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The first Transplant Games took place in 1978 in Portsmouth, England. Since then, numerous Olympic-style sporting 'Games' have been established, each aiming to increase public awareness of organ donation, demonstrate the benefits of transplantation, and encourage patient fitness. Despite this, there is limited research exploring the psycho-social and health impacts of the Games. Drawing on qualitative research conducted at the 2022 British Transplant Games and the 2022 European Transplant and Dialysis Games, this paper explores the Games through a therapeutic landscapes framework, a concept that examines the ways in which environments contribute to health and wellbeing. Building upon work that acknowledges the relational and contingent nature of health-in-place, I argue that the Games are a therapeutic landscape of social relations for transplant recipients in three ways: providing a landscape of belonging , a landscape of hope , and a landscape of motivation. Through this therapeutic landscapes perspective, the Transplant Games are presented as a peer-to-peer clinic – a care space where individuals are more actively involved in their health on a reciprocal level than in the traditional hospital clinic. In turn, this paper emphasises the crucial role of affective peer support in producing health-promoting environments. This research seeks to make a practical contribution to the wider transplant community by promoting the Games as an environment which may positively contribute to both physical and mental wellbeing. • The Transplant Games function as a therapeutic landscape for organ recipients. • They provide a peer-to-peer clinic where participants are active in their health. • The Games provide a landscape of belonging, acceptance, understanding and family. • In showing you can still lead a healthy life, the Games become a landscape of hope. • As a landscape of motivation, the Games improve both physical and mental health. [ABSTRACT FROM AUTHOR]

Abstract This paper provides evidence of different teenage-smoking dynamics between genders with social progression. In particular, we find that descending from more gender-equal societies makes girls relatively more prone to smoke than those from less gender-equal societies relative to their male counterparts. Using data from over 6,000 second-generation immigrant teenagers sharing culture and institutions from one host country (Spain) but coming from 45 different countries of ancestry, we find that the higher the degree of gender equality in the country of ancestry, the higher the likelihood that girls smoke relative to boys. Our result holds even after we control for parental, sibling, and peer smoking, as well as for country-of-ancestry indicators of economic development and the smoking gender gap, among others. Highlights • Gender social norms determine the gender smoking gap among teenagers. • Descending from less traditional societies raises females smoking relative to males. • Result are robust to including both individual and country-of-ancestry controls. [ABSTRACT FROM AUTHOR]

Community-based participatory research (CBPR) has become an increasingly common approach to research involving people who use(d) drugs (PWUD), who are often employed as peer researchers on these projects. This paper seeks to understand the impact of CBPR on PWUD, particularly those living in heavily researched and stigmatized neighbourhoods where CBPR projects are often located. This study draws on 14 in-depth interviews with PWUD who had previous experience as both peer researchers and research participants in CBPR projects conducted between July 2010 and February 2011. The study employed a CBPR approach in its study design, recruitment, interviewing, and analysis. Our analysis indicates that participants were supportive of CBPR in principle and described the ways in which it helped contest stigmatizing assumptions and researcher bias. Participants also reported positive personal gains from participation in CBPR projects. However, many participants had negative experiences with CBPR projects, especially when CBPR principles were implemented in a superficial or incomplete manner. Participants emphasized the importance of inclusiveness and active deconstruction of hierarchy between researchers and community members to successful CBPR among drug using populations. CBPR has been widely adopted as a research approach within marginalized communities but has often been implemented inconsistently. Still, CBPR can empower communities to contest forms of social stigma that are often reproduced through academic research on marginalized communities. Our findings describe how the benefits of CBPR are maximized when CBPR principles are consistently applied and when community-based researchers are supported in ways that reduce power hierarchies. This suggests a need for capacity building within affected communities to develop independent support, training, and grievance processes for peer researchers. [ABSTRACT FROM AUTHOR]

