Masks and respirators for prevention of respiratory infections: a state of the science review.

SUMMARYThis narrative review and meta-analysis summarizes a broad evidence base on the benefits-and also the practicalities, disbenefits, harms and personal, sociocultural and environmental impacts-of masks and masking. Our synthesis of evidence from over 100 published reviews and selected primary studies, including re-analyzing contested meta-analyses of key clinical trials, produced seven key findings. First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens. Fifth, masks are important sociocultural symbols; non-adherence to masking is sometimes linked to political and ideological beliefs and to widely circulated mis- or disinformation. Sixth, while there is much evidence that masks are not generally harmful to the general population, masking may be relatively contraindicated in individuals with certain medical conditions, who may require exemption. Furthermore, certain groups (notably D/deaf people) are disadvantaged when others are masked. Finally, there are risks to the environment from single-use masks and respirators. We propose an agenda for future research, including improved characterization of the situations in which masking should be recommended or mandated; attention to comfort and acceptability; generalized and disability-focused communication support in settings where masks are worn; and development and testing of novel materials and designs for improved filtration, breathability, and environmental impact.

Bearing witness poetically in a pandemic: documenting suffering and care in conditions of physical isolation and uncertainty.

The COVID-19 crisis is still affecting millions of people worldwide. However, government and mass media attention to the continuing loss of life, severe illness and prolonged effects of COVID-19 has subsided, rendering the suffering of those who have become ill or disabled, or who have lost loved ones to the disease, largely hidden from view. In this article, we employ autoethnographic poetic inquiry from the perspective of a mother/carer whose young adult daughter became critically ill and hospitalised after becoming infected while the mother herself was isolating at home due to her own COVID-19 diagnosis. The first author created a poem from notes she had made in a journal from telephone conversations and messages with the healthcare providers caring for her daughter. The second author responded to the poem, identifying the feelings and meanings it surfaced. Together, the authors draw on scholarship discussing concepts of uncertainty, liminality, moral distress, bearing witness and illness narratives to reflect on how autoethnographic poetic inquiry can document and make visible COVID-19-related suffering.

Dimensões socioculturais da saúde: contribuições para os estudos sobre risco, sociologia digital e desinformação / Sociocultural dimensions of health: contributions to studies on risk, digital sociology, and disinformation / Dimensiones socioculturales de la salud: contribuciones a los estudios sobre riesgo, sociología digital y desinformación

Deborah Lupton é uma renomada acadêmica, cuja trajetória trouxe grandes contribuições para os estudos da sociologia digital e das dimensões socioculturais da medicina e da saúde pública. Em entrevista à Reciis, Lupton comenta sobre um dos principais desafios da contemporaneidade -a desinformação e as fake news- por meio da sociologia digital e aborda as perspectivas socioculturais do risco a partir do lançamento da terceira edição de seu livro Risk, em que traz um capítulo inédito sobre as problemáticas envolvendo o risco e a disseminação de desinformação durante a pandemia de covid-19. Com comentários sobre os cenários australiano e brasileiro, Lupton discorre sobre a questão do anticientificismo, do negacionismo e do papel ocasionado por governos populistas no combate à doença. Por fim, ela discorre sobre as potencialidades dos métodos criativos para os estudos qualitativos, especialmente naqueles que buscam entender as racionalidades, as lógicas e os sentimentos das pessoas

Deborah Lupton is a renowned academic whose research has made significant contributions to the field of digital sociology and the sociocultural dimensions of medicine and public health. In an interview with Reciis, Lupton discusses one of the main contemporary challenges - misinformation and fake news - through the lens of digital sociology and addresses the sociocultural perspectives of risk based on the release of the third edition of her book Risk. In this edition, she includes a new chapter on the issues related to risk and the spread of misinformation during the COVID-19 pandemic. With comments on the Australian and Brazilian scenarios, Lupton delves into the issues of anti-science, denialism, and the role played by populist governments in combating the disease. Finally, she explores the potential of creative methods in qualitative studies, especially those that seek to understand people's rationalities, logics, and feelings

