MI) has been associated with PTSD in military populations, but is not well studied in healthcare contexts. Moral Distress (MD), a related concept, may enhance understandings of MI and its relation to PTSD among HCWs. This study examined the independent and combined impact of MI and MD on PTSD symptoms in Canadian HCWs during the pandemic.Methods: HCWs participated in an online survey between February and December 2021, with questions regarding sociodemographics, mental health and trauma history (e.g. MI, MD, PTSD, dissociation, depression, anxiety, stress, childhood adversity). Structural equation modelling was used to analyze the independent and combined impact of MI and MD on PTSD symptoms (including dissociation) among the sample when controlling for sex, age, depression, anxiety, stress, and childhood adversity.Results: A structural equation model independently regressing both MI and MD onto PTSD accounted for 74.4% of the variance in PTSD symptoms. Here, MI was strongly and significantly associated with PTSD symptoms (β = .412, p

BACKGROUND: Given the highly stressful environment surrounding the SARS-CoV-2 pandemic, healthcare workers (HCW) and public safety personnel (PSP) are at an elevated risk for adverse psychological outcomes, including posttraumatic stress disorder (PTSD) and alcohol/substance use problems. As such, the study aimed to identify associations between PTSD severity, related dissociation and emotion dysregulation symptoms, and alcohol/substance use problems among HCWs and PSP. METHODS: A subset of data (N = 498; HCWs = 299; PSP = 199) was extracted from a larger study examining psychological variables among Canadian HCWs and PSP during the pandemic. Structural equation modelling assessed associations between PTSD symptoms and alcohol/substance use-related problems with dissociation and emotion dysregulation as mediators. RESULTS: Among HCWs, dissociation fully mediated the relation between PTSD and alcohol-related problems (indirect effect β = .133, p = .03) and emotion dysregulation partially mediated the relation between PTSD and substance-related problems (indirect effect β = .151, p = .046). In PSP, emotion dysregulation fully mediated the relation between PTSD and alcohol-related problems (indirect effects β = .184, p = .005). For substance-related problems among PSP, neither emotion dysregulation nor dissociation (ps >.05) had any effects. CONCLUSION: To our knowledge, this is the first study examining associations between PTSD severity and alcohol/substance use-related problems via mediating impacts of emotion dysregulation and dissociation among HCWs and PSP during the SARS-CoV-2 pandemic. These findings highlight dissociation and emotion dysregulation as important therapeutic targets for structured interventions aimed at reducing the burden of PTSD and/or SUD among Canadian HCWs or PSP suffering from the adverse mental health impacts of the SARS-CoV-2 pandemic.

Background: Educational outcomes in the United Kingdom vary as a function of students' family background, with those of lower socioeconomic status (SES) and certain ethnic minority groups among the worst affected. Aims: This pre-registered study investigates: (i) whether knowledge about students' socioeconomic and ethnic background influences teachers' judgements about the quality of their work and potential for the future, and (ii) the role of teachers' beliefs--most notably about meritocracy--in their practices. Sample: Our findings are based on the responses of 416 in-service (88%) and trainee (12%) teachers who successfully passed several stringent exclusion criteria. Methods: As part of a 2 × 2 independent measures design, teachers were randomly assigned to assess an identical piece of work ostensibly written by a student who varied by SES (higher vs. lower) and ethnicity (White British vs. Black Caribbean). Following this, they responded to several measures assessing their beliefs about education. Results: Teachers judged students of lower SES to be inferior to students of higher SES across a range of indicators. By contrast, we found no evidence of racial bias in teachers' judgements, though potential reasons for this are discussed. Teachers who believed that schooling is meritocratic were significantly less likely to support equity-enhancing teaching practices and initiatives. Conclusions: Unconscious teacher biases and beliefs may be contributing to the relative underperformance of students from poorer backgrounds. These findings provide a mandate for educational institutions to help teachers reflect upon, and develop the skills required to mitigate potentially harmful biases.

The current research aimed to evaluate UK student mental health during the first 4 months of the COVID-19 pandemic. Specifically, we were interested in exploring factors that contribute to students' anxiety levels about COVID-19. Demographics, mental health symptomatology and well-being-related variables were tested as predictors of COVID-19 anxiety. A cross-sectional online survey was completed by 1,164 UK university students (71.8% females). Measures included self-reported data on stress, social phobia, anxiety, depression, psychotic-like experiences, hopefulness, group membership, social identity, belonging, loneliness, COVID-19 related variables and demographics. The majority of participants were between 18 and 24 years old (92.2%), White British (57.9%) and in the first or second year of their course study (63.12%). A series of multiple linear regressions revealed that being female, experiencing more stress and anxiety, and greater worry about COVID-19 and its effects on social relationships were significant in explaining students' pandemic-related anxiety. Students' level of pandemic-related anxiety was independent of ethnicity, socioeconomic background and pre-existing mental health problems. Worrying about the future was the most common pandemic-related stressor, but it was not a significant predictor of COVID-19 anxiety. Our findings are in line with previous findings that females and students experiencing more stress have been disproportionately affected by the COVID-19 pandemic. Our findings could inform the delivery of targeted stress-management interventions that might prove beneficial for student wellbeing.