This paper explores the interaction between peer relationships and sexual health among street youth in three Sub-Saharan African cities: Accra (Ghana), Bukavu (Democratic Republic of Congo), and Harare (Zimbabwe). It begins by conceptualising peer relationships for youth globally and considers why these are pivotal for young people living in street settings. The paper reconceptualizes street peer relationships not as replacement families, but as sharing 'social anchorage' in the street space. It draws on qualitative ethnographic data from Growing up on the Streets, a longitudinal research project with a participatory methodology undertaken between 2012 and 2016 and engaging street youth (aged 14–20 at project outset) trained in ethnographic observations as research assistants (n = 18), following a network of ten peers (n = 229 by 2016), reporting their experiences in weekly interviews with facilitators. A wider network attended focus groups (n = 399). The project engaged a 'capability' approach, with ten capabilities defined by street youth as key to their daily lives. Empirical evidence is from a subset of data qualitatively coded (using NVivo) against capabilities 'Health and Wellbeing' and 'Friendship', across all interviews, focus groups and cities (n = 212 sources). In exploring this intersection, the paper demonstrates beneficial and adverse impacts of peer influence on sexual health, including misinformation about contraceptives and death from an informal sector abortion; highlighting findings from across the three cities around primacy of same-sex peer relations, mistrust between genders and in healthcare providers. The paper finds that while street youth remain subject to cultural norms around gender identities, street peer relationships hold a persuasive power; contributing to both everyday survival and moments of acute need. It concludes that recognising the right of young people to live and seek livelihoods in urban settings, and adopting the social networks they create to advance street youth's sexual health has become even more relevant in a (post)pandemic world. • Young people are the majority living in new urban informality. • A new conceptualization positions street peer relations as socio-spatially anchored. • Peers can play a critical role in the sexual wellbeing of young street people. • Policy, practice and peer social networks can advance sexual health of street youth. [ABSTRACT FROM AUTHOR]

Malawian adolescents overestimate their HIV infection risk. Understanding why they do so is important since such overestimation is likely to be linked to later-life outcomes. This study focuses on the influence peers have on HIV infection expectations. I use novel school-based survey data collected in Malawi between October 2011 and March 2012 (n = 7910), which has more reliable measures of peers' HIV infection expectations than other studies. I employ a combined instrumental variables/fixed effects methodology designed to addresses several methodological challenges in estimating peer effects, including self-selection of friends, the issue of unobserved environmental confounders, and the bi-directionality of peer effects. Several tests are conducted in order to assess the robustness of the specifications. Results suggest that a one-percentage-point increase in the mean probabilistic expectation of HIV infection among peers increases an adolescent's own subjective expectation of infection by an average of 0.65 percentage points. This paper shows that peer influence is greater for males than for females. Results also suggest that the peer effects on HIV infection expectations are only statistically significant among those lacking more complete knowledge of HIV/AIDS. [ABSTRACT FROM AUTHOR]

Peer relations inform consumption practices that shape both alcohol use and prescription drug misuse. Integrating studies on pharmaceutical cognitive enhancement with research on consumptive based edgework, this paper examines the role of psychostimulant medications in resolving contradictory aspects of contemporary peer building processes. Drawing on qualitative interviews (n = 162) from a U.S. based study on the context of young adult prescription drug misuse, we demonstrate how medical resources are incorporated into peer bonding rituals in order to enhance consumptive capacity, reduce social risks, and facilitate the accumulation of relational capital. These findings highlight the paradoxical and problematic health ramifications of consumptive based peer bonding practices as well as how psycho-stimulant medications may compound those issues in unintended ways. • Explores how peer bonding and accumulation of relational capital shape substance use. • Examines medicines role in resolving paradoxical aspects of over-consumption. • Expands contextual understandings of pharmaceutical based cognitive enhancement. • Offers insight into unintended consequences of psychostimulant prescribing practices. [ABSTRACT FROM AUTHOR]