Deborah Lupton es una académica de renombre, cuya trayectoria ha aportado grandes contribuciones a los estudios de sociología digital y a las dimensiones socioculturales de la medicina y la salud pública. En una entrevista con Reciis, Lupton comenta uno de los principales desafíos contemporáneos - la desinformación y las noticias falsas -, a través de la sociología digital, y aborda las perspectivas socioculturales del riesgo a partir del lanzamiento de la tercera edición de su libro Risk, en el que incluye un capítulo inédito sobre los problemas relacionados con el riesgo y la difusión de desinformación durante la pandemia de covid-19. Con comentarios sobre las situaciones en Australia y Brasil, Lupton habla sobre la cuestión del anticientificismo, el negacionismo y el papel desempeñado por los gobiernos populistas en la lucha contra la enfermedad. Finalmente, ella reflexiona sobre las posibilidades de los métodos creativos en los estudios cualitativos, especialmente en aquellos que buscan comprender las racionalidades, lógicas y sentimientos de las personas.

Australians' experiences of COVID-19 during the early months of the crisis: A qualitative interview study.

Introduction: The COVID-19 crisis has wrought major changes to people's lives across the globe since the beginning of the outbreak in early 2020. The "Australians' Experiences of COVID-19" qualitative descriptive study was established to explore how Australians from different geographical areas and social groups experienced the COVID-19 crisis. Methods: Three sets of semi-structured interviews, each with a diverse group of 40 adults across Australia, were completed between 2020 and 2022. This article reports findings from the first set of interviews, conducted by telephone in mid-2020. Results: The participants discussed their experiences of living through this period, which was characterized by strong public health measures to contain the spread of COVID, including a national lockdown and border closures. Interview fieldnotes and verbatim transcripts were used to conduct an interpretive thematic analysis. The analysis is structured around the following five themes covering the quotidian and affective aspects of participants' lives in the early months of the COVID crisis: "disruption to routines;" "habituating to preventive measures;" "social isolation and loneliness;" "changes to work and education;" and "little change to life." A sixth theme concerns how participants responded to our question about what they imagined their lives would be like after the pandemic: "imagining post-COVID life." Discussion: The crisis affected participants' experience of daily life variously according to such factors as their social circumstances and obligations as well as their histories of illness, making visible some of the unequal social and economic effects of the pandemic across different genders, ages, localities and socioeconomic groups. Our participants fell into three roughly equal groups: (i) those who found the lockdown and associated restrictions very difficult; (ii) those who reported feeling barely affected by these conditions; and (iii) those who found benefits to the "slowing down" of life during this period.

Health information in creative translation: establishing a collaborative project of research and exhibition making.

There are numerous ways that researchers can creatively approach social research and translation. This article discusses elements from the first stages of a novel project that centres social research translation in the form of a public exhibition. 'Creative Approaches to Health Information Ecologies' is a project by a multidisciplinary research team in collaboration with an Australian health consumer organisation. The project uses creative workshop methods to explore how people learn, think, and feel about their bodies and health states, and brings attention to the significance of communities, places, spaces, objects, and other living things - the 'ecologies' of health information. It then builds on these insights to create an interactive exhibition of materials designed for public engagement. This reflexive article unpacks how this creative translation-centred collaboration contributed to the make-up of the project team, the project's research methods, and the process of making exhibition materials. We discuss what the research team learned from the process about creative collaboration, research-creation, and research translation.

Attitudes to COVID-19 Vaccines Among Australians During the Delta Variant Wave: A Qualitative Interview Study.