Objective: School closures due to the COVID-19 pandemic left millions of pupils to continue their education at home. We investigated gender and socioeconomic inequalities in pupils' home learning, and some mechanisms underlying those inequalities. Method: We analysed online survey responses from 3,167 parents collected between May and July 2020 in the UK, when most schools were closed. Results: Boys, pupils who were eligible for free school meals (FSM), pupils from families that were financially struggling, and pupils whose parents had not graduated from university were less engaged and spent less time home learning. Pupils of non-graduate parents found home learning challenging because they were less likely to have someone in their home who could supervise their work. Pupils eligible for FSM and from financially struggling families found home learning challenging because of noise, a lack of space, lack of technology and insufficient internet in their homes. The quality of educational resources schools provided positively predicted engagement and learning for all pupils. Conclusion: Pupils from lower socioeconomic status families and boys were less involved with home learning, although for different reasons. We discuss how these findings can inform policy and practice to reduce educational inequalities resulting from school closures.

Viral haemorrhagic fevers (VHF) pose a significant threat to human health. In recent years, VHF outbreaks caused by Ebola, Marburg and Lassa viruses have caused substantial morbidity and mortality in West and Central Africa. In 2022, an Ebola disease outbreak in Uganda caused by Sudan virus resulted in 164 cases with 55 deaths. In 2023, a Marburg disease outbreak was confirmed in Equatorial Guinea and Tanzania resulting in over 49 confirmed or suspected cases; 41 of which were fatal. There are no clearly defined correlates of protection against these VHF, impeding targeted vaccine development. Any vaccine developed should therefore induce strong and preferably long-lasting humoral and cellular immunity against these viruses. Ideally this immunity should also cross-protect against viral variants, which are known to circulate in animal reservoirs and cause human disease. We have utilized two viral vectored vaccine platforms, an adenovirus (ChAdOx1) and Modified Vaccinia Ankara (MVA), to develop a multi-pathogen vaccine regime against three filoviruses (Ebola virus, Sudan virus, Marburg virus) and an arenavirus (Lassa virus). These platform technologies have consistently demonstrated the capability to induce robust cellular and humoral antigen-specific immunity in humans, most recently in the rollout of the licensed ChAdOx1-nCoV19/AZD1222. Here, we show that our multi-pathogen vaccines elicit strong cellular and humoral immunity, induce a diverse range of chemokines and cytokines, and most importantly, confers protection after lethal Ebola virus, Sudan virus and Marburg virus challenges in a small animal model.

Achieving global elimination of hepatitis C virus requires a substantial scale-up of testing. Point-of-care HCV viral load assays are available as an alternative to laboratory-based assays to promote access in hard to reach or marginalized populations. The diagnostic performance and lower limit of detection are important attributes of these new assays for both diagnosis and test of cure. Therefore, our objective was to determine an acceptable LLoD for detectable HCV viraemia as a test for cure, 12 weeks post-treatment (SVR12). We assembled a global data set of patients with detectable viraemia at SVR12 from observational databases from 9 countries (Egypt, the United States, United Kingdom, Georgia, Ukraine, Myanmar, Cambodia, Pakistan, Mozambique) and two pharmaceutical-sponsored clinical trial registries. We examined the distribution of HCV viral load at SVR12 and presented the 90th, 95th, 97th and 99th percentiles. We used logistic regression to assess characteristics associated with low-level virological treatment failure (defined as

IntroductionRespiratory therapists (RTs) faced morally distressing situations throughout the COVID-19 pandemic, including working with limited resources and facilitating video calls for families of dying patients. Moral distress is associated with a host of adverse psychological and functional outcomes (e.g. depression, anxiety, symptoms of posttraumatic stress disorder [PTSD] and functional impairment) and consideration of position departure. The purpose of this study was to understand the impact of moral distress and its associated psychological and functional outcomes on consideration to leave a clinical position among Canadian RTs during the COVID-19 pandemic. MethodsCanadian RTs (N = 213) completed an online survey between February and June 2021. Basic demographic information (e.g. age, sex, gender) and psychometrically validated measures of moral distress, depression, anxiety, stress, PTSD, dissociation, functional impairment, resilience and adverse childhood experiences were collected. ResultsOne in four RTs reported considering leaving their position. RTs considering leaving reported elevated levels of moral distress and adverse psychological and functional outcomes compared to RTs not considering leaving. Over half (54.5%) of those considering leaving scored above the cut-off for potential diagnosis of PTSD. Previous consideration to leave a position and having left a position in the past each significantly increased the odds of currently considering leaving, along with system-related moral distress and symptoms of PTSD, but the contribution of these latter factors was small. ConclusionCanadian RTs considering leaving their position reported elevated levels of distress and adverse psychological and functional outcomes, yet these individual-level factors appear unlikely to be the primary factors underlying RTs’ consideration to leave, because their effects were small. Further research is required to identify broader, organizational factors that may contribute to consideration of position departure among Canadian RTs.

