The impact of COVID-19 vaccine reactions on secondary vaccine hesitancy.

BACKGROUND: Primary and booster vaccinations are critical for mitigating COVID-19 transmission, morbidity, and mortality. Future booster vaccine campaigns rely on an increased understanding of vaccine hesitancy. OBJECTIVE: To evaluate self-reported allergic and skin vaccine reactions as factors potentially associated with vaccine hesitancy in a nationwide vaccine allergy registry. METHODS: Responses to survey questions concerning COVID-19 vaccine perceptions, coded from free text by 2 independent reviewers. Multivariable logistic regression models were used to determine the association between changed negative perception and respondent demographics, vaccination history, and reaction characteristics. RESULTS: A total of 993 individuals (median of 46 years [IQR, 36-59], 88% female, 82% White) self-reported reactions to COVID-19 vaccination. Reactions included the following: delayed large local skin reaction (40%), hives/urticaria (32%), immediate large local skin reaction (3%), swelling (3%), anaphylaxis (2%), and other or unspecified (20%). Most respondents were initially unconcerned about the safety of COVID-19 vaccines (56%). After reactions, 401 of 993 (40%) report negative change in perception of vaccination, with more than half of these respondents (n = 211, 53%) citing their reasoning as a negative experience with adverse effects. Of 102 individuals asked about future vaccination, 79 (77%) indicated that they were unlikely or very unlikely to receive future COVID-19 vaccinations. Increased negative perception after reaction was associated with younger age, later COVID-19 vaccination dose number, and reaction type. CONCLUSION: Our findings reveal that an individual's experience with allergic or cutaneous adverse effects after COVID-19 vaccination affects attitudes and decision-making regarding future vaccination, even in initially non-hesitant individuals. Further investigation of secondary vaccine hesitancy is necessary for adapting public health messaging to this important population.

"We don't want to run before we walk": the attitudes of Australian stakeholders towards using psychedelics for mental health conditions.

OBJECTIVES: This study was aimed at understanding the attitudes and positions of key Australian organisational and political stakeholders towards using psychedelic agents in medically supervised environments to treat mental health conditions. Specifically, this research was designed to identify some of the issues that might impede the clinical implementation of psychedelics. METHODS: Semi-structured interviews were conducted with four Australian politicians and nine representatives of key stakeholder organisations between September 2022 and January 2023. Data analyses were completed using pattern-based inductive thematic analysis. RESULTS: Participants were cautiously optimistic about using psychedelics to treat mental health conditions, with hesitancy emerging due to the perceived inadequacy of research into the efficacy and feasibility of these treatments. Politicians consistently mentioned that negative stigma prevented them and their peers from supporting the use of psychedelics in Australia. Effective, evidence-based, clear messaging that refutes misconceptions, uses persuasive messaging and provides clear information to inform implementation is needed to improve knowledge and challenge attitudes, biases and emotions that can influence the debate around psychedelics. CONCLUSIONS: Stakeholder representatives and politicians agree that insufficient evidence exists to support the widespread clinical implementation of psychedelics in Australia. Politicians also perceive the stigma associated with psychedelics might negatively influence progressive legislation. Additional research and a clear presentation of this research are needed before the clinical use of psychedelics can be supported.

Identifying and Prioritising Behaviours to Slow Antimicrobial Resistance.

As a nation with relatively low levels of AMR, due to both community and agricultural stewardship, as well as geographical isolation, Australia is somewhat unique. As this advantage is being eroded, this project aimed to investigate the spectrum of human behaviours that could be modified in order to slow the spread of AMR, building upon the argument that doable actions are the best-targeted and least complex to change. We conducted a workshop with a panel of diverse interdisciplinary AMR experts (from sociology, microbiology, agriculture, veterinary medicine, health and government) and identified twelve behaviours that, if undertaken by the public, would slow the spread of AMR. These were then assessed by a representative sample of the public (285 Australians) for current participation, likelihood of future participation (likelihood) and perceived benefits that could occur if undertaken (perceived impact). An impact-likelihood matrix was used to identify four priority behaviours: do not pressure your doctor for antibiotics; contact council to find out where you can safely dispose of cleaning products with antimicrobial marketing; lobby supermarkets to only sell antibiotic free meat products; and return unused antibiotics to a pharmacy. Among a multitude of behavioural options, this study also highlights the importance of tailoring doable actions to local conditions, increasing community education, and emphasizing the lack of a one-size fits all approach to tackling this global threat.