Since the outbreak of COVID-19 globally, a range of vaccines has been developed and delivered to reduce viral transmission and prevent COVID cases. This article reports findings from a qualitative research project involving telephone interviews with a diverse group of 40 adult Australians about their experiences of the COVID crisis. Interviews were conducted in late 2021 when Australians were dealing with the Delta variant outbreak and following a major effort on the part of government authorities to improve COVID-19 vaccination supplies and take-up. Responses to a question about COVID vaccines revealed that attitudes to and acceptance of COVID vaccines among this group were overwhelmingly positive. All participants had received at least one vaccine dose and the majority expressed views in support of mass vaccination against COVID. People who were hesitant or cautious about accepting COVID vaccination referred to the vaccines' novelty and potential side effects. While many people were aware of debates about vaccine safety in the news media, trust in science and medical advice about COVID vaccines was strong. Participants wanted to protect themselves and others by accepting the recommended doses. Participants' locale was a major factor in shaping experiences and stances on vaccines. The setting of government targets and mandates for vaccination was a key motivating factor. The goal of 'getting back to normal' was expressed as another reason for accepting vaccination, particularly for those living in areas that had been badly affected by high COVID cases and prolonged lockdowns.

Attitudes to COVID-19 vaccines have changed over time, as different variants have emerged, and new vaccines have become available. Identification of the geographical, socioeconomic and political contextual aspects of why people may accept, reject or feel hesitant about COVID vaccines is important. This Australian-based study shows that government road maps and targets can play a key role in encouraging people to accept COVID vaccines. Trust in science and medical advice is an important factor in accepting COVID vaccines in the context in which they have been fast-tracked and side effects have been publicized. Socio-spatial dimensions play a major role in shaping experiences and attitudes towards COVID vaccines.

Photodiagnosis of genital herpes and warts: a sociomaterial perspective on users' experiences of online sexual health care.

Online sexual health services potentially transform modes of engagement with service users. We report findings from an in-depth interview study with users of a photo-diagnosis service offered by an established UK-based online sexual health service (SH:24). Adopting a sociomaterial theoretical perspective, we analyse the interviews for descriptions of health care with and through the affordances offered by SH:24. We focus on how the interactions of service users and clinicians with nonhuman agents opened or closed off capacities for better health and wellbeing. Our findings explore navigating online and in-person service options; digitising bodies; temporal affordances; the tension between anonymous and personalised care; configuring digital privacy; and when automated care is not enough. We conclude that emerging practices of care within digital health services delivered by more-than-human collaborations reconfigure experiences of diagnosis and treatment and require detailed attention to understand how they create and close down opportunities to improve or maintain health.

From human-centric digital health to digital One Health: Crucial new directions for mutual flourishing.

This brief communication puts forward an argument for expanding the concept of 'digital health' to that of 'digital One Health' by going beyond a human-centric approach to incorporating nonhuman agents, including other living things, places and space. One Health approaches recognise the interconnected and ecological dimensions of human health and wellbeing, but rarely focus on the role of digital technologies. A set of key questions can take the idea of digital One Health forward: (i) How can we learn more about and establish deeper connections with other animals and the natural environment through digital media, devices and data?; (ii) How can we attune humans to these more-than-human worlds using digital technologies, cultivating attentiveness and responsiveness?; (iii) How can we better develop and implement digital technologies that support the health and wellbeing of the planet and all its living creatures (including humans) so that all can flourish?; and (iv) How can digital technologies affect ecological systems, for better or for worse? Developing digital One Health expands both the digital health field and the One Health perspective, leading them into crucial new directions for mutual flourishing.

Rethinking digital biopedagogies: How sociomaterial relations shape English secondary students' digital health practices.

It is widely recognised that while many young people in high-income countries are active users of digital health technologies, their engagement can be short term. In this article, we draw on feminist materialism theory to analyse findings from the two qualitative phases of a mixed-methods three phase study of English secondary students' digital health practices. Bringing together work on biopedagogies alongside more-than-human thinking, we analyse our participants' accounts of their intra-actions with human and nonhuman affordances and materialities. Our findings reveal how young people's capacity for navigating the digital health landscape and translating knowledge into health practice is highly contingent on the complex engagement of different actors in digital health assemblages, including more-than-digital relational connections. Our study found that key human actors - typically in face-to-face settings - were crucial in doing the affective work necessary to guide adolescents through the tensions and conflicts they experienced when dealing with competing knowledges and expectations. The research underlines the ways in which feminist materialism perspectives can supplement scholarship on biopedagogies, specifically contributing to the theorising on young people's learning and embodiment through digital practices.