IntroductionLes thérapeutes respiratoires ont été confrontés à des situations moralement difficiles tout au long de la pandémie de COVID-19, en particulier le fait d’avoir peu de ressources pour effectuer leur travail ou encore la participation à des appels vidéo avec les familles de patients mourants. La détresse morale est associée à une foule de conséquences psychologiques et fonctionnelles négatives (dépression, anxiété, symptômes du trouble de stress post-traumatique [TSPT], déficience fonctionnelle, etc.) et au fait d’envisager de quitter son poste. L’objectif de cette étude était de comprendre l’effet de la détresse morale et de ses conséquences psychologiques et fonctionnelles sur le fait que des thérapeutes respiratoires canadiens aient envisagé de quitter leur poste clinique pendant la pandémie de COVID-19. MéthodologieDes thérapeutes respiratoires canadiens (N = 213) ont répondu à un sondage en ligne entre février et juin 2021. Des caractéristiques inividuelles de base (âge, sexe/genre, etc.) ont été recueillies, ainsi que des mesures psychométriques validées de la détresse morale, de la dépression, de l’anxiété, du stress, du TSPT, de la dissociation, de la déficience fonctionnelle, de la résilience et des expériences négatives vécues durant l’enfance. RésultatsUn thérapeute respiratoire sur quatre a déclaré envisager de quitter son poste. Ceux qui envisageaient de le faire ont fait état de niveaux élevés de détresse morale et de conséquences psychologiques et fonctionnelles négatives comparativement aux thérapeutes respiratoires qui n’envisageaient pas de quitter leur poste. Plus de la moitié (54,5 %) de ceux qui envisageaient de quitter leur poste ont obtenu un score supérieur au seuil indiquant un diagnostic potentiel de TSPT. Le fait d’avoir déjà envisagé de quitter un poste auparavant et le fait d’avoir effectivement quitté un poste antérieur augmentaient significativement la probabilité d’envisager de quitter son poste, tout comme la détresse morale liée au système et les symptômes de TSPT, mais la contribution de ces derniers facteurs était faible. ConclusionLes thérapeutes respiratoires canadiens qui envisageaient de quitter leur poste ont signalé des niveaux élevés de détresse et de conséquences psychologiques et fonctionnelles négatives. Il semble néanmoins peu probable que ces facteurs individuels soient les principaux facteurs pour lesquels ils envisageaient de quitter leur poste, car les effets en étaient faibles. D’autres recherches sont nécessaires pour cerner les facteurs organisationnels plus vastes susceptibles d’inciter les thérapeutes respiratoires canadiens à vouloir quitter leur poste.

Chikungunya virus (CHIKV) is a mosquito-borne alphavirus causing a debilitating febrile illness with rheumatic disease symptoms of arthralgia and arthritis. Since its spread outside of Africa in 2005, it continues to cause outbreaks and disseminates into new territories. Intervention strategies are urgently required, including vaccination and antiviral approaches. To test efficacy, the use of small animal models is required. Two mouse strains, A129, with a deficiency in their type-I interferon (IFN) receptor, and C57BL/6 are widely used. A direct comparison of these strains alongside the wild-type parental strain of the A129 mice, 129Sv/Ev, was undertaken to assess clinical disease progression, viral loads in key tissues, histological changes and levels of sera biomarkers. Our results confirm the severe disease course in A129 mice which was not observed in the parental 129Sv/Ev strain. Of the two wild-type strains, viral loads were higher in 129Sv/Ev mice compared to C57BL/6 counterparts. Our results have established these models and parameters for the future testing of vaccines and antiviral approaches.

Previous research has linked working for pay while attending university with negative academic and health outcomes; yet, working students are often resilient when experiencing such adverse circumstances. This makes it crucial to explore potential psychological mechanisms that transform adverse experiences into sources of motivation and persistence for working students. We explore one mechanism—social identification—and its different foci—identifying as a student, employee, working student, or a student of one’s discipline of study—as potential predictors of important academic (academic self-efficacy, approaches to learning, and academic achievement) and social (status in society) outcomes in three cross-sectional studies. In Study 1, part-time working hours (but not identification processes) were associated with academic self-efficacy. In Study 2, discipline identification and part-time working hours were associated with using deep approaches to learning. In Study 3, student identification was associated with increased status in society. Overall, discipline identification may be solely linked to academic outcomes, but student identification should be explored further as a potential enhancer of social and graduate outcomes. We discuss additional mechanisms that can help to transform working students’ experiences through their social identities and suggest boundary conditions that can affect the link between these identities and important outcomes.