A brief intervention for improving alcohol literacy and reducing harmful alcohol use by women attending a breast screening service: a randomised controlled trial.

OBJECTIVES: To assess the effectiveness of a brief alcohol intervention for improving awareness of alcohol as a breast cancer risk factor, improving alcohol literacy, and reducing alcohol consumption by women attending routine breast screening. DESIGN: Single-site, double-blinded randomised controlled trial. SETTING: Maroondah BreastScreen (Eastern Health, Melbourne), part of the national breast cancer screening program. PARTICIPANTS: Women aged 40 years or more, with or without a history of breast cancer and reporting any alcohol consumption, who attended the clinic for routine mammography during 5 February - 27 August 2021. INTERVENTION: Active arm: animation including brief alcohol intervention (four minutes) and lifestyle health promotion (three minutes). CONTROL ARM: lifestyle health promotion only. MAJOR OUTCOME MEASURE: Change in proportion of women who identified alcohol use as a clear risk factor for breast cancer (scaled response measure). RESULTS: The mean age of the 557 participants was 60.3 years (standard deviation, 7.7 years; range, 40-87 years); 455 had recently consumed alcohol (82%). The proportions of participants aware that alcohol use increased the risk of breast cancer were larger at four weeks than at baseline for both the active intervention (65% v 20%; odds ratio [OR], 41; 95% confidence interval [CI], 18-97) and control arms of the study (38% v 20%; OR, 4.9; 95% CI, 2.8-8.8), but the change over time was greater for the active intervention arm (arm × time: P < 0.001). Alcohol literacy also increased to a greater extent in the active than the control arm, but alcohol consumption did not significantly change in either arm. CONCLUSION: A tailored brief alcohol intervention for women attending breast screening was effective for improving awareness of the increased breast cancer risk associated with alcohol use and alcohol literacy more broadly. Such interventions are particularly important given the rising prevalence of risky drinking among middle-aged and older women and evidence that even very light alcohol consumption increases breast cancer risk. REGISTRATION: ClinicalTrials.gov, NCT04715516 (prospective; 20 January 2021).

A Brief Intervention for Improving Alcohol Literacy and Addressing Harmful Alcohol Use Among Women Attending an Australian Breast Screening Service (Health4her): Protocol for a Hybrid Effectiveness-Implementation Trial.

BACKGROUND: Alcohol consumption is a major modifiable risk factor for female breast cancer, even in small amounts. However, awareness of this risk remains low. National breast screening programs are uniquely positioned to provide timely and targeted health information and behavior change strategies to improve alcohol literacy and reduce consumption. A breast screening service is a novel health care setting for brief alcohol intervention, with the potential for extensive reach. OBJECTIVE: This study aimed to conduct a formative evaluation with breast screening service consumers to understand the need for, and acceptability of, brief alcohol intervention in the breast screening setting and collaboratively design a brief alcohol intervention (Health4Her); to test the effectiveness of Health4Her in improving knowledge of alcohol as a breast cancer risk factor (primary outcome), improving alcohol literacy, and reducing consumption among women attending a breast screening service; and to examine the implementation strategy through process evaluation. METHODS: This was a hybrid type II effectiveness-implementation trial comprising a randomized controlled trial (RCT) alongside a mixed methods program evaluation guided by applicable elements of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework and Consolidated Framework for Implementation Research. Formative evaluation comprised a retrospective analysis of alcohol consumption data (n=49,240), a web-based survey (n=391), and focus groups and interviews (n=31) with breast screening service consumers. Women attending routine mammography, drinking at any level, were recruited to the single-site, double-blind RCT (n=558), and completed a baseline assessment before randomization (1:1) to receive Health4Her (alcohol brief intervention + lifestyle information) or control (lifestyle information) via animation on an iPad. Follow-up assessments were performed 4 and 12 weeks after randomization. The process evaluation included evaluation of trial administrative data, participant quantitative (n=497) and qualitative feedback (n=30), and site staff qualitative feedback (n=11). RESULTS: This research was funded in March and May 2019. Data collection for the formative evaluation and trial recruitment occurred between January and April 2020 and February and August 2021, respectively, with finalization of follow-up data collection in December 2021. Quantitative process evaluation data were collected during trial implementation, and collection of participant and staff feedback was finalized in December 2021. Results of the retrospective analysis of alcohol consumption data from breast screening service consumers is anticipated to be published in March 2023 and the results of the RCT to be published in March 2023. CONCLUSIONS: This study is anticipated to generate new substantial knowledge on the alcohol consumption and literacy needs of women attending breast screening and the extent to which these can be addressed using a novel, tailored brief alcohol intervention. The study design permits the evaluation of the effectiveness and implementation of Health4Her to predict and facilitate uptake in breast screening services. TRIAL REGISTRATION: ClinicalTrials.gov NCT04715516; https://clinicaltrials.gov/ct2/show/NCT04715516. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/44867.

