The Brief Solastalgia Scale: A Psychometric Evaluation and Revision.

Witnessing degradation and loss to one's home environment can cause the negative emotional experience of solastalgia. We review the psychometric properties of the 9-item Solastalgia subscale from the Environmental Distress Scale (Higginbotham et al. (EcoHealth 3:245-254, 2006)). Using data collected from three large, independent, adult samples (N = 4229), who were surveyed soon after the 2019/20 Australian bushfires, factor analyses confirmed the scale's unidimensionality, while analyses derived from Item Response Theory highlighted the poor psychometric performance and redundant content of specific items. Consequently, we recommend a short-form scale consisting of five items. This Brief Solastalgia Scale (BSS) yielded excellent model fit and internal consistency in both the initial and cross-validation samples. The BSS and its parent version provide very similar patterns of associations with demographic, health, life satisfaction, climate emotion, and nature connectedness variables. Finally, multi-group confirmatory factor analysis demonstrated comparable construct architecture (i.e. configural, metric, and scalar invariance) across validation samples, gender categories, and age. As individuals and communities increasingly confront and cope with climate change and its consequences, understanding related emotional impacts is crucial. The BSS promises to aid researchers, decision makers, and practitioners to understand and support those affected by negative environmental change.

Predictors of individual mental health and psychological resilience after Australia's 2019-2020 bushfires.

AIMS: We assessed the mental health effects of Australia's 2019-2020 bushfires 12-18 months later, predicting psychological distress and positive psychological outcomes from bushfire exposure and a range of demographic variables, and seeking insights to enhance disaster preparedness and resilience planning for different profiles of people. METHODS: We surveyed 3083 bushfire-affected and non-affected Australian residents about their experiences of bushfire, COVID-19, psychological distress (depression, anxiety, stress, post-traumatic stress disorder) and positive psychological outcomes (resilient coping, wellbeing). RESULTS: We found high rates of distress across all participants, exacerbated by severity of bushfire exposure. For people who were bushfire-affected, being older, having less financial stress, and having no or fewer pre-existing mental disorders predicted both lower distress and higher positive outcomes. Being male or having less income loss also predicted positive outcomes. Severity of exposure, higher education and higher COVID-19-related stressors predicted both higher distress and higher positive outcomes. Pre-existing physical health diagnosis and previous bushfire experience did not significantly predict distress or positive outcomes. RECOMMENDATIONS: To promote disaster resilience, we recommend investment in mental health, particularly for younger adults and for those in rural and remote areas. We also recommend investment in mechanisms to protect against financial distress and the development of a broader definition of bushfire-related impacts than is currently used to capture brushfires' far-reaching effects.

Is conservative opposition to climate change threat-based? Articulating an integrated threat model of climate change attitudes.

Throughout the literature, there are assertions that those endorsing conservative ideologies reject the science and solutions of climate change due to perceived threat. That is, they fear that accepting climate change means accepting problems with a favoured socioeconomic system and supporting action on climate change threatens to disrupt these systems. We draw together lines of research and reasoning on this topic to outline three key predictions this perspective makes about the drivers of conservative denial of climate change and opposition to climate policy. The first is that an asymmetry exists in climate-related threat perceptions, whereby greater endorsement of conservative ideology predicts lower perceived threat from climate change and greater perceived threat from climate reform. Second, climate-related threat perceptions are multifaceted, such that threats to economic and cultural well-being can be experienced, at personal or collective levels. Third, the asymmetry in threat perceptions explains conservatives' lower support for pro-climate reforms. We then specify a new integrated threat model of climate change attitudes, review the current evidence for and against each prediction in this model and outline ways to interrogate these theoretical predictions with empirical research. Doing so will advance understanding of the underpinnings of ideological disagreement on climate change.

A Research Translation, Implementation and Impact Strategy for the Australian Healthy Environments and Lives (HEAL) Research Network.