University students in paid employment have less time for studying, report more stress, and participate in fewer extracurricular activities than non-employed students. These negative outcomes that result from combining work and study can cause employed students to experience the domains of work, study, and social life as practically incompatible, but also to experience a sense of identity incompatibility. Therefore, we used insights from previous quantitative and qualitative data on employed students and previous work on identity incompatibility to generate two research questions (RQs): RQ1. What type(s) of incompatibility (practical, identity or other) do employed students experience? and RQ2. What strategies have they adopted to reduce the experienced incompatibility? In order to answer these questions, we performed a thematic analysis with a deductive approach on transcripts from 21 UK university students who we interviewed. The students reported two types of incompatibilities: practical incompatibility, which stems from the lack of time, lack of energy, and lack of social contact associated with combining work and study; and identity incompatibility, which emanates from status differences and differences between one's own and others' perception of oneself. In order to reduce or resolve these incompatibilities, the students also developed practical (e.g. taking paid leave) and cognitive (e.g. compartmentalising contexts) strategies. Finally, the students also noted how the experience of practical incompatibility can reaffirm their values of hard work and productivity and make them resilient learners.

Background: School students who are eligible for reduced or free school meals (FSM) -- an indicator of economic disadvantage -- have lower academic attainment than their peers. Aims: We investigated whether identity compatibility -- the perceived compatibility between one's social identities and the stereotype of a high-achieving student -- contributes to this socioeconomic attainment gap, and whether the association between socioeconomic status and identity compatibility is moderated by school context. Sample: Our sample was 4,629 students aged 15-16 years old across 29 schools in England. Method: We assessed students' perceptions of identity compatibility via self-report questionnaires 8 months prior to them taking national, standardized exams. Results: Multilevel regression analyses revealed a negative indirect effect from eligibility for FSM to exam results via identity compatibility. These effects existed even while accounting for students' gender and language status, other psychological variables known to predict academic attainment, and their previous exam results. Furthermore, school context moderated the relationship between FSM eligibility and identity compatibility. In line with the identities in context model of educational inequalities, there was a significant negative association between FSM and identity compatibility only for students attending schools in which there was previously a relatively large socioeconomic attainment gap. Conclusions: Our results demonstrate the importance of social psychological variables in explaining educational inequalities, and of the local educational context in determining the educational experience of students from lower socioeconomic status backgrounds.

Abstract The development of new therapies against SARS-CoV-2 is required to extend the toolkit of intervention strategies to combat the global pandemic. In this study, hyperimmune plasma from sheep immunised with whole spike SARS-CoV-2 recombinant protein has been used to generate candidate products. In addition to purified IgG, we have refined candidate therapies by removing non-specific IgG via affinity binding along with fragmentation to eliminate the Fc region to create F(ab′)2 fragments. These preparations were evaluated for in vitro activity and demonstrated to be strongly neutralising against a range of SARS-CoV-2 strains, including Omicron B2.2. In addition, their protection against disease manifestations and viral loads were assessed using a hamster SARS-CoV-2 infection model. Results demonstrated protective effects of both IgG and F(ab′)2, with the latter requiring sequential dosing to maintain in vivo activity due to rapid clearance from the circulation.

Abstract Background Achieving World Health Organization (WHO) targets for viral hepatitis elimination will require simplification and decentralisation of care, supported through task-shifting and training of non-specialist frontline healthcare workers. To inform development of national health worker trainings in viral hepatitis, we review and summarise available online and workshop trainings for management of hepatitis B virus (HBV) and hepatitis C virus (HCV). Methods We performed a systematic search of PubMed, Embase, Web of Science, conference abstracts, and grey literature using Google to identify online and in-person workshop trainings for health workers focused on HBV and/or HCV. Additional trainings were identified through a WHO regional network. We included online trainings written in English and in-person workshops developed for low-and-middle-income countries (LMICs). Available curricula are summarised together with key operational features (e.g. training length, year developed/updated, developing institution) and programmatic features (e.g. content, mechanism for self-assessment, use of clinical case studies). Results A total of 30 trainings met our inclusion criteria (10 online trainings; 20 in-person workshops). 50% covered both HBV and HCV, 13% HBV alone and 37% HCV alone. Among online trainings, only 2 (20%) were specifically developed or adapted for LMICs; 70% covered all aspects of hepatitis care, including prevention, assessment, and treatment; 9 (90%) included guidance on when to refer to specialists, and 6 (60%) included modules on management in specific populations (e.g., people who inject drugs [PWID], prisoners, and children). Online trainings used different formats including text-based modules, narrated slide-sets, and interactive web-based modules. Most workshops (95%) were targeted towards non-specialty providers, and 50% were an integral part of a national strategy for viral hepatitis elimination. Workshop length ranged from several hours to multiple sessions over the course of months, and many were part of a blended educational model, which included other opportunities for ongoing learning (e.g., telementorship). Conclusion This compendium of online and in-person workshop trainings for HBV and HCV is a useful resource for national hepatitis programmes developing training curricula for non-specialists. Additional online training curricula are needed for use in LMICs, and additional materials are needed to address management challenges in key populations, such as PWID.