Demographic and spatial variables associated with spending time in nature during COVID-19 lockdowns.

To stop the spread of SARS-CoV-2 coronavirus (COVID-19) governments around the world implemented lockdowns restricting public travel. In the Australian state of Victoria, this included limiting permitted reasons for leaving home and restricting movements to within a 5 km radius of one's home. In 2020, we conducted a state-wide survey (N = 1024) of Victorians that coincided with a lockdown. We asked respondents where they had spent time in nature and how they perceived lockdowns affected the amount of time they spent in nature. We then considered demographic and spatial predictors of spending more or less time in nature. Women, younger people, and those living in areas with higher socio-economic status were likely to report spending more time in nature. Closer proximity of residents to parks and waterways and higher proportional area of native vegetation within a 1-km radius were also associated with more time in nature. Understanding how different groups were affected by restrictions on access to nature can help improve government management of crises like pandemics, including through urban planning for green space, supporting improved individual and societal resilience. We discuss the implications of our findings for improving access to nature during lockdowns as well as opportunities for a post-pandemic relationship with nature, particularly in urban settings.

Root-TT[over ¯] Deformations in Two-Dimensional Quantum Field Theories.

In this Letter, we introduce a one-parameter deformation of two-dimensional quantum field theories generated by a nonanalytic operator that we call Root-TT[over ¯]. For a conformal field theory, the operator coincides with the square root of the TT[over ¯] operator. More generally, the operator is defined so that classically it is marginal and generates a flow that commutes with the TT[over ¯] flow. Intriguingly, the Root-TT[over ¯] flow is closely related to the ModMax theory recently constructed by Bandos, Lechner, Sorokin, and Townsend.

Retirement Confidence: Development of an Index.

Older workers who are confident about the changes accompanying retirement report higher well-being. We have developed an index to measure retirement confidence - the Retirement Confidence Index (RCI). A six-stage approach was used to develop the index items, including (i) a literature review to catalogue retirement confidence components; (ii) a consultation with a panel of experts to review the proposed indicators and combine components according to their meaning; (iii) normalisation of the selected components to make them comparable; (iv) weighting of the top-level dimensions using experts' judgement; (v) linear aggregation of the dimension scores according to their corresponding relative weight; and (vi) correlation of the composite score with a self-report measure of retirement confidence. Based on the review of the literature, a list of nine sub-components (financial literacy, financial attitude and behaviour, financial control, financial anxiety, physical health, mental health, social connectedness, goal setting for retirement and future uncertainties) was compiled. Subsequently, these components were grouped into four broad dimensions. Correlations between these dimensions (social, financial awareness and skills, health and well-being, and retirement awareness and planning dimensions) and the corresponding self-reported measures were as high as r = 0.555, r = 0.603, r = 0.591 and r = 0.569, reflecting 30.8%, 36.3%, 34.9% and 32.3% shared variance with the corresponding self-reported indices, respectively. The Retirement Confidence Index provides the foundation for future research to measure retirement confidence, with the aim of identifying deficient RCI dimensions and directing efforts to targeted policies to ensure older workers are confident about retirement.

The introduction of a mandatory mask policy was associated with significantly reduced COVID-19 cases in a major metropolitan city.