Understandings and practices related to risk, immunity and vaccination during the Delta variant COVID-19 outbreak in Australia: An interview study.

Background: The aim of this study was to use indepth social research to better understand the relationships and intersections between understandings and practices of COVID-19 risk, immunity and vaccination in lay people's accounts. Methods: This article reports findings from a qualitative research project involving semi-structured telephone interviews with a diverse group of 40 adults from around Australia about their experiences of the COVID crisis, conducted in late 2021 during the Delta variant outbreak. The participants' responses to questions about COVID risk, COVID vaccines and how they thought they could best protect their health were analysed using an inductive thematic approach. Results: A notion of 'communal risk' was expressed together with 'individual risk'. Relatedly, people's understandings of what might be characterised as 'communal immunity' as well as individual immunity also dominated in their accounts. Both communal risk and communal immunity are influenced by a range of constantly changing and interrelated factors. Locale was a strong factor in shaping people's experiences and stances related to COVID risk. The participants referred to aspects such as their community's geographical location; the number of COVID cases and the level of COVID vaccination by others living in their state or territory; adoption of preventive measures; vaccine availability, scheduling and take-up; viral testing and tracing reporting; and the extent and timing of viral spread in the population. These factors were continually related back to highly specific conditions and practices in their community or state of residence. Conclusions: Understandings and practices related to COVID risk, immunity and vaccination were based both on individual experiences and broader ideas about the role of community. Spatial contexts are influential but there is also a strong temporality to these understandings and practices. There is a fine balance to be maintained between individual-level protection from COVID risk and community-level actions.

Remote Fieldwork in Homes During the COVID-19 Pandemic: Video-Call Ethnography and Map Drawing Methods.

Restrictions on physical movements and in-person encounters during the COVID-19 crisis confronted many qualitative researchers with challenges in conducting and completing projects requiring face-to-face fieldwork. An exploration of engaging in what we term 'agile research' in such circumstances can offer novel methodological insights for researching the social world. In this article, we discuss the changes we made to our ethnographic fieldwork in response to the introduction of a national lockdown to contain the spread of the novel coronavirus. The 'Living with Personal Data' project, based in Sydney, Australia, and designed well before the advent of COVID-19, explores a diverse range of people's feelings, practices and understandings concerning home-based digital devices and the personal digital data generated with their use. Using a video ethnography 'home tour' and an elicitation technique involving hand-drawn maps of people's homes, digital devices and the personal data generated with and through these devices, this approach was designed to elicit the sensory, affective and relational elements of people's digital device and personal data use at home. The fieldwork had just commenced when stay-at-home and physical distancing orders were suddenly introduced. Our article builds on and extends a growing body of literature on conducting fieldwork in the difficult conditions of the extended COVID-19 crisis by detailing our experiences of very quickly converting an ethnographic study that was planned to be in-person to a remote approach. We describe the adaptations we made to the project using video-call software and discuss the limits and opportunities presented by this significant modification.

Sociomaterialities of health, risk and care during COVID-19: Experiences of Australians living with a medical condition.

People living with pre-existing illnesses were identified as one of the groups most at risk when COVID-19 erupted. In this article, using the method of case studies developed from interviews, we explore how Australians in this category considered their risk and responded to it as they were learning about COVID-19 and living with restrictions and lockdown conditions in the early months of the pandemic. Building on the literature on assemblages of health and illness, therapeutic landscapes and the materialities of care, our analysis considers sociomaterialities of health, risk and care described in six featured case studies. Each person recounted a unique narrative that described the coming together of several different human and nonhuman agents in their experiences. Yet a number of overarching and intersecting themes can also be traced across the participants' narratives: the vital contributions of lay care and self-care as part of the materialities of care, health and wellbeing; the role played by social networks, both online and in-person, for people in learning about and coping with COVID-19 and its potential risks; previous embodied and affective experiences of illness, vulnerability and care; and the role played by place and space in generating either therapeutic or distressing affective atmospheres. These findings have implications for better understandings of the situated sociomaterial contexts of how embodied experience, affective forces and encounters and relationships with other people and with things, place and space come together in crises such as COVID-19.