Abstract Background Telementorship has emerged as an innovative strategy to decentralise medical knowledge and increase healthcare capacity across a wide range of disease processes. We report the global experience with telementorship to support healthcare workers delivering hepatitis B virus (HBV) and hepatitis C virus (HCV) care and treatment. Methods In early 2020, we conducted a survey of HBV and HCV telementorship programmes, followed by an in-depth interview with programme leads. Programmes were eligible to participate if they were located outside of the United States (U.S.), focused on support to healthcare workers in management of HBV and/or HCV, and were affiliated with or maintained adherence to the Project ECHO model, a telementorship programme pioneered at the University of New Mexico. One programme in the U.S., focused on HCV treatment in the Native American community, was purposively sampled and invited to participate. Surveys were administered online, and all qualitative interviews were performed remotely. Descriptive statistics were calculated for survey responses, and qualitative interviews were assessed for major themes. Results Eleven of 18 eligible programmes completed the survey and follow up interview. Sixty-four percent of programmes were located at regional academic medical centers. The majority of programmes (64%) were led by hepatologists. Most programmes (82%) addressed both HBV and HCV, and the remainder focused on HCV only. The median number of participating clinical spoke sites per programme was 22, and most spoke site participants were primary care providers. Most ECHO sessions were held monthly (36%) or bimonthly (27%), with sessions ranging from 45 min to 2 h in length. Programme leaders identified collective learning, empowerment and collaboration to be key strengths of their telementorship programme, while insufficient funding and a lack of protected time for telementorship leaders and participants were identified as major barriers to success. Conclusion The Project ECHO model for telementorship can be successfully implemented across high and low-and-middle-income countries to improve provider knowledge and experience in management of viral hepatitis. There is a tremendous opportunity to further expand upon the existing experience with telementorship to support non-specialist healthcare workers and promote elimination of viral hepatitis.

Systematic reviews (SRs) employ standardized methodological processes for synthesizing empirical evidence to answer specific research questions. These processes include rigorous screening phases to determine eligibility of articles against strict inclusion and exclusion criteria. Despite these processes, SRs are a significant undertaking, and this type of research often necessitates extensive human resource requirements, especially when the scope of the review is large. Given the substantial resources and time commitment required, we investigated a way in which the screening process might be accelerated while maintaining high fidelity and adherence to SR processes. More recently, researchers have turned to artificial intelligence-based (AI) software to expedite the screening process. This paper evaluated the agreement and usability of a novel machine learning program, Sciome SWIFT-ActiveScreener (ActiveScreener), in a large SR of mental health outcomes following treatment for PTSD. ActiveScreener exceeded the expected 95% agreement of the program with screeners to predict inclusion or exclusion of relevant articles at the title/abstract assessment phase of the review and was reported to be user friendly by both novice and seasoned screeners. ActiveScreener, when used appropriately, may be a useful tool when performing SR in a clinical context.

Sex workers’ humor has received comparatively little attention in the literature to date, and work that does consider this phenomenon focuses on humor in face-to-face contexts. Increasingly, elements of sex workers’ labor and community building take place online. This article examines the emergence of sex work humor in online spaces, considering how this humor provides evidence of resilience within this community. The article uses a critical discourse analysis approach blended with a cultural studies lens to examine 171 discrete texts drawn from sex work communities in Australia and New Zealand. These include social media postings from peer-led organizations and correspondence between sex workers and their clients, which was profiled in news media during the COVID-19 lockdowns. The humor evident within these texts falls into three major categories: humor about clients; humor as a mechanism of discussing stigma and discrimination; and humor as an agent of activism and social change. The findings indicate that humor can be evidence of resilience among sex-working communities, that it is politically productive and effective from a communications perspective, and present the possibility that it may also contribute to resilience. The presence of humor in online sex work spaces of sociality further highlights the importance of these spaces for community building, and draws attention to additional harms created by deplatforming.