BACKGROUND: Whilst evidence of use of face masks in reducing COVID-19 cases is increasing, the impact of mandatory use across a large population has been difficult to assess. Introduction of mandatory mask use on July 22, 2020 during a resurgence of COVID-19 in Melbourne, Australia created a situation that facilitated an assessment of the impact of the policy on the epidemic growth rate as its introduction occurred in the absence of other changes to restrictions. METHODS AND FINDINGS: Exponential epidemic growth or decay rates in daily COVID-19 diagnoses were estimated using a non-weighted linear regression of the natural logarithm of the daily cases against time, using a linear spline model with one knot (lspline package in R v 3.6.3). The model's two linear segments pivot around the hinge day, on which the mask policy began to take effect, 8 days following the introduction of the policy. We used two forms of data to assess change in mask usage: images of people wearing masks in public places obtained from a major media outlet and population-based survey data. Potential confounding factors (including daily COVID-19 tests, number of COVID-19 cases among population subsets affected differentially by the mask policy-e.g., healthcare workers) were examined for their impact on the results. Daily cases fitted an exponential growth in the first log-linear segment (k = +0.042, s.e. = 0.007), and fitted an exponential decay in the second (k = -0.023, s.e. = 0.017) log-linear segment. Over a range of reported serial intervals for SARS-CoV-2 infection, these growth rates correspond to a 22-33% reduction in an effective reproduction ratio before and after mandatory mask use. Analysis of images of people in public spaces showed mask usage rose from approximately 43% to 97%. Analysis of survey data found that on the third day before policy introduction, 44% of participants reported "often" or "always" wearing a mask; on the fourth day after, 100% reported "always" doing so. No potentially confounding factors were associated with the observed change in growth rates. CONCLUSIONS: The mandatory mask use policy substantially increased public use of masks and was associated with a significant decline in new COVID-19 cases after introduction of the policy. This study strongly supports the use of masks for controlling epidemics in the broader community.

Institutional and behaviour-change interventions to support COVID-19 public health measures: a review by the Lancet Commission Task Force on public health measures to suppress the pandemic.

The Lancet COVID-19 Commission Task Force for Public Health Measures to Suppress the Pandemic was launched to identify critical points for consideration by governments on public health interventions to control coronavirus disease 2019 (COVID-19). Drawing on our review of published studies of data analytics and modelling, evidence synthesis and contextualisation, and behavioural science evidence and theory on public health interventions from a range of sources, we outline evidence for a range of institutional measures and behaviour-change measures. We cite examples of measures adopted by a range of countries, but especially jurisdictions that have, thus far, achieved low numbers of COVID-19 deaths and limited community transmission of severe acute respiratory syndrome coronavirus 2. Finally, we highlight gaps in knowledge where research should be undertaken. As countries consider long-term measures, there is an opportunity to learn, improve the response and prepare for future pandemics.

Gendered stereotypes and norms: A systematic review of interventions designed to shift attitudes and behaviour.

In the face of ongoing attempts to achieve gender equality, there is increasing focus on the need to address outdated and detrimental gendered stereotypes and norms, to support societal and cultural change through individual attitudinal and behaviour change. This article systematically reviews interventions aiming to address gendered stereotypes and norms across several outcomes of gender inequality such as violence against women and sexual and reproductive health, to draw out common theory and practice and identify success factors. Three databases were searched; ProQuest Central, PsycINFO and Web of Science. Articles were included if they used established public health interventions types (direct participation programs, community mobilisation or strengthening, organisational or workforce development, communications, social marketing and social media, advocacy, legislative or policy reform) to shift attitudes and/or behaviour in relation to rigid gender stereotypes and norms. A total of 71 studies were included addressing norms and/or stereotypes across a range of intervention types and gender inequality outcomes, 55 of which reported statistically significant or mixed outcomes. The implicit theory of change in most studies was to change participants' attitudes by increasing their knowledge/awareness of gendered stereotypes or norms. Five additional strategies were identified that appear to strengthen intervention impact; peer engagement, addressing multiple levels of the ecological framework, developing agents of change, modelling/role models and co-design of interventions with participants or target populations. Consideration of cohort sex, length of intervention (multi-session vs single-session) and need for follow up data collection were all identified as factors influencing success. When it comes to engaging men and boys in particular, interventions with greater success include interactive learning, co-design and peer leadership. Several recommendations are made for program design, including that practitioners need to be cognisant of breaking down stereotypes amongst men (not just between genders) and the avoidance of reinforcing outdated stereotypes and norms inadvertently.