Healthy Environments And Lives (HEAL) is the Australian national research network established to support improvements to health, the Australian health system, and the environment in response to the unfolding climate crisis. The HEAL Network comprises researchers, community members and organisations, policymakers, practitioners, service providers, and other stakeholders from diverse backgrounds and sectors. HEAL seeks to protect and improve public health, reduce health inequities and inequalities, and strengthen health system sustainability and resilience in the face of environmental and climate change, all with a commitment to building on the strengths, knowledge, wisdom, and experience of Aboriginal and Torres Strait Islander people, culture, and communities. Supporting applied research that can inform policy and practice, and effective research translation, implementation, and impact are important goals across the HEAL Network and essential to achieve its intended outcomes. To aid translation approaches, a research translation, implementation, and impact strategy for the HEAL Network was developed. The strategy has been created to inform and guide research translation across HEAL, emphasising communication, trust, partnerships, and co-design with communities and community organisations as well as the decision-makers responsible for public policies and programs. Development of the strategy was guided by research translation theory and practice and the Health in All Policies and Environment in All Policies frameworks. As described in this paper, the strategy is underpinned by a set of principles and outlines preliminary actions which will be further expanded over the course of the HEAL Network's activities. Through these actions, the HEAL Network is well-positioned to ensure successful research translation and implementation across its program of work.

Social group connections support mental health following wildfire.

PURPOSE: As environmental disasters become more common and severe due to climate change, there is a growing need for strategies to bolster recovery that are proactive, cost-effective, and which mobilise community resources. AIMS: We propose that building social group connections is a particularly promising strategy for supporting mental health in communities affected by environmental disasters. METHODS: We tested the social identity model of identity change in a disaster context among 627 people substantially affected by the 2019-2020 Australian fires. RESULTS: We found high levels of post-traumatic stress, strongly related to severity of disaster exposure, but also evidence of psychological resilience. Distress and resilience were weakly positively correlated. Having stronger social group connections pre-disaster was associated with less distress and more resilience 12-18 months after the disaster, via three pathways: greater social identification with the disaster-affected community, greater continuity of social group ties, and greater formation of new social group ties. New group ties were a mixed blessing, positively predicting both resilience and distress. CONCLUSIONS: We conclude that investment in social resources is key to supporting mental health outcomes, not just reactively in the aftermath of disasters, but also proactively in communities most at risk.

Body image explains differences in intuitive eating between men and women: Examining indirect effects across negative and positive body image.

Intuitive eating is an adaptive and flexible form of eating. Men report higher rates of intuitive eating than women. Objectification processes are proposed to underlie this (binary) gender difference due to the intense body-related pressures that disrupt body image in women. The current study is the first known to test whether body image indirectly explains lower levels of intuitive eating in women relative to men. A cross-sectional sample of 498 adults aged 18-74 years recruited through Prolific completed an online survey assessing intuitive eating and negative and positive body image indicators. Women reported poorer body image and lower levels of intuitive eating compared to men. Significant indirect effects suggested body image explained gender differences in intuitive eating, controlling for age and body mass index. In women relative to men, greater body surveillance and lower aesthetic satisfaction explained lower total intuitive eating and reliance on hunger and satiety, greater aesthetic investment explained lower total intuitive eating and eating for physical reasons, and lower functionality investment explained lower body-food choice congruence. More research is needed, but findings suggest programs may benefit from decreasing critical views of appearance and strengthening functionality investment in women to reduce gender differences in intuitive eating.

"I can't make all this work." End of life care provision in natural disasters: a qualitative study.