Abstract Background Since the onset of the COVID-19 pandemic, overdose rates in North America have continued to rise, with more than 100,000 drug poisoning deaths in the past year. Amidst an increasingly toxic drug supply, the pandemic disrupted essential substance use treatment and harm reduction services that reduce overdose risk for people who use drugs. In British Columbia, one such treatment is injectable opioid agonist treatment (iOAT), the supervised dispensation of injectable hydromorphone or diacetylmorphine for people with opioid use disorder. While evidence has shown iOAT to be safe and effective, it is intensive and highly regimented, characterized by daily clinic visits and provider–client interaction—treatment components made difficult by the pandemic. Methods Between April 2020 and February 2021, we conducted 51 interviews with 18 iOAT clients and two clinic nurses to understand how the pandemic shaped iOAT access and treatment experiences. To analyze interview data, we employed a multi-step, flexible coding strategy, an iterative and abductive approach to analysis, using NVivo software. Results Qualitative analysis revealed the ways in which the pandemic shaped clients’ lives and the provision of iOAT care. First, client narratives illuminated how the pandemic reinforced existing inequities. For example, socioeconomically marginalized clients expressed concerns around their financial stability and economic impacts on their communities. Second, clients with health comorbidities recognized how the pandemic amplified health risks, through potential COVID-19 exposure or by limiting social connection and mental health supports. Third, clients described how the pandemic changed their engagement with the iOAT clinic and medication. For instance, clients noted that physical distancing guidelines and occupancy limits reduced opportunities for social connection with staff and other iOAT clients. However, pandemic policies also created opportunities to adapt treatment in ways that increased patient trust and autonomy, for example through more flexible medication regimens and take-home oral doses. Conclusion Participant narratives underscored the unequal distribution of pandemic impacts for people who use drugs but also highlighted opportunities for more flexible, patient-centered treatment approaches. Across treatment settings, pandemic-era changes that increase client autonomy and ensure equitable access to care are to be continued and expanded, beyond the duration of the pandemic.

This paper describes an independently evaluated randomised controlled trial of a self-affirmation intervention, replicating earlier studies, mostly conducted in the US with ethnic minority students. Self-affirmation theory suggests that some stigmatised groups, such as those from ethnic minority or poor families, face stereotype threats which undermine their academic performance. Engaging in value affirmation writing activities when such threats are most salient can give individuals a positive sense of value, negating harmful feelings, and fostering academic learning. The present study, involving 10,807 pupils aged 14 to 16 in England showed that the intervention can be successfully replicated with children from low socioeconomic backgrounds in England. The analysis showed positive effects for the intervention group. Pupils who completed more exercises also performed better. The findings are worth consideration given that it costs virtually nothing and does no harm.

Background: Potentially morally injurious experiences (PMIEs) are common during military service. However, it is unclear to what extent PMIEs are related to well-established adverse mental health outcomes. Objective: The objective of this study was to use a population-based survey to determine the associations between moral injury endorsement and the presence of past-year mental health disorders in Canadian Armed Forces (CAF) personnel and Veterans. Methods: Data were obtained from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS). With a sample of 2,941 respondents, the weighted survey sample represented 18,120 active duty and 34,380 released CAF personnel. Multiple logistic regressions were used to assess the associations between sociodemographic characteristics (e.g. sex), military factors (e.g. rank), moral injury (using the Moral Injury Events Scale [MIES]) and the presence of specific mental health disorders (major depressive episode, generalized anxiety disorder, panic disorder, social anxiety disorder, PTSD, and suicidality). Results: While adjusting for selected sociodemographic and military factors, the odds of experiencing any past-year mental health disorder were 1.97 times greater (95% CI = 1.94–2.01) for each one-unit increase in total MIES score. Specifically, PTSD had 1.91 times greater odds (95% CI = 1.87–1.96) of being endorsed for every unit increase in MIES total score, while odds of past-year panic disorder or social anxiety were each 1.86 times greater (95% CI = 1.82–1.90) for every unit increase in total MIES score. All findings reported were statistically significant (p < .001). Conclusion: These findings emphasize that PMIEs are robustly associated with the presence of adverse mental health outcomes among Canadian military personnel. The results of this project further underscore the necessity of addressing moral injury alongside other mental health concerns within the CAF.