The CN-12: A Brief, Multidimensional Connection With Nature Instrument.

In recent decades, there has been increasing interest in (re)connecting people with nature to foster sustainability outcomes. There is a growing body of evidence suggesting a relationship between connection with nature and pro-environmental behaviors. Connection with nature has often been conceptualized as a unidimensional construct, and although recent evidence suggests that it is multidimensional, there is ongoing debate regarding the dimensions that make up connection with nature. Existing multidimensional connection with nature instruments capture similar dimensions, yet they are lengthy and may not have practical application in real-world contexts. This research sought to clarify the dimensions of connection with nature and to develop and validate an abbreviated yet multidimensional connection with nature instrument-the CN-12. Analyses of two large datasets revealed three dimensions of connection with nature-identity, experience, and philosophy. Results suggested that the CN-12 and its three dimensions are positively correlated with: (1) environmental and altruistic values; (2) time spent in nature; and (3) a range of pro-environmental behaviors. Results also suggested that the CN-12 and its three dimensions are stable over time and are positively correlated with two existing multidimensional connection with nature instruments, the Nature Relatedness (NR) Scale and Environmental Identity (EID) Scale. The utility of the CN-12 for exploring human connections with nature and the role of fostering connection with nature to increase engagement in pro-environmental behaviors are discussed.

Solvent-Mediated Activation/Deactivation of Photoinduced Electron-Transfer in a Molecular Dyad.

Herein is presented a molecular dyad comprised of a [Ru(bpy)3]2+ photosensitizer and an anthraquinone (AQ) acceptor coupled by an ethynyl linker ([Ru(bpy)2(bpy-cc-AQ)]2+) in which activation/deactivation of photoinduced electron-transfer from the [Ru(bpy)3]2+ photosensitizer to the AQ acceptor is achieved and characterized as a function of the dielectric constant and hydrogen-bond donating ability of the solvent used. It is demonstrated that the rate of photoinduced electron-transfer can be modulated over several orders of magnitude (105-1011 s-1) by choice of solvent. Nanosecond transient absorption spectra are dominated by MLCT signals and exhibit identical decay kinetics to the corresponding emission signals. Ultrafast transient absorption and time-resolved infrared spectroscopies provide direct evidence for the formation of the charge-separated (CS) state and rapid (on the order of a few picoseconds) establishment of an excited-state pseudoequilibrium.

Experiments on Liquid Flow through Non-Circular Micro-Orifices.

Microfluidics is an active research area in modern fluid mechanics, with several applications in science and engineering. Despite their importance in microfluidic systems, micro-orifices with non-circular cross-sections have not been extensively investigated. In this study, micro-orifice discharge with single-phase liquid flow was experimentally investigated for seven square and rectangular cross-section micro-orifices with a hydraulic diameter in the range of 326-510 µm. The discharge measurements were carried out in pressurized water (12 MPa) at ambient temperature (298 K) and high temperature (503 K). During the tests, the Reynolds number varied between 5883 and 212,030, significantly extending the range in which data are currently available in the literature on non-circular micro-orifices. The results indicate that the cross-sectional shape of the micro-orifice has little, if any, effect on the hydrodynamic behavior. Thus, existing methods for the prediction of turbulent flow behavior in circular micro-orifices can be used to predict the flow behavior in non-circular micro-orifices, provided that the flow geometry of the non-circular micro-orifice is described using a hydraulic diameter.

Digital Inclusion & Health Communication: A Rapid Review of Literature.

Information and communication technologies can be a valuable tool for enhancing health communication. However, not everyone is utilising the wide suite of digital opportunities. This disparity has the potential to exacerbate existing social and health inequalities, particularly among vulnerable groups such as those who are in poor health and the elderly. This review aimed to systematically identify the common barriers to, and facilitators of, digital inclusion. A comprehensive database search yielded 969 citations. Following screening, seven systematic reviews and three non-systematic reviews were identified. Collectively, the reviews found that physical access continues to be a barrier to digital inclusion. However, provision of access alone is insufficient, as digital ability and attitude were also potential barriers. Social support, direct user experience and collaborative learning/design were identified as key strategies to improve inclusion. These review findings provide guidance for health communication practitioners in designing and implementing effective programmes in the digital environment.