BACKGROUND: Natural disasters are becoming more frequent and severe and profoundly impact the end-of-life care experience, including service provision. There is a paucity of research examining healthcare workers' experiences in responding to care demands when disasters strike. This research aimed to fill this gap by exploring end-of-life care providers' perceptions of the impact of natural disasters on end-of-life care. METHODS: Between Feb 2021-June 2021 ten in-depth semi-structured interviews were conducted with healthcare professionals providing end-of-life care during recent natural disasters, COVID-19, and/or fires and floods. Interviews were audio-recorded, transcribed, and analysed using a hybrid inductive and deductive thematic approach. RESULTS: The overarching theme from the healthcare workers' accounts was of being unable to provide effective compassionate and quality care - "I can't make all this work." They spoke of the considerable burdens the system imposed on them, of being overextended and overwhelmed, having their roles overturned, and losing the human element of care for those at end-of-life. CONCLUSION: There is urgent need to pioneer effective solutions to minimise the distress of healthcare professionals in delivering end-of-life care in disaster contexts, and to improve the experience of those dying.

The influence of trust and social identity in farmers' intentions to report suspected emergency disease outbreaks.

This study examines the influence of trust on farmers' intentions to report suspected disease on their farm. Disease reporting is essential to detect and respond to disease early, thereby minimising its impacts on agriculture businesses, the economy, and the environment. Trust has been identified as an important factor influencing farmers' disease reporting intentions but has not been quantitatively investigated. We use an established model of trust-the Integrative Model of Organisational Trust (IMOT)-to conceptualise how trust influences disease reporting intentions. We also examine how social identity is related to trust and disease reporting. Australian plant, livestock, and aquaculture farmers (N = 41) completed an online questionnaire developed from existing validated measures and we also developed two new measures for disease reporting intentions. Trust in government positively and significantly predicted farmer intentions to report suspected disease outbreaks, explaining 26% of the variance. For every one-unit increase in trust, disease reporting intentions increased by over four times. Results also support the role of shared values and group membership as aspects of social identity that influence trust and disease reporting. These results highlight the importance of government decision-makers developing and maintaining trust with farmers to support early detection and response to emergency disease outbreaks.

An unusual presentation of gross cerebral vascular dilatation in a TB/HIV co-infected individual.

Aneurysmal dilatation secondary to HIV vasculitis is well described being more common in patients under 45 years of age with advanced stage HIV infection (CD4 < 200 cells/µl). Tuberculous meningitis is far more common than previously anticipated with centres in Cape Town publishing that more than half of all cases of adult meningitis were secondary to tuberculosis. But aneurysmal dilatation of the cerebral vessels is exceedingly rare complication in this population. We report a 14-year-old male presenting to Robert Mangaliso Sobukwe Hospital in South Africa, with a first seizure and Tuberculous Meningitis. The patient was lost to follow-up with subsequent representation 2 years later with worsening clinical picture and imaging revealing marked anterior circulation aneurysmal dilatation. The patient was newly diagnosed as being HIV positive giving uncertainty of the aetiology of his vascular malformations. Aneurysmal dilatation in HIV associated cerebral vasculitis is rare. It is more frequently encountered in young adults with advanced disease who are severely immunocompromised. Tuberculous involvement in the central nervous system is thought to be due to secondary reactivation of quiescent foci of micro infection. Aneurysmal dilatation in the setting of Tuberculous Meningitis is infrequently reported in medical literature.

End-of-life care in natural disasters including epidemics and pandemics: a systematic review.

