Intergroup Contact Improves Medical Student Attitudes and Skill in Transgender Health Care.

Purpose: Poorer health outcomes for transgender and gender diverse (TGD) individuals have been associated with lack of health care provider knowledge and personal bias. Training at all levels of medical education has been positioned as one strategy to combat these inequities. This study sought to characterize preclinical medical student attitude, skill, and knowledge pre- and post-teaching with TGD community volunteers.

'A human face and voice': transgender patient-educator and medical student perspectives on gender-diversity teaching.

Background: Transgender and gender diverse (TGD) people face many obstacles in accessing health care, including discrimination, institutional bias, and clinician knowledge deficits. We developed a clinical skills and education module on gender-affirming care for pre-clinical medical students, in collaboration with a TGD-led civil society organisation. The module consisted of an educational session followed by preceptor-facilitated small group tutorials, led by TGD patient-educators (n = 22) who used their lived experience to explore medical history-taking and broader issues related to TGD healthcare with students (n = 199).

Is non-occupational HIV Post Exposure Prophylaxis (nPEP) still used? An exploration of nPEP use since widespread availability of HIV PrEP.

Background: Non-occupational Post-Exposure Prophylaxis (nPEP) is an effective HIV prevention strategy in gay and bisexual men (GBM) taken after possible exposure. HIV Pre-Exposure Prophylaxis (PrEP) is also a highly effective HIV prevention strategy.

Methods: A retrospective audit of medical records of GBM presenting to a sexual health centre and provided with nPEP compared two periods to determine if nPEP usage changed following availability of PrEP.

Synthesizing contemporary integrative interpersonal theory and the narrative identity approach to examine personality dynamics and regulatory processes.

Objective: The goal of this paper is to promote the integration of two approaches to personality and assessment: Contemporary Integrative Interpersonal Theory (CIIT) and the Narrative Identity Approach (NI).

Methods: We review CIIT and NI, describe their similarities and differences, and articulate opportunities to integrate the approaches to more fully account for personality dynamics and self-regulation.

Results: We identify several areas within which concepts from CIIT and NI could be synthesized and offer four concrete suggestions for integrating the assessment methods within each approach: (1) using narratives to explicate interpersonal perception, (2) using stories to clarify interpersonal context, (3), using the Interpersonal Situation as a framework for unpacking narrative elements, and (4) coding interpersonal sequences in narrative data.

, , and to Integrate Narrative Identity Within Dimensional Approaches to Personality Disorders.

Researchers and clinicians are beginning to adopt dimensional approaches in the study and treatment of personality disorders (PD). Although dimensional approaches in the and ICD-11 hold considerable benefit, they need to better incorporate an appreciation of individuals' life stories, or narrative identities. Doing so will be necessary to flesh out the emphasis that both frameworks place on the role of identity in personality pathology.

The Impasse on Overall Survival in Oncology Reimbursement Decision-Making: How Can We Resolve This?

Mature overall survival (OS) data are often unavailable at the time of regulatory and reimbursement decisions for a new cancer treatment. For patients with early-stage cancers treated with potentially curative treatments, demonstrating an OS benefit may take years and may be confounded by subsequent lines of therapy or crossover to the investigational treatment. For patients with advanced-stage cancers, mature OS data may be available but difficult to interpret for similar reasons.

Cost Effectiveness of Durvalumab in Unresectable Stage III NSCLC: 4-Year Survival Update and Model Validation from a UK Healthcare Perspective.

Background: In the phase III PACIFIC study, durvalumab improved survival versus placebo in patients with unresectable stage III non-small-cell lung cancer (NSCLC) whose disease had not progressed after platinum-based concurrent chemoradiotherapy. The appraisal by the UK's National Institute for Health and Care Excellence (NICE) included a cost-effectiveness analysis based on an early data readout from PACIFIC [March 2018 data cut-off (DCO); median follow-up duration 25.2 months; range 0.

The cycle of life and story: Redemptive autobiographical narratives and prosocial behaviors.

Adults often understand their lives by constructing personal stories and then living into them. Time and time again, a positive relation has been found between the tendency to build redemptive personal stories wherein negative and challenging experiences ultimately give way to positive endings and prosocial behavior. Here, I review the relevant literature in the interest of advancing the notion that redemptive stories and prosociality exist in a virtuous cycle.

Incorporating narrative repair in the treatment of avoidant personality disorders: A case in point.

Avoidant personality disorder (AvPD) is characterized by multiple struggles, including shyness, feelings of inadequacy, and hypersensitivity to interpersonal judgments. Research indicates that people with AvPD also show disturbances in narrative identity, which is an internal and evolving story created about the personal past, present, and presumed future. Here, the novel Guide for Narrative Repair (GNaR) recently developed by (Thomsen et al.

Psychological mediators of exercise adherence among older adults in a group-based randomized trial.

Objective: To examine the psychological mediators of exercise adherence among older adults in a group-based physical activity randomized controlled trial.

Method: Older adults (≥65 years) were randomized to one of three conditions as part of the "GrOup-based physical Activity for oLder adults" (GOAL) randomized controlled trial. These included similar age same gender (SASG) and similar age mixed gender (SAMG) exercise programs that were informed by the tenets of self-categorization theory, and a "standard" mixed age mixed gender (MAMG) exercise program.

The redemption and contamination research form: exploring relations with narrative identity, personality traits, response styles, and life satisfaction.

Narrative identity is typically assessed by collecting participants' autobiographical scenes and then coding these stories for themes including redemption (negative beginning, positive ending) and contamination (positive beginning, negative ending). Complimenting this approach, we introduce a self-report measure capturing the degree to which individuals explicitly view their lives and social worlds in redemptive and contaminated ways - the Redemption and Contamination Research Form (RCRF). In Studies 1 and 2, participants completed the RCRF and a measure of life satisfaction.