Background: Given the highly stressful environment surrounding the SARS-CoV-2 pandemic, healthcare workers (HCW) and public safety personnel (PSP) are at an elevated risk for adverse psychological outcomes, including posttraumatic stress disorder (PTSD) and alcohol/substance use problems. As such, the study aimed to identify associations between PTSD severity, related dissociation and emotion dysregulation symptoms, and alcohol/substance use problems among HCWs and PSP. Methods: A subset of data (N = 498; HCWs = 299; PSP = 199) was extracted from a larger study examining psychological variables among Canadian HCWs and PSP during the pandemic. Structural equation modelling assessed associations between PTSD symptoms and alcohol/substance use-related problems with dissociation and emotion dysregulation as mediators. Results: Among HCWs, dissociation fully mediated the relation between PTSD and alcohol-related problems (indirect effect β = .133, p = .03) and emotion dysregulation partially mediated the relation between PTSD and substance-related problems (indirect effect β = .151, p = .046). In PSP, emotion dysregulation fully mediated the relation between PTSD and alcohol-related problems (indirect effects β = .184, p = .005). For substance-related problems among PSP, neither emotion dysregulation nor dissociation (ps >.05) had any effects. Conclusion: To our knowledge, this is the first study examining associations between PTSD severity and alcohol/substance use-related problems via mediating impacts of emotion dysregulation and dissociation among HCWs and PSP during the SARS-CoV-2 pandemic. These findings highlight dissociation and emotion dysregulation as important therapeutic targets for structured interventions aimed at reducing the burden of PTSD and/or SUD among Canadian HCWs or PSP suffering from the adverse mental health impacts of the SARS-CoV-2 pandemic.

Abstract Background Nursing home (NH) residents’ experiences are embedded within their relationships to others. Our objectives were to describe how residents and care partners (family or staff members) jointly construct, discuss, and act on care priorities. Methods We used Action-Project Method, a qualitative method focused on action within social context. We recruited 15 residents and 12 care partners (5 family and 7 staff members) from 3 urban NHs in Alberta, Canada. Residents and care partners participated in a video-recorded conversation about their experiences in the NH, then individually reviewed the video-recording to add context to the conversation. Following transcription, preliminary narrative construction, and participant feedback, the research team conducted in-depth analysis to identify participant actions, goals, and projects, including those jointly shared by dyad members. Results All participants’ intentions could be broadly described as “making time in the NH as good as possible” and projects were grouped into five categories: resident identity, relationships (both presence and absence), advocacy, positivity, and respectful care. Participants often raised issues of short-staffing as a significant barrier to respectful care. Care partners, especially staff, used positivity to redirect residents from difficult topics. Joint projects could be identified in some, but not all, cases. Conclusions We found that maintaining a sense of identity, fostering relationships, and receiving respectful care were important to residents but that short-staffing created barriers. Methods to capture these aspects of the resident experience are needed but should not be influenced by care partners’ tendency towards positivity in resident interactions.

Abstract Background To inform the development of updated World Health Organization (WHO) guidelines on simplified service delivery for HCV infection, a global survey was undertaken among people affected or infected by HCV. The objective of this analysis is to identify specific needs and preferences among people who inject drugs. Methods A multi-country, anonymous, self-administered online survey conducted in 2021 was developed by Coalition PLUS and the World Hepatitis Alliance in partnership with the WHO. Preferences for test and treat locations and simplifying HCV care were collected among people affected or infected by HCV. Chi-square tests were used to compare respondents who identified with current or former injection drug users through identification with key population to other respondents who did not identify with this key population. Results Among 202 respondents, 62 (30.7%) identified with current/former injection drug users. Compared to other respondents, they were: older [median (IQR): 48 (36–57) vs. 39 (31–51) years, p = 0.003]; more likely to have been tested for HCV (90.2% vs. 64.3%, p = 0.001); more likely to prefer testing in a community-based centre (CBC) (55.4% vs. 33.3%, p = 0.005); or in a support centres for people who use drugs (SCPUD)(50.0% vs. 9.8%, p

Abstract Background Despite facing a dual burden of HBV and HIV, Africa lacks experience in offering integrated care for HIV and HBV. To contextualize individual and group-level feasibility and acceptability of an integrated HIV/HBV care model, we explored perspectives of health care providers and care recipients on feasibility and acceptability of integration. Methods In two regional hospitals of West Nile region, we performed a demonstration project to assess feasibility and acceptability of merging the care of HBV-monoinfected patients with existing HIV care system. Using interviews with health care providers as key informants, and 6 focus groups discussions with 3 groups of patients, we explored feasibility [(i)whether integration is perceived to fit within the existing healthcare infrastructure, (ii) perceived ease of implementation of HIV/HBV integrated care, and (iii) perceived sustainability of integration] and acceptability [whether the HIV/HBV care model is perceived as (i) suitable, (ii) satisfying and attractive (iii) there is perceived demand, need and intention to recommend its use]. We audio-recorded the interviews and data was analysed using framework analysis. Results The following themes emerged from the data (i) integrating HBV into HIV care is perceived to be feasible, fit and beneficial, after making requisite adjustments (ii) integration is acceptable due to the need for both free treatment and anticipated collaboration between HIV and HBV clients in terms of peer-support (iii) there are concerns about the likely rise in stigma and the lack of community awareness about integrated care. Conclusion The integrated HIV/HBV care model is feasible and acceptable among both providers and recipients. Necessary adjustments to the existing care system, including training, for community sensitization on the reasons and significance of integration are required.

