The proximal and distal effects of mortality salience on COVID-19-related health perceptions and intentions.

Health preventative measures are important in reducing transmission of COVID-19, yet death-related thoughts might hinder preventative action. Using two online samples (N = 948), we examined how mortality salience (MS) may produce health-related proximal and distal defenses relevant to COVID-19, examining health optimism and appearance self-worth as moderators. MS decreased perceived vulnerability as a proximal defense for those with high health optimism (Study 1), while those with low health optimism decreased perceived response efficacy of face masks and intention to wear a protective face mask (Study 2). Additionally, those with high appearance self-worth displayed increased intention to wear an aesthetically appealing face mask as a distal defense to MS (Study 2). Our findings demonstrate the importance of considering how mortality concerns may channel health-defeating and health-promoting behaviors in respect to COVID-19 and provide insight into how to produce sustained engagement in health preventative action to combat the pandemic.

Changes in quality of life (QoL) and other patient-reported outcome measures (PROMs) in living-donor and deceased-donor kidney transplant recipients and those awaiting transplantation in the UK ATTOM programme: a longitudinal cohort questionnaire survey with additional qualitative interviews.

OBJECTIVE: To examine quality of life (QoL) and other patient-reported outcome measures (PROMs) in kidney transplant recipients and those awaiting transplantation. DESIGN: Longitudinal cohort questionnaire surveys and qualitative semi-structured interviews using thematic analysis with a pragmatic approach. SETTING: Completion of generic and disease-specific PROMs at two time points, and telephone interviews with participants UK-wide. PARTICIPANTS: 101 incident deceased-donor (DD) and 94 incident living-donor (LD) kidney transplant recipients, together with 165 patients on the waiting list (WL) from 18 UK centres recruited to the Access to Transplantation and Transplant Outcome Measures (ATTOM) programme completed PROMs at recruitment (November 2011 to March 2013) and 1 year follow-up. Forty-one of the 165 patients on the WL received a DD transplant and 26 received a LD transplant during the study period, completing PROMs initially as patients on the WL, and again 1 year post-transplant. A subsample of 10 LD and 10 DD recipients participated in qualitative semi-structured interviews. RESULTS: LD recipients were younger, had more educational qualifications and more often received a transplant before dialysis. Controlling for these and other factors, cross-sectional analyses at 12 months post-transplant suggested better QoL, renal-dependent QoL and treatment satisfaction for LD than DD recipients. Patients on the WL reported worse outcomes compared with both transplant groups. However, longitudinal analyses (controlling for pre-transplant differences) showed that LD and DD recipients reported similarly improved health status and renal-dependent QoL (p<0.01) pre-transplant to post-transplant. Patients on the WL had worsened health status but no change in QoL. Qualitative analyses revealed transplant recipients' expectations influenced their recovery and satisfaction with transplant. CONCLUSIONS: While cross-sectional analyses suggested LD kidney transplantation leads to better QoL and treatment satisfaction, longitudinal assessment showed similar QoL improvements in PROMs for both transplant groups, with better outcomes than for those still wait-listed. Regardless of transplant type, clinicians need to be aware that managing expectations is important for facilitating patients' adjustment post-transplant.

To be or not to be tolerant? A Terror Management perspective exploring the ideological dilemma of tolerance and prejudice.

Tolerance has been identified as a way to reduce prejudice. However, tolerance has also been posited as an ideological dilemma and may have its limits. The present research explores this idea, utilizing insights from Terror Management Theory. Three studies were conducted using online samples. Study 1 found that a tolerance prime led to less discrimination towards Muslims after being reminded of death, but increased discrimination when reminded of terrorism. Additionally, tolerance did not affect levels of affective prejudice. Study 2 found that reading an essay that threatened the norm of tolerance led to increased levels of death-thought accessibility and worldview defence, particularly amongst liberal participants. Study 3 found that a tolerance prime attenuated mortality salience decreasing support for author rights, but not if the worldview critic was intolerant. Taken together, the present findings suggest that using tolerance to reduce prejudice and foster more positive intergroup relations has its boundaries. If others are perceived to not be tolerant themselves, then people may be more motivated to defend, rather than uphold the norm of tolerance.

Changes in quality of life, health status and other patient-reported outcomes following simultaneous pancreas and kidney transplantation (SPKT): a quantitative and qualitative analysis within a UK-wide programme.