Coping with COVID-19: The sociomaterial dimensions of living with pre-existing mental illness during the early stages of the coronavirus crisis.

In this article, we use the case study method to detail the experiences of five participants who reported living with pre-existing mental illness during COVID-19. We adopted a sociomaterial analytical approach, seeking to identify how human and nonhuman agents came together to generate states of wellbeing or distress during this challenging period. As the case studies show, feelings of anxiety, fear and risk were generated from the following sociomaterial conditions: loss of face-to-face contact with friends and family members; concerns about hygiene and infecting others; financial stress; loss of regular paid employment or volunteering work; public spaces; and the behaviour of unknown others in public spaces. The agents and practices that emerged as most important for opening capacities for coping and maintaining wellness during lockdown included: the space of the home; contact with a small number of intimate others; online therapeutic care; practising self-care skills learnt from previous difficult times; helping and supporting others; engaging in leisure activities; and the companionship of pets. Contributing to an affirmative approach to more-than-human assemblages of health, distress and recovery, these findings demonstrate what bodies can do in times of crisis and the agents and practices that can generate capacities for coping.

'The hardest job I've ever done': a qualitative exploration of the factors affecting junior doctors' mental health and well-being during medical training in Australia.

BACKGROUND: Medical practitioners can experience considerable stress and poor mental health during their careers, with doctors in training known to be particularly vulnerable. Previous research has documented work-related factors that may play a role in the mental health status of junior doctors. However, these and additional factors, need to be explored further by considering theory-driven, social, structural and contextual issues. This qualitative study aimed to explore the experiences of junior doctors working in Australian hospitals to identify factors that impact their mental health during medical training. METHOD: Semi-structured interviews were conducted with 12 junior medical officers (JMOs) employed across six hospitals in Australia. Transcribed de-identified interviews were analysed thematically using a data-driven inductive approach. RESULTS: Four interrelated main themes were identified: i) professional hierarchies; ii) occupational stress; iii) emotional labour, and iv) taking distress home; which detail the complex affective, relational and professional experiences of JMOs. The accounts demonstrate how the social, professional and organisational dimensions of these experiences impact upon trainee's well-being and mental health, both positively and negatively. Together, the findings document the dynamic, nuanced aspects of junior doctors' experiences of medical training and practice and highlights the importance of relational connections and the workplace environment in shaping JMOs' social and emotional well-being. CONCLUSION: The current study adds to the understanding of how junior doctors navigate medical training in Australian hospitals and highlights the complexities of this experience, particularly the ways in which mental health and well-being are shaped by different elements. These findings have important implications to inform new strategies to improve JMO mental health and to leverage work and non-work contexts to better support JMOs during medical training.

"Sharing Is Caring:" Australian Self-Trackers' Concepts and Practices of Personal Data Sharing and Privacy.

Self-tracking technologies and practices offer ways of generating vast reams of personal details, raising questions about how these data are revealed or exposed to others. In this article, I report on findings from an interview-based study of long-term Australian self-trackers who were collecting and reviewing personal information about their bodies and other aspects of their everyday lives. The discussion focuses on the participants' understandings and practices related to sharing their personal data and to data privacy. The contextual elements of self-tracked sharing and privacy concerns were evident in the participants' accounts and were strongly related to ideas about why and how these details should be accessed by others. Sharing personal information from self-tracking was largely viewed as an intimate social experience. The value of self-tracked data to contribute to close face-to-face relationships was recognized and related aspects of social privacy were identified. However, most participants did not consider the possibilities that their personal information could be distributed well-beyond these relationships by third parties for commercial purposes (or what has been termed "institutional privacy"). These findings contribute to a more-than-digital approach to personal data sharing and privacy practices that recognizes the interplay between digital and non-digital practices and contexts. They also highlight the relational and social dimensions of self-tracking and concepts of data privacy.