The Henry's law solubility (HS) and liquid-phase loss rate constants (kl) of the tropospheric trace gas constituents peroxyacetic nitric anhydride (PAN; CH3C(O)O2NO2, commonly known as peroxyacetyl nitrate) and peroxypropionic nitric anhydride (PPN; C2H5C(O)O2NO2, also known as peroxypropionyl nitrate) in deionized (DI) water and of PPN in n-octanol were measured using a flow bubble apparatus at temperatures between 5.0 and 25.0 ∘C. For PAN in DI water, the observed values for HS,aq are consistent with the literature, whereas the solubility of PPN in DI water is slightly lower than literature values, ranging from HScp(PPN)aq = (1.49 ± 0.05) M atm−1 at 25.0 ∘C to HScp(PPN)aq = (7.01 ± 0.25) M atm−1 at 5.0 ∘C (stated uncertainties are at the 1σ level). The data are best described by ln⁡(HScp(PAN)aq/[Matm-1]) = -(17.8±0.3) + (5620±85)/T and ln⁡(HScp(PPN)aq/[Matm-1]) = -(19.5±1.7) + (5955±480)/T, where T is in kelvin. For n-octanol, the PPN solubility ranges from HScp(PPN)oct = (88±5)Matm-1 at 25.0 ∘C to HScpoct = (204±16)Matm-1 at 5.0 ∘C and is best described by ln⁡(HScp(PPN)oct/[Matm-1]) = -(6.92±0.75) + (3390±320)/T. n-Octanol–water partition coefficients (KOW) for PPN were determined for the first time, ranging from 59 ± 4 at 25.0 ∘C to 29 ± 3 at 5.0 ∘C. Observed loss rate constants in DI water are consistent with recent literature and larger than the thermal dissociation rates for both PAN and PPN, consistent with a hydrolysis mechanism, whereas kl values in n-octanol are significantly smaller than gas-phase dissociation rate constants, likely owing to a “cage effect” in the organic liquid. The results imply that uptake of either PAN or PPN on cloud water and organic aerosol is negligible but that uptake of PPN may constitute an overlooked source of peroxy radicals in organic aerosol.

Parent-mediated intervention programs have demonstrated benefits for toddlers with autism spectrum disorder (ASD). Interest is emerging in other community-level models, such as those that can be integrated into child care settings. These programs have the potential to reach a wide range of high-risk toddlers who spend the majority of their day in child care. The objective of this study was to translate and evaluate the feasibility of the "Social ABCs" caregiver-mediated intervention program into a community child care setting by training front-line early childhood educators (ECEs). Twenty-two ECEs attended a workshop on early intervention and ASD, and six ECEs and one special needs resource consultant received hands-on intervention training. Nineteen participants completed a workshop quiz, with significant mean improvement of 22.26% from pre- to post-workshop. After 12 weeks of live coaching (4 weeks in one case), participants attained a high level of fidelity in implementing the intervention strategies (> 80%), which was maintained after a 3-month period of non-contact with the training team. Nine of ten specific strategies were mastered after the 12-week training period, with only one technique failing to reach a mean fidelity level of 75%. Findings reveal that the model of training front-line child care staff in a community child care setting is feasible using a relatively short-term training approach.

Background There is growing evidence of a beneficial effect of social group processes on well-being and mental health. Aims To investigate the role of group membership continuity in reducing mental ill-health among young people who were already vulnerable pre-pandemic, and to understand the social and psychological mechanisms of the benefits of group memberships for vulnerable young people. Method This study takes a cross-sectional design, using survey data from a sample of 105 young people aged 16–35 years, collected approximately 1 year after the global COVID-19 outbreak (January to July 2021). Correlational and path analyses were used to test the associations between group membership continuity and mental health problems (depression, anxiety, psychotic-like experiences) and the mediation of these associations by hope and social connectedness (in-person and online). To correct for multiple testing, the Benjamini–Hochberg procedure was implemented for all analyses. Indirect effects were assessed with coverage of 99% confidence intervals. Results Multiple prior group memberships were associated with preservation of group memberships during the COVID-19 pandemic. In-person social connectedness, online social connectedness and hope mediated the relationship between group membership continuity and mental health problem symptoms. Conclusions The results suggest that clinical and public health practice should support vulnerable young people to foster and maintain their social group memberships, hopefulness and perceived sense of social connectedness as means of helping to prevent exacerbation of symptoms and promote recovery of mental health problems, particularly during significant life events.