We examined quality of life (QoL) and other patient-reported outcome measures (PROMs) in 95 simultaneous pancreas and kidney transplant (SPKT) recipients and 41 patients wait-listed for SPKT recruited to the UK Access to Transplantation and Transplant Outcome Measures (ATTOM) programme. Wait-listed patients transplanted within 12 months of recruitment (n = 22) were followed 12 months post-transplant and compared with those still wait-listed (n = 19) to examine pre- to post-transplant changes. Qualitative interviews with ten SPKT recipients 12 months post-transplant were analysed thematically. Cross-sectional analyses showed several better 12-month outcomes for SPKT recipients compared with those still wait-listed, a trend to better health utilities but no difference in diabetes-specific QoL or diabetes treatment satisfaction. Pre- to post-transplant, SPKT recipients showed improved treatment satisfaction, well-being, self-reported health, generic QoL and less negative impact on renal-specific QoL (ps < 0.05). Health utility values were better overall in transplant recipients and neither these nor diabetes-specific QoL changed significantly in either group. Pre-emptive transplant advantages seen in 12-month cross-sectional analyses disappeared when controlling for baseline values. Qualitative findings indicated diabetes complications, self-imposed blood glucose monitoring and dietary restrictions continued to impact QoL negatively post-transplant. Unrealistic expectations of SPKT caused some disappointment. Measuring condition-specific PROMs over time will help in demonstrating the benefits and limitations of SPKT.

Patient preferences, knowledge and beliefs about kidney allocation: qualitative findings from the UK-wide ATTOM programme.

OBJECTIVE: To explore how patients who are wait-listed for or who have received a kidney transplant understand the current UK kidney allocation system, and their views on ways to allocate kidneys in the future. DESIGN: Qualitative study using semistructured interviews and thematic analysis based on a pragmatic approach. PARTICIPANTS: 10 deceased-donor kidney transplant recipients, 10 live-donor kidney transplant recipients, 12 participants currently wait-listed for a kidney transplant and 4 participants whose kidney transplant failed. SETTING: Semistructured telephone interviews conducted with participants in their own homes across the UK. RESULTS: Three main themes were identified: uncertainty of knowledge of the allocation scheme; evaluation of the system and participant suggestions for future allocation schemes. Most participants identified human leucocyte anitgen matching as a factor in determining kidney allocation, but were often uncertain of the accuracy of their knowledge. In the absence of information that would allow a full assessment, the majority of participants consider that the current system is effective. A minority of participants were concerned about the perceived lack of transparency of the general decision-making processes within the scheme. Most participants felt that people who are younger and those better matched to the donor kidney should be prioritised for kidney allocation, but in contrast to the current scheme, less priority was considered appropriate for longer waiting patients. Some non-medical themes were also discussed, such as whether parents of dependent children should be prioritised for allocation, and whether patients with substance abuse problems be deprioritised. CONCLUSIONS: Our participants held differing views about the most important factors for kidney allocation, some of which were in contrast to the current scheme. Patient participation in reviewing future allocation policies will provide insight as to what is considered acceptable to patients and inform healthcare staff of the kinds of information patients would find most useful.

Beliefs in conspiracy theories and the need for cognitive closure.

An important component of conspiracy theories is how they influence, and are influenced by, the evaluation of potential evidence. Some individuals may be more open minded regarding certain explanations for events whereas others may seek closure and thus cut off a conspiracy explanation. Two studies examined the relationship between the need for cognitive closure (NFCC), levels of belief in real world conspiracy theories, and the attribution of conspiracy theories to explain events. A first, small (N = 30) and preliminary study found no relationship between NFCC and beliefs in conspiracy theories, suggesting that both advocates and opponents of conspiracy explanations do not differ on this dimension. A second study (N = 86) revealed that evidence for and against conspiracy theories had an influence on attributions of the likelihood of a conspiracy to explain a novel event. Specifically, after reading evidence individuals with high levels of belief in conspiracy theories tended to rate a conspiracy explanation as more likely whereas those with low levels of belief rated it as less likely. However, when the need for cognitive closure (NFCC) was experimentally lowered the effects of prior beliefs in conspiracy theories diminished.

Support systems for and barriers to diabetes management in South Asians and Whites in the UK: qualitative study of patients' perspectives.