BACKGROUND: Natural disasters are becoming more frequent and severe, and place additional strains on end-of-life care services and users. Although end-of-life and palliative care are considered essential components of disaster planning and response, there are gaps in understandings about their real-life application, and how natural disasters impact end-of-life care. OBJECTIVE: To synthesise existing evidence of the impacts of natural disasters (eg, bushfires, communicable pandemics, etc) on end-of-life care. METHODS: A systematic review with a narrative synthesis was undertaken. The review was registered on PROSPERO (registration: CRD42020176319). PubMed, Scopus, PsycINFO, Science Direct and Web of Science were searched for studies published in English between 2003 and 2020, with findings explicitly mentioning end-of-life care impacts in relation to a natural disaster. Articles were appraised for quality using a JBI-QARI tool. RESULTS: Thirty-six empirical studies met the inclusion criteria and quality assessment. Findings were synthesised into three key themes: impacts on service provision, impacts on service providers and impacts on service users. This review demonstrates that natural disasters impact profoundly on end-of-life care, representing a stark departure from a palliative care approach. CONCLUSIONS: Clinical practitioners, policy makers and researchers must continue to collaborate for viable solutions to achieve universal access to compassionate and respectful end-of-life care, during natural disasters. Using models, policies and practices already developed in palliative care, involving those most impacted in disaster planning and anticipating barriers, such as resource shortages, enables development of end-of-life care policies and practices that can be rapidly implemented during natural disasters.

A Time-Varying Model for Predicting Formaldehyde Emission Rates in Homes.

Recent studies have succeeded in relating emissions of various volatile organic compounds to material mass diffusion transfer using detailed empirical characteristics of each of the individual emitting materials. While significant, the resulting models are often scenario specific and/or require a host of individual component parameters to estimate emission rates. This study developed an approach to estimate aggregated emissions rates based on a wide number of field measurements. We used a multi-parameter regression model based on previous mass transfer models to predict formaldehyde emission rate for a whole dwelling using field-measured, time-resolved formaldehyde concentrations, air exchange rates, and indoor environmental parameters in 63 California single-family houses built between 2011 and 2017. The resulting model provides time-varying formaldehyde emission rates, normalized by floor area, for each study home, assuming a well-mixed mass balance transport model of the home, and a well-mixed layer transport model of indoor surfaces. The surface layer model asserts an equilibrium concentration within the surface layer of the emitted materials that is a function of temperature and RH; the dwelling ventilation rate serves as a surrogate for indoor concentration. We also developed a more generic emission model that is suitable for broad prediction of emission for a population of buildings. This model is also based on measurements aggregated from 27 homes from the same study. We showed that errors in predicting household formaldehyde concentrations using this approach were substantially less than those using a traditional constant emission rate model, despite requiring less unique building information.

Respect, interaction, immediacy and the role community plays in registering an organ donation decision.

BACKGROUND: Registering a donation decision is fundamental to increasing the number of people who donate the organs and tissues essential for transplantation, but the number of registered organ donors is insufficient to meet this demand. Most people in Australia support organ donation, but only a third have registered their decision on the Australian Organ Donor Register (AODR). We addressed this paradox by investigating how feelings of community, engendered through an ethic of hospitality and care and a non-proselytizing dialogue about organ donation, facilitated the decision to register. METHODS: An Immediate Registration Opportunity was set up in a large public hospital in NSW, Australia. The public was approached and invited to engage in an open, respectful dialogic interaction that met people where their beliefs were and allowed their concerns and fears about donation to be discussed. This included a survey that measured positive and negative beliefs about organ donation, mood, atmosphere, and feelings of community coupled with an on-the-spot opportunity to register their donation decision. RESULTS: Over four days, we interacted with 357 participants; 75.5% (210) of eligible-to-register participants registered on the AODR. Generalized Structural Equation Modelling highlighted that as connection to community increased, so did the salience of positive beliefs about organ donation. Positive beliefs, in turn, were negatively correlated with negative beliefs about donation and, as the strength of negative beliefs decreased, the probability of registration on the AODR increased. Participants who registered on the AODR reported stronger connection to the broader community than participants who did not register. CONCLUSION: A respectful non-judgmental interaction that allows beliefs and concerns about organ donation to be discussed, coupled with an immediate opportunity to register, encouraged registration. Within this framework, feelings of belonging to a community were a key determinant that enabled many to make the decision to register.

Australians underestimate social compliance with coronavirus restrictions: findings from a national survey.