This paper examines whether a peer group intervention that reduced self-reported risky behaviors for rural adults in Malawi also had impacts on non-participants in the same communities. We randomly assigned two districts to the intervention and control conditions, and conducted surveys at baseline and 18 months post-intervention using unmatched independent random samples of intervention and control communities in 2003–2006. The six-session peer group intervention was offered to same-gender groups by trained volunteers. In this analysis, we divided the post-intervention sample into three exposure groups: 243 participants and 170 non-participants from the intervention district (total n = 415) and 413 control individuals. Controlling for demographics and participation, there were significant favorable diffusion effects on five partially overlapping behavioral outcomes: partner communication, ever used condoms, unprotected sex, recent HIV test, and a community HIV prevention index. Non-participants in the intervention district had more favorable outcomes on these behaviors than survey respondents in the control district. One behavioral outcome, community HIV prevention, showed both participation and diffusion effects. Participating in the intervention had a significant effect on six psychosocial outcomes: HIV knowledge (two measures), hope, condom attitudes, and self-efficacy for community HIV prevention and for safer sex; there were no diffusion effects. This pattern of results suggests that the behavioral changes promoted in the intervention spread to others in the same community, most likely through direct contact between participants and non-participants. These findings support the idea that diffusion of HIV-related behavior changes can occur for peer group interventions in communities, adding to the body of research supporting diffusion of innovations theory as a robust approach to accelerating change. If diffusion occurs, peer group intervention may be more cost-effective than previously realized. Wider implementation of peer group interventions can help meet the global goal of reducing new HIV infections. [ABSTRACT FROM AUTHOR]

Interest in leadership development in healthcare is substantial. Yet it remains unclear which interventions are most reliably associated with positive outcomes. We focus on the important area of physician leadership development in a systematic literature review of the latest research from 2007 to 2016. The paper applies a validated instrument used for medical education, MERSQI, to the included studies. Ours is the first review in this research area to create a tiered rating system to assess the best available evidence. We concentrate on findings from papers in the highly-rated categories. First, our review concludes that improvements in individual-level outcomes can be achieved (e.g. knowledge, motivation, skills, and behaviour change). Second, development programs can substantially improve organizational and benefit to patients outcomes. Third, some of the most effective interventions include: interactive workshops, videotaped simulations followed by peer and expert feedback, Multisource Feedback (MSF), coaching, action learning, and mentoring. Fourth, the evidence suggests that objective outcome data should be collected at baseline, end of program, and retrospectively. An outcomes-based approach appears to be the most effective design of programs. We also make recommendations for future research and practice. • Critically appraises evidence linking leadership programs for physicians to outcomes. • Uses a validated instrument (MERSQI) to assess study quality transparently. • Unique methodology: a tiered rating system to isolate the most reliable evidence. • Identifies elements of program design, delivery, and evaluation that maximize outcomes. • Provides an evidence-informed model of effective leadership development. [ABSTRACT FROM AUTHOR]

Abstract: Although it is widely believed that one of the key factors influencing whether an adolescent smokes or not is the smoking behaviour of his or her peers, empirical evidence on the magnitude of such peer effects, and even on their existence, is mixed. This existing evidence comes from a range of studies using a variety of country-specific data sources and a variety of identification strategies. This paper exploits a rich source of individual level, school-based, survey data on adolescent substance use across countries – the 2007 European Schools Survey Project on Alcohol and Other Drugs – to provide estimates of peer effects between classmates in adolescent smoking for 75,000 individuals across 26 European countries, using the same methods in each case. The results suggest statistically significant peer effects in almost all cases. These peer effects estimates are large: on average across countries, the probability that a ‘typical’ adolescent smokes increases by between.31 and.38 percentage points for a one percentage point increase in the proportion of classmates that smoke. Further, estimated peer effects in adolescent smoking are stronger intra-gender than inter-gender. They also vary across countries: in Belgium, for example, a one percentage point increase in reference group smoking is associated with a.16 to.27 percentage point increase in own smoking probability; in the Netherlands the corresponding increase is between.42 and.59 percentage points. [Copyright &y& Elsevier]

