Aarti Iyer

Many medication side effects are the result of negative patient expectations rather than the pharmacological action of the drugs, thus triggering a “nocebo effect.” Negative expectations can be generated by contextual factors that contribute to the perceived quality of care. Research shows that perceived discrimination in healthcare settings among Black, Asian, and other Minority Ethnic (BAME) groups is associated with lower perceived quality of care. Yet, no work has considered whether perceived discrimination contributes to experiences of nocebo effects among BAME groups, leading to potentially poorer medication adherence and health outcomes. We conducted an online cross-sectional survey of 801 participants representing the four largest UK racial/ethnic groups (Asian, Black, Mixed, and White) who had been prescribed a new medication in a general practitioner (GP) consultation in the previous 6 months. Participants’ perceived discrimination during their GP consultation was significantly and positively associated with their side-effect experience, and significantly and negatively associated with their adherence to the prescribed medication, with side-effect expectations significantly mediating these relationships. There was a significant interaction between ethnicity and perceived discrimination: participants who identified as mixed race were less likely to report side effects than White participants who experienced the same level of discrimination. Future longitudinal studies are needed to confirm the identified causal relationships and to explore the types of perceived discrimination BAME individuals are experiencing in health care to help develop interventions to reduce nocebo effects.

Until very recently, the question of how residents might be affected by the gradient of neighbourhood boundaries – whether these boundaries are abrupt or gradual – has remained largely absent from mainstream segregation research. Yet, theoretical and empirical findings emerging from recent studies suggest the impacts could be profound and far-reaching. This article seeks to provide a conceptual foundation for understanding such effects. We focus on the concept of ‘social frontiers’: spatial discontinuities in the geography of residential mix which occur when community boundaries are abrupt. Drawing on insights from cognate disciplines, we develop a theory of social frontier impacts that articulates their potential importance in limiting and shaping contact between neighbouring communities, exacerbating territorial conflict and ultimately affecting the psychological wellbeing and life course outcomes of those living at the frontier. We present our thesis as a series of propositions and corollaries, and reflect on the implications for empirical research.

Whether life transitions are anticipated or unforeseen, they can be challenging to navigate because the change process involves a period of uncertainty and adjustment. Specifically, transitions often require social identity change, whereby individuals leave one or more social groups behind and join one or more groups in the new environment. Such changes can be especially hard when individuals belong to a disadvantaged group (e.g., a low-income or racial- or ethnic-minority group) because they also have to contend with the additional hurdle of systemic inequality. Yet members of disadvantaged groups also have resources to navigate social identity change during life transitions—resources that facilitate and support successful social identity change. We review our research with immigrants and university students to show how individuals’ social connectedness with groups can facilitate positive outcomes during life transitions, including social integration, psychological well-being, positive beliefs about the self, and successful academic performance. In particular, we consider individuals’ group memberships prior to the transition and the new identities they adopt in the new context as key determinants of successful identity change. We conclude with implications for policy and practice.

To combat social inequality, organizations develop and implement initiatives that seek to improve the status of disadvantaged groups (e.g., women, racial/ethnic minority groups). Such diversity, equity, and inclusion (DEI) policies are controversial, because people disagree about whether they are necessary and what their (positive and negative) consequences may be. Opposition can be particularly fierce from people who belong to advantaged groups that benefit from the status quo (e.g., men, racial/ethnic majority groups). Given the power wielded by advantaged groups, their opposition can undermine the successful implementation of DEI policies, thus resulting in continued inequality, wasted resources, and potential for tension in the organization. In this paper, I draw on theory and research to consider three types of threat that can explain advantaged groups' opposition to DEI policies: (1) resource threat , or concern about losing access to outcomes and opportunities; (2) symbolic threat , or concern about the introduction of new values, culture, and expectations; and (3) ingroup morality threat , or concern about their group's role in perpetuating inequality. I review strategies identified by the literature to mitigate these threats, and discuss their potential negative consequences. The final section takes stock of the literature and considers directions for future research.