OBJECTIVES: To explore experiences of UK-based South Asian and White patients with diabetes in relation to their support systems for and barriers to diabetes management. DESIGN: Qualitative study (semistructured interviews analysed using a form of Interpretative Phenomenological Analysis). PARTICIPANTS: 20 outpatients with diabetes (12 British South Asians and 8 British Whites) with either good or poor glycaemic control. SETTING: Hillingdon Hospital, Uxbridge, UK. RESULTS: Qualitative analysis revealed distinct themes for the two ethnic groups. For the South Asian participants, challenges surrounding diet management and social stigma attached to having diabetes were the two predominant barriers to effective diabetes management. Support from immediate family members was commonly reported as a strong support system for optimising diabetes management by the South Asian sample in addition to the perceived positive impact of religion (healing power of prayer), the valuable informational support from their diabetes-care team, patient leaflets and diabetes magazines. Similar to the South Asians, adhering to dietary recommendations was the most difficult aspect of diabetes management for the White participants followed by the inconveniences surrounding injecting insulin. The hospital diabetes-care team was considered as the most effective support system for diabetes management by the White sample and interestingly, this was the only dominant theme in their reported sources of support. CONCLUSIONS: Both South Asian and White participants emphasised adherence to dietary recommendations as the most difficult aspect of living with diabetes. In addition, social stigma attached to diabetes was a prominent concern among South Asian participants that seemed to have a significant negative impact on their diabetes control and overall management. Given South Asian patients' reliance on their family for the management of their condition, interventions targeting improved diabetes outcomes in this population may prove more successful if they are designed to involve significant family members.

Identity processes, threat, and interpersonal relations: accounts from British Muslim gay men.

This study explores identity processes, identity threat, and interpersonal relations with other gay men in a qualitative interview study with a sample of young British Muslim gay men of Pakistani background. Transcripts were subjected to qualitative thematic analysis. Data were analyzed through the interpretive lens of Identity Process Theory. Three superordinate themes are reported: (a) self-continuity and the transition from straight to gay space; (b) interpersonal relations with other gay men and self- and other categorization; and (c) interpersonal contact or identification with White gay men as an identity enhancer. Theoretical and practical implications of the results are discussed.

Coping with potentially incompatible identities: accounts of religious, ethnic, and sexual identities from British Pakistani men who identify as Muslim and gay.

This study explores how a group of young British Muslim gay men (BMGM) of Pakistani background in non-gay affirmative religious contexts understood and defined their sexual, religious, and ethnic identities, focusing upon the negotiation and construction of these identities and particularly upon strategies employed for coping with identity threat. A total of 12 BMGM were interviewed using a semi-structured interview schedule. Transcripts were subjected to qualitative thematic analysis as described by Braun and Clarke. The aim was to explore participants' lived experiences through the interpretive lens of identity process theory. Four superordinate themes are reported, entitled 'I'm gay because … ': making sense of gay identity, 'It's all about temptation': invoking religious discourses to explain sexual identity, 'Going against God': fear of divine retribution, 'It's easier to be gay here': external attributions and British national identity. The data suggest the existence of an additional identity principle, which is referred to as the psychological coherence principle. This motive represents the need to ensure a sense of coherence between existing identities, and we discuss how individuals may adopt strategies to deal with threats to the principle.

The role of religious fundamentalism in terrorist violence: a social psychological analysis.

This paper examines the social-psychological factors often implicated in discussions of terrorist violence/martyrdom, with a particular focus on the role of religion. We offer a brief description of the psychological theories underpinning terrorist research before focusing on social-psychological factors. The roles of psychopathology, irrationality and grievance/threat are examined, followed by empirical research on the beliefs which have been associated with the perpetration and support of terrorist violence, and the social factors which foster those beliefs, including social identity, socially carried interpretations, group leadership and individual differences. Although religion is not a single, simple causal factor in terrorist violence, religious elements often feature strongly in the belief systems associated with terrorist violence, and can also feature in other important fostering factors for terrorist violence, such as the use of rhetoric. Finally, the status of lay explanations of terrorist violence, focusing on the role of religious fundamentalism is examined.

Faith conquers all? Beliefs about the role of religious factors in coping with depression among different cultural-religious groups in the UK.

How effective is religious activity believed to be in coping with depression? This study assessed the perceived effectiveness of different religious activities - previously identified as important in coping - among 282 people in the UK. The mean age was 25 years, and participants were either Christian, Hindu, Jewish, Muslim, other religion, or no religion. Relative to other kinds of help for depression, religious activity was not seen as particularly helpful for depression. Religious activity was seen as less helpful by the ever-depressed than by the never-depressed and as less helpful by women than by men. Among religious activities, faith and prayer were seen as the most helpful. Muslims believed more strongly than other groups in the efficacy of religious coping methods for depression, were most likely to say they would use religious coping behaviour, and were least likely to say they would seek social support or professional help for depression. Other differences between groups were also observed, and comparisons with qualitative material obtained in an earlier study were made. The implications of these findings for help-seeking are considered.