Learning about COVID-19: a qualitative interview study of Australians' use of information sources.

BACKGROUND: A multitude of information sources are available to publics when novel infectious diseases first emerge. In this paper, we adopt a qualitative approach to investigate how Australians learnt about the novel coronavirus and COVID-19 and what sources of information they had found most useful and valuable during the early months of the pandemic. METHODS: In-depth semi-structured telephone interviews were conducted with a diverse group of 40 Australian adults in mid-2020 about their experiences of the COVID-19 crisis. Participants were recruited through Facebook advertising. Detailed case studies were created for each participant, providing the basis of a thematic analysis which focused on the participants' responses to the questions about COVID-19-related information sources. RESULTS: Diverse sources of COVID-19-related information, including traditional media, online media and in-person interactions, were actively accessed, appraised and engaged with by participants. There was a high level of interest in COVID-19 information as people grappled with uncertainty, anxiety and feeling overwhelmed. Certain key events or experiences made people become aware that the outbreak was threatening Australia and potentially themselves. Most people demonstrated keen awareness that misinformation was rife in news outlets and social media sites and that they were taking steps to determine the accuracy of information. High trust was placed in health experts, scientists and government sources to provide reliable information. Also important to participants were informal discussions with friends and family members who were experts or working in relevant fields, as well as engaging in-person in interactions and hearing from friends and family who lived overseas about what COVID-19 conditions were like there. CONCLUSION: A constantly changing news environment raises challenges for effective communication of risk and containment advice. People can become confused, distressed and overwhelmed by the plethora of information sources and fast-changing news environment. On the other hand, seeking out information can provide reassurance and comfort in response to anxiety and uncertainty. Clarity and consistency in risk messaging is important, as is responding quickly to changes in information and misinformation. Further research should seek to identify any changes in use of and trust in information sources as time goes by.

Young People's Use of Digital Health Technologies in the Global North: Narrative Review.

BACKGROUND: A diverse array of digital technologies are available to children and young people living in the Global North to monitor, manage, and promote their health and well-being. OBJECTIVE: This article provides a narrative literature review of the growing number of social research studies published over the past decade that investigate the types of digital technologies used by children and young people in the Global North, in addition to investigating which of these technologies they find most useful or not useful. Key findings as well as major gaps and directions for future research are identified and discussed. METHODS: A comprehensive search of relevant publications listed in Google Scholar was conducted, supported by following citation trails of these publications. The findings are listed under type of digital technology used for health: cross-media, internet, social media, apps and wearable devices, sexual health support and information, and mental health support and information. RESULTS: Many young people in the Global North are active users of digital health technologies. However, it is notable that they still rely on older technologies, such as websites and search engines, to find information. Apps and platforms that may not have been specifically developed for young people as digital health resources often better suit their needs. Young people appreciate the ready availability of information online, the opportunities to learn more about their bodies and health states, and the opportunities to learn how to improve their health and physical fitness. They enjoy being able to connect with peers, and they find emotional support and relief from distress by using social media platforms, YouTube, and online forums. Young people can find the vast reams of information available to them difficult to navigate. They often look to trusted adults to help them make sense of the information they find online and to provide alternative sources of information and support. Face-to-face interactions with these trusted providers remain important to young people. Risks and harms that young people report from digital health use include becoming overly obsessed with their bodies' shape and size when using self-tracking technologies and comparing their bodies with the social media influencers they follow. CONCLUSIONS: Further details on how young people are using social media platforms and YouTube as health support resources and for peer-to-peer sharing of information, including attention paid to the content of these resources and the role played by young social media influencers and microcelebrities, would contribute important insights to this body of literature. The role played by visual media, such as GIFs (Graphics Interchange Format) and memes, and social media platforms that have recently become very popular with young people (eg, Snapchat and TikTok) in health-related content creation and sharing requires more attention by social researchers seeking to better understand young people's use of digital devices and software for health and fitness.