Characteristics and outcomes of Aboriginal and Torres Strait Islander patients with dialysis-dependent kidney disease in Australian intensive care units.

Background: In Australia, 531 people per million population have dialysis-dependent chronic kidney disease (CKD5D). The incidence is four times higher for Aboriginal and Torres Strait Islander (indigenous) people compared with non-Indigenous Australians. CKD5D increases the risk of hospitalisation, admission to the intensive care unit (ICU) and mortality compared with patients without CKD5D.

Narrating the nadir: examining personal and vicarious stories of cancer-related low points among survivors and romantic partners.

To investigate low point autobiographical narratives among cancer survivors and romantic partners. Cancer survivors (Study 1) and romantic partners (Study 2) narrated the low points of their cancer experiences. Partners also narrated stories of cancer survivors' low points.

Effects of Group-Based Exercise on Flourishing and Stigma Consciousness among Older Adults: Findings from a Randomised Controlled Trial.

Background: To examine the extent to which group-based exercise programs, informed by self-categorisation theory, result in improvements in psychological flourishing and reductions in age- and gender-related stigma consciousness among older adults.

Methods: In the study, older adults (N = 485, ≥ 65 years) were randomised to similar age same gender (SASG), similar age mixed gender (SAMG), or "standard" mixed age mixed gender (MAMG) group-based exercise programs. Flourishing and stigma consciousness were assessed on six occasions during the 24-week intervention and represented secondary trial outcomes.

Australian private emergency departments can assist ambulance services by taking public emergency patients during surge and disasters.

We describe a novel ambulance diversion programme, piloted in Victoria. This article discusses creating increased emergency capacity during surge or disasters by utilising private EDs, tested during a recent thunderstorm asthma disaster and an influenza epidemic. Public hospitals and EDs often run at or over capacity during normal operations.

The empirical structure of narrative identity: The initial Big Three.

A robust empirical literature suggests that individual differences in the thematic and structural aspects of life narratives are associated with and predictive of psychological well-being. However, 1 limitation of the current field is the multitude of ways of capturing these narrative features, with little attention to overarching dimensions or latent factors of narrative that are responsible for these associations with well-being. In the present study we uncovered a reliable structure that accommodates commonly studied features of life narratives in a large-scale, multi-university collaborative effort.

Medical perspectives regarding goals-of-care consultations in Emergency Departments.

Goals-of-care discussions aim to establish patient values for shared medical decision-making. These discussions are relevant towards end-of-life as patients may receive non-beneficial treatments if they have never discussed preferences for care. End-of-life care is provided in Emergency Departments (EDs) but little is known regarding ED-led goals-of-care discussions.

Impact of scribes on emergency medicine doctors' productivity and patient throughput: multicentre randomised trial.

Objectives: To evaluate the changes in productivity when scribes were used by emergency physicians in emergency departments in Australia and assess the effect of scribes on throughput.

Design: Randomised, multicentre clinical trial.

Setting: Five emergency departments in Victoria used Australian trained scribes during their respective trial periods.

Contextualizing personality: Personality within and across social roles and conceptual levels.

Objective: Personality psychologists have begun to consider the predictive ability of comparable personality characteristics at the levels of traits, goals, and narrative identity. Here, we build upon and extend this work by adopting a contextualized personality approach. Doing so entailed exploring the implications of personality characteristics within three social roles and at each level of personality in relation to role-specific and generalized measures of psychological adjustment.

Cost-effectiveness modeling for neuropathic pain treatments: investigating the relative importance of parameters using an open-source model.

Aims: The study objective was to develop an open-source replicate of a cost-effectiveness model developed by National Institute for Health and Care (NICE), in order to explore uncertainties in health economic modeling of novel pharmacological neuropathic pain treatments.

Materials And Methods: The NICE model, consisting of a decision tree with branches for discrete levels of pain relief and adverse event (AE) severities, was replicated using R, and used to compare a hypothetical neuropathic pain drug to pregabalin. Model parameters were sourced from NICE's clinical guidelines and associated with probability distributions to account for underlying uncertainty.

Cost-utility analysis of an intervention designed to reduce the critical handling error of insufficient inspiratory effort.

Objectives: Up to 70-80% of patients use inhalers incorrectly. Dry-powder inhalers (DPIs) require forceful inhalation for optimal delivery, and approximately 40% of Global Initiative for Asthma (GINA)-defined Step-3+ patients inhale corticosteroid and long-acting beta-agonist through DPIs. The CRITIKAL study (Price et al.

Group-based physical activity for older adults (GOAL) randomized controlled trial: Exercise adherence outcomes.

Background: Despite the health benefits of regular physical activity, across the globe older adults represent the least active section of society.

Purpose: The GrOup-based physical Activity for oLder adults (GOAL) trial was a three-arm parallel randomized controlled trial (RCT) that was designed to test the efficacy of two group-based exercise programs for older adults, informed by self-categorization theory (SCT), in comparison to a standard group-based exercise program.

Methods: RCT conducted in Greater Vancouver, Canada, enrolled 627 older adults (Mage = 71.

Cost-Effectiveness of Take-Home Naloxone for the Prevention of Overdose Fatalities among Heroin Users in the United Kingdom.

Background: Heroin overdose is a major cause of premature death. Naloxone is an opioid antagonist that is effective for the reversal of heroin overdose in emergency situations and can be used by nonmedical responders.

Objective: Our aim was to assess the cost-effectiveness of distributing naloxone to adults at risk of heroin overdose for use by nonmedical responders compared with no naloxone distribution in a European healthcare setting (United Kingdom).