Coagulopathies common to patients with diabetes and chronic kidney disease (CKD) are not fully understood. Fibrin deposits in the kidney suggest the local presence of clotting factors including tissue factor (TF). In this study, we investigated the effect of glucose availability on the synthesis of TF by cultured human kidney tubular epithelial cells (HTECs) in response to activation of protease-activated receptor 2 (PAR2). PAR2 activation by peptide 2f-LIGRLO-NH₂ (2F, 2 µM) enhanced the synthesis and secretion of active TF (~45 kDa) which was blocked by a PAR2 antagonist (I-191). Treatment with 2F also significantly increased the consumption of glucose from the cell medium and lactate secretion. Culturing HTECs in 25 mM glucose enhanced TF synthesis and secretion over 5 mM glucose, while addition of 5 mM 2-deoxyglucose (2DOG) significantly decreased TF synthesis and reduced its molecular weight (~40 kDa). Blocking glycosylation with tunicamycin also reduced 2F-induced TF synthesis while reducing its molecular weight (~36 kDa). In conclusion, PAR2-induced TF synthesis in HTECs is enhanced by culture in high concentrations of glucose and suppressed by inhibiting either PAR2 activation (I-191), glycolysis (2DOG) or glycosylation (tunicamycin). These results may help explain how elevated concentrations of glucose promote clotting abnormities in diabetic kidney disease. The application of PAR2 antagonists to treat CKD should be investigated further.

Members of high-status groups (e.g., men) often lead social justice efforts that seek to benefit low-status groups (e.g., women), but little is known about how observers respond to such instances of visible and influential solidarity. We presented information about a nonprofit organization seeking to address gender (Study 1, N = 198) or racial (Study 2, N = 216) inequality, in which the leadership team was manipulated to include a numerical majority of either high-status group members or low-status group members. Members of low-status groups who read about the majority high-status leadership team reported lower levels of collective action intentions, compared with those who read about the majority low-status leadership team. Mediation analyses (Studies 1 and 2) and an experimental-causal-chain design (Study 3, N = 405) showed that lower collective action intentions in response to the majority high-status leadership team were mediated by participants' perception of a specific problem presented by high-status group leaders (lower awareness of inequality) and lower levels of hope. Study 4 (N = 555) demonstrated that low-status group members responded more negatively to a majority high-status leadership team in an organization seeking to benefit their low-status ingroup (solidarity context), compared with organizations seeking to benefit other groups (nonsolidarity contexts). Results provide the first evidence that the presence of influential high-status group leaders can discourage members of low-status groups from joining a social justice effort that seeks to benefit their ingroup, and that these negative responses extend beyond preferences predicted by frameworks of ingroup bias and role congruity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Fictional narratives can serve as an indirect contact strategy when direct contact between two groups is not feasible. This study investigated whether exposing cisgender individuals to transgender-related fiction was associated with reduced transnegativity. Two emotion-related mediators were examined in this relationship: transportation into the story (proximal to fiction exposure) and intergroup anxiety (proximal to contact theory). Cisgender participants (N = 84) viewed or read stories involving transgender characters or read a science article. Those who encountered transgender characters reported lower transnegativity than those who read the control story. Transportation into the story and intergroup anxiety serially mediated this relationship. The findings suggest conditions under which a fictional story can expand an audience’s social world and thereby serve as a strategy for prejudice reduction.

Refugees often experience poor physical and mental health outcomes following resettlement. These outcomes have been linked to the conditions that are experienced by refugees in the post‐migration context, but little is known about the mechanisms by which these conditions influence health. We therefore conducted secondary analyses of the Survey of New Refugees, a large longitudinal study commissioned by the UK Home Office with data collected at four time points spanning 21 months. Refugees’ experience of emotional distress such as feeling stressed, worried, and depressed fully mediated the relationship between post‐migration stressors and longitudinal general health. There was no evidence that perceived social support influenced this relationship. These findings suggest that emotional distress contributes to poor health outcomes among refugees and thus that interventions might target emotional distress.