Disabled young people have lower levels of participation in community life than nondisabled peers across a number of domains, including sporting activities, with profound implications for health, wellbeing and life course opportunities. Playing sport is a defining feature of identity for many young people in Aotearoa/New Zealand. Participation in sporting activities provides opportunities to develop competencies, to have fun and to compete, while also providing a sense of inclusion and peer group belonging. However, despite policies promoting inclusion of disabled young people in school and club sport, ableist attitudes and practices still function to exclude individuals who do not fit able-bodied norms. Drawing on recent 'assemblage thinking' in health and cultural geography, this paper explores the material, social and affective dimensions of 'enabling' and 'disabling' sporting assemblages, drawing on interviews with 35 disabled young people (12–25 years), parents and key informants. Many reported instances of demoralising exclusion in mainstream sporting activities. Some turned to adaptive sporting codes, designed for inclusion. In our exploration of participants' embodied experiences of enabling and disabling assemblages we employ assemblage theory to examine how social, affective and material forces and processes converge to either enable or constrain participation in local sporting activities. We close with a brief assessment of the implications of our analysis for ongoing efforts to promote inclusion for disabled youth in physical activity. • Disabled young people have lower sports participation levels than non-disabled peers. • Ableist attitudes and practices frequently exclude those who do not fit able-bodied norms. • Ableist attitudes produce social, cultural and physical barriers to participation. • Disability-specific sports can enable experiences of pleasure, freedom and inclusion. • Assemblage thinking has helped identify forces that enable/constrain participation. [ABSTRACT FROM AUTHOR]

There is a growing body of research involving transgender (trans) individuals that foregrounds elevated rates of suicidality in trans populations. Although peer support is increasingly studied as a protective factor against suicide among trans persons, the scholarship in this area continues to be limited and has yet to be synthesized and appraised. In this paper, we address this existing gap in the literature by presenting the results of a scoping review of the literature examining the significance and function of peer support in mitigating suicide risk in trans populations. This scoping review is based on an analysis of 34 studies that were included following the execution of a methodical search and selection process. Drawing on scoping review methodology, along with PRISMA-P guidelines, we selected peer-reviewed empirical works, published between 2000 and 2020, which examined relationships between providing, seeking, and/or receiving peer support and suicide risk in trans populations. Our findings, which are conceptualized using the minority stress model as a guiding theoretical framework, reveal that while the literature generally substantiates the protective significance of peer support for trans persons, a small body of work also uncovers novel and unanticipated sources of peer support, including social support offered by trans peers online, which are infrequently and inconsistently examined in this body of scholarship. Using our appraisal of the literature, we outline the need for future research to further elucidate the significance and function of peer support in protecting against suicide among trans persons. In particular, we discuss the need for exploratory inquiry to inform a conceptualization and operationalization of peer support that more fully and consistently accounts for how such support (including online and community-based support) is sought, received, and experienced among trans persons in the context of suicide. • We review evidence on peer support and suicide in transgender (trans) populations. • Peer support is generally significant in attenuating suicide risk in trans persons. • Social support from peers is inconsistently operationalized in the literature. • Online peer support, though salient in mitigating suicidality, is seldom examined. • Inquiry is needed to improve how peer support in trans persons is conceptualized. [ABSTRACT FROM AUTHOR]

When seeking advice online about health concerns, forums dedicated to medical themes are increasingly becoming an appreciated source of information for many individuals. In online health communities, patients can ask questions or otherwise seek advice that is particularly relevant to them. While they may find some of the advice useful, other advice may be perceived as less valuable. By studying the advice-seeking, advice-giving, and advice-evaluation behaviours in one of the largest online health communities in Europe, this paper looks at what determines which advice is perceived as helpful, and why. Drawing on network theory, we analysed the interaction data of 108,569 users over twelve consecutive years based on all publicly available information of an established Q&A online health community. Utilising zero-inflated negative binominal modelling, our results show that advice received from others, who have similar predominant interests, is valued more when reaching out for lay expertise. If this advice is given by peers, who can also draw on expertise from other health areas, allowing for a combination of diverse "lay" expertise, the advice is valued even more. Advice provided by those who are quick to obtain the latest knowledge available in the larger community further reinforces these effects. Our findings offer an original view to understand the influence of lay expertise exchanged via online health communities and hold implications for both policy-makers and medical practitioners regarding their approach to patient-initiated use of social media for health-related reasons. • People readily seek health advice online. • People value advice from others who have similar predominant health interests. • People value advice from knowledgeable others. • People value speed of access to their peers' expertise. [ABSTRACT FROM AUTHOR]