Ultrasonic Exfoliation of Hydrophobic and Hydrophilic Metal-Organic Frameworks To Form Nanosheets.

The modular structure of metal-organic framework nanosheets (MONs) provides a convenient route to creating two-dimensional materials with readily tuneable surface properties. Here, the liquid exfoliation of two closely related layered metal-organic frameworks functionalised with either methoxy-propyl (1) or pentyl (2) pendent groups intended to bestow either hydrophilic or hydrophobic character to the resulting nanosheets is reported. Exfoliation of the two materials in a range of different solvents highlighted significant differences in their dispersion properties, as well as their molecular and nanoscopic structures. Exchange or loss of solvent was found to occur at the labile axial position of the paddle-wheel based MONs and DFT calculations indicated that intramolecular coordination by the oxygen of the methoxy-propyl pendant groups may take place. The nanoscopic dimensions of the MONs were further tuned by varying the exfoliation conditions and through "liquid cascade centrifugation". Aqueous suspensions of the nanosheets were used as sensors to detect aromatic heterocycles with clear differences in binding behaviour observed and quantified.

Understanding the biosecurity monitoring and reporting intentions of livestock producers: Identifying opportunities for behaviour change.

In many countries, government strategies for biosecurity planning and outbreaks depend upon private livestock producers being willing and able to conduct surveillance of their animals and the timely reporting of suspicious signs of disease. From a behavioural perspective, these two kinds of behaviours - surveillance and reporting - should be treated separately when developing a biosecurity plan in which producers play a key role in the prevention, detection, and reporting of animal diseases. Having an effective surveillance system in place is conceptually and practically independent of a reporting system that is both feasible and trustworthy. The behavioural intentions of 200 Australian producers to monitor their livestock and report to either the government or a private vet were measured in a structured telephone interview. Structural equation modelling revealed that these intentions had different statistical relationships with a common set of predictor variables. Moreover, classification of the producers based on belief about monitoring and surveillance resulted in three contrasting groups. These results are discussed in terms of their meaning for the development of behavioural strategies to promote surveillance and monitoring of animal disease.

Predictors of illegal dumping at charitable collection points.

Cleaning and disposal of illegal dumping at charitable collection points costs charities and diverts funds from their charitable programs. However, there is no published literature that attempts to better understand this problem. The current study assesses site-specific characteristics, community level indicators and sociodemographic factors as predictors of both charity stores and collection bin dumping in the metropolitan area of Perth, Australia. Multiple regression analyses revealed that higher levels of dumping at stores were predicted by being open on Sundays, the presence of gates/fencing, bringing bins in at night, greater 5-year mobility and lower levels of education and occupation in the area. The analysis also suggests that preventative measures have not necessarily been effective at reducing the amount of illegal dumping at stores. For charity bins, significant predictors of higher levels of dumping included private land ownership, if the site is shared with bins from another charity, the number of bins at the site, the number of days serviced per week, if the bin/s are located at a park/reserve and greater 5-year mobility. These results indicate that there is a combination of site-specific characteristics and community level indicators that play a role in illegal dumping at charitable collection points and indicate the type of interventions which may be successful in reducing illegal dumping. These may include improved maintenance, better placement of bins and signage and collaborations with real estate agents.

Visitors or visits? An examination of zoo visitor numbers using the case study of Australia.

Usually cited in reference to the potential reach of zoo education, one of the popular figures for global zoo visitation is that 600 million people visit zoos annually. However, this number needs clarification on two fronts. First, there are many zoo visitors who are not included in the calculation because they visited a zoo that was not included in the count. Second, it does not take into consideration the people visit either the same or different zoos more than once annually. Using data collected from several sources, including zoo visitors themselves, this article focuses on one country--Australia--that contributes 15.6 million to the visitation total, and contends that the correct number of unique annual zoo visitors to Australian zoos is likely to be between 8 and 10 million. However, rather than suggesting an overemphasis on the potential of zoos for educating visitors, having regular repeat visitors represents a distinct advantage for zoos, allowing for progressive education opportunities.