OBJECTIVE: We assessed differences between Australians' perceptions of their own compliance with coronavirus restrictions and their perceptions of community compliance. METHODS: We surveyed a national quota sample of 1,691 Australians in August and September 2020. Participants reported their level of compliance with coronavirus restrictions and estimated compliance from others in their state/territory. RESULTS: Overwhelmingly, most people reported complying with restrictions. They believed their fellow community members were much less compliant. Age and other demographics were only weakly associated with self-reported compliance and perceptions of others' compliance. CONCLUSIONS: The results are consistent with prevalent cognitive biases, including the tendency to believe one is better-than-average, and to more easily recall instances of deviances from social norms. IMPLICATIONS FOR PUBLIC HEALTH: We recommend public health messaging avoids amplifying instances of social transgressions of coronavirus restrictions. Instead, the widespread nature of social compliance with restrictions across the country should be emphasised.

Testing the validation and reliability of the Caregiver-Patient Activation Measure (CG-PAM).

Objective: The objective of this study was to test the reliability and validity of the Caregiver-Patient Activation Measure (CG-PAM). Methods: Based on the psychometric testing of the original Patient Activation Measure (PAM), three assessments of reliability and validity were completed on the CG-PAM. Test-retest reliability was assessed across two weeks (n = 23). Criterion validity was assessed by interviewing participants from the test-retest cohort (n = 10), with transcripts assessed by subject matter experts (n = 3) to classify activation levels of the interviewee. Construct validity was assessed through a survey (n = 179) consisting of demographic questions, the CG-PAM and concepts hypothesised to be related to caregiver activation. Results: There was strong test-retest reliability (r = 0.893), but poor criterion validity. Assessment o;f construct validity demonstrated significant relationships found between caregiver activation and weekly hours of care provided (p < 0.001), relationship satisfaction (p < 0.001), and dyad typology (p < 0.001), but not with perceived levels of stress or social support. Conclusion: The CG-PAM was found to have strong reliability, but there were inconsistent results across the validation tests conducted. Innovation: Future research must consider the dynamic nature of caring and the importance of the relationship between the caregiver/recipient when defining activation levels within the CG-PAM.

Physical and Mental Health Effects of Bushfire and Smoke in the Australian Capital Territory 2019-20.

The 2019-20 bushfire season in south-eastern Australia was one of the most severe in recorded history. Bushfire smoke-related air pollution reached hazardous levels in major metropolitan areas, including the Australian Capital Territory (ACT), for prolonged periods of time. Bushfire smoke directly challenges human health through effects on respiratory and cardiac function, but can also indirectly affect health, wellbeing and quality of life. Few studies have examined the specific health effects of bushfire smoke, separate from direct effects of fire, and looked beyond physical health symptoms to consider effects on mental health and lifestyle in Australian communities. This paper describes an assessment of the health impacts of this prolonged exposure to hazardous levels of bushfire smoke in the ACT and surrounding area during the 2019-20 bushfire season. An online survey captured information on demographics, health (physical and mental health, sleep) and medical advice seeking from 2,084 adult participants (40% male, median age 45 years). Almost all participants (97%) experienced at least one physical health symptom that they attributed to smoke, most commonly eye or throat irritation, and cough. Over half of responders self-reported symptoms of anxiety and/or feeling depressed and approximately half reported poorer sleep. Women reported all symptoms more frequently than men. Participants with existing medical conditions or poorer self-rated health, parents and those directly affected by fire (in either the current or previous fire seasons) also experienced poorer physical, mental health and/or sleep symptoms. Approximately 17% of people sought advice from a medical health practitioner, most commonly a general practitioner, to manage their symptoms. This study demonstrated that prolonged exposure to bushfire smoke can have substantial effects on health. Holistic approaches to understanding, preventing and mitigating the effects of smoke, not just on physical health but on mental health, and the intersection of these, is important. Improved public health messaging is needed to address uncertainty about how individuals can protect their and their families health for future events. This should be informed by identifying subgroups of the population, such as those with existing health conditions, parents, or those directly exposed to fire who may be at a greater risk.

Meeting support needs for informal caregivers of people with heart failure: a rapid review.

AIMS: To explore whether a support-based intervention for informal caregivers of people with heart failure changes their psychosocial and emotional wellbeing. Background Successful self-management of heart failure includes addressing the psychosocial and emotional wellbeing needs of informal caregivers. However, there is limited evidence of how caregivers are supported in this way. METHODS AND RESULTS: A rapid review was conducted searching four electronic databases with restrictions to dates January 1996 - September 2019. Specific inclusion and exclusion criteria were applied, and the first author reviewed articles based on title, abstract and then full text, before articles were assessed for conclusions and outcomes. Six studies met the criteria for review. The key caregiver outcomes were burden, depression/anxiety, and quality of life. Significant reductions in caregiver burden were demonstrated in the three studies that measured this outcome. There were mixed results for the outcome measures of depression/anxiety, as well as quality of life, with some interventions demonstrating either significant reductions in depression or anxiety scores, or increases in quality of life scores. CONCLUSION: With only six studies included in this rapid review, it is not possible to make any definitive conclusions regarding the success, or otherwise, of interventions for caregivers of people with heart failure to improve their psychosocial and emotional wellbeing. Whilst some papers would tend to suggest that such interventions can reduce caregiver burden, there is a need to interrogate further interventions in this area to fill the current gap in the literature.

The effects of a temporal framing manipulation on environmentalism: A replication and extension.

Recent research promotes comparing the current state of the environment with the past (and not the future) to increase the pro-environmental attitudes of those on the political right. We aimed to replicate this temporal framing effect and extend on research in this area by testing the potential drivers of the effect. Across two large-scale replication studies, we found limited evidence that past comparisons (relative to future comparisons) increase pro-environmentalism among those with a more conservative political ideology, thus precluding a full investigation into the mediators of the effect. Where the effect was present, it was not consistent across studies. In Study One, conservatives reported greater certainty that climate change was real after viewing past comparisons, as the environmental changes were perceived as more certain. However, in Study Two, the temporal framing condition interacted with political orientation to instead undermine the certainty about climate change among political liberals in the past-focused condition. Together, these studies present the first evidence of backfire from temporal frames, and do not support the efficacy of past comparisons for increasing conservatives' environmentalism. We echo recent calls for open science principles, including preregistration and efforts to replicate existing work, and suggest the replication of other methods of inducing temporal comparisons.

Indoor air quality in new and renovated low-income apartments with mechanical ventilation and natural gas cooking in California.

This paper presents pollutant concentrations and performance data for code-required mechanical ventilation equipment in 23 low-income apartments at 4 properties constructed or renovated 2013-2017. All apartments had natural gas cooking burners. Occupants pledged to not use windows for ventilation during the study but several did. Measured airflows of range hoods and bathroom exhaust fans were lower than product specifications. Only eight apartments operationally met all ventilation code requirements. Pollutants measured over one week in each apartment included time-resolved fine particulate matter (PM2.5 ), nitrogen dioxide (NO2 ), formaldehyde and carbon dioxide (CO2 ) and time-integrated formaldehyde, NO2 and nitrogen oxides (NOX ). Compared to a recent study of California houses with code-compliant ventilation, apartments were smaller, had fewer occupants, higher densities, and higher mechanical ventilation rates. Mean PM2.5 , formaldehyde, NO2 , and CO2 were 7.7 µg/m3 , 14.1, 18.8, and 741 ppm in apartments; these are 4% lower, 25% lower, 165% higher, and 18% higher compared to houses with similar cooking frequency. Four apartments had weekly PM2.5 above the California annual outdoor standard of 12 µg/m3 and also discrete days above the World Health Organization 24-hour guideline of 25 µg/m3 . Two apartments had weekly NO2 above the California annual outdoor standard of 30 ppb.