ublic health measures to limit the spread of coronavirus disease 2019 (COVID-19) include requirements not to leave home except for specified purposes, to work from home when practical, to limit proximity to other people, to not visit residential aged care homes, to limit the number of people at social events (weddings, funerals, celebrations), to restrict interstate and international travel, and to accept the enforcement of these restrictions. The mental health consequences of these measures are likely to be unevenly distributed across the community because they also depend on individual social and economic circumstances. A recent position paper 1 summarised international expert opinion on research priorities for mental health during the COVID-19 pandemic. The first recommendation was to gather high quality population level data on its mental health effects. The aim of our study was to assess the mental health of people in Australia during the first month of COVID-19-related restrictions. Our specific objectives were to estimate population prevalence rates of clinically significant symptoms of depression, generalised anxiety, thoughts of being better off dead, increased irritability, and high optimism about the future; to estimate the prevalence of direct experiences of COVID-19, loss of employment caused by COVID-19 restrictions, concern about contracting COVID-19, and major disadvantage because of the restrictions; and to assess associations between these experiences and mental health symptoms. Methods A short, anonymous survey (estimated completion time, 8 minutes) of people living in Australia and aged at least 18 years was available on the Monash University website (https:// www.monash.edu/medic ine/living-with-covid-19-restr ictio nssurvey) from 3 April 2020 (four days after national stage two COVID-19 restrictions were announced by the Prime Minister; phase one restrictions had been gradually introduced during March) until midnight on 2/3 May 2020 (further information: online Supporting Information). Mental health Psychological symptoms experienced during the preceding fortnight were assessed with the Patient Health Questionnaire 9 (PHQ-9) and the Generalised Anxiety Disorder Scale (GAD-7). The PHQ-9 2 is an easily understood scale that asks respondents to rate their experience of nine symptoms from 0 (not experienced) to 3 (experienced nearly every day); a total PHQ-9 score of 10 or more indicates clinically significant (moderate to severe) symptoms, while scores of 5-9 indicate mild symptoms. The GAD-7 3 is an easily understood scale that asks respondents to rate their experience of seven symptoms of anxiety with the same response options as the PHQ-9; a total GAD-7 score of 10 or more indicate clinically significant (moderate to severe) symptoms, while scores of 5-9 indicate mild symptoms. Optimism about the future was assessed with a visual analogue scale (from 0, not at all optimistic, to 10, extremely optimistic).

Aim To review evidence about the experience of being the recipient of a donated heart, lungs, or heart and lungs. Design A systematic review (registered with PROSPERO: CRD42017067218), in accordance with PRISMA guidelines. Data sources Seven databases and Google Scholar were searched in May 2017 and July 2019 for papers reporting English-language research that had used qualitative methods to investigate experiences of adult recipients. Review methods Quality was assessed and results were analysed thematically. Results 24 papers (reporting 20 studies) were eligible and included. Their results were organised into three chronological periods: pre-transplant (encompassing the themes of ‘dynamic psychosocial impact’, ‘resources and support’), transplant (‘The Call’, ‘intensive care unit’), and post-transplant (‘dynamic psychosocial impact’, ‘management’, ‘rejection’). Sub-themes were also identified. It was evident that contemplating and accepting listing for transplantation entailed or amplified realisation of the precipitating illness’s existential threat. The period surrounding transplantation surgery was marked by profound, often surreal, experiences. Thereafter, although life usually improved, it incorporated unforeseen challenges. The transplantation clinic remained important to the recipient. The meaning of the clinic and its staff could be both reassuring (providing care and support) and threatening (representing onerous medical requirements and potential organ rejection). Conclusion This review has implications for the psychosocial care of transplant recipients and indicates the need for further research to gain insight into the experience of receiving a donated heart and/or lung. Impact Medical consequences of heart and lung transplantation are well documented; this is the first systematic review of research using qualitative methods to investigate the experience of heart, lung, and heart-and-lung transplantation. The psychosocial impact of transplantation was found to be dynamic and complex, with notable features evident before, during, and after transplantation. Clinic staff remained significant to recipients. It is clear that recipients need continuing psychosocial as well as medical support.

Unintended pregnancy can be difficult to identify and conceptualise. We aimed to understand how unintended pregnancies are constructed, explained and situated in a reproductive life. A total of 41 women and 7 men aged 20-50 years were interviewed in depth. Transcripts were analysed using iterative hermeneutic techniques informed by narrative theory. Of 34 participants who had been pregnant or had a partner in pregnancy, 12 women and 1 man described 23 'unintended' pregnancies, about half of which ended in abortion. Their accounts reveal that an unintended pregnancy is identified subjectively, that the same pregnancy may be identified by one partner in the pregnancy as unintended and by the other as intended, and that a researcher's supposedly objective assessment of an unintended pregnancy may be inconsistent with the assessment of the woman who experienced it. A pejorative discourse was evident, predominantly among participants who did not report having an unintended pregnancy: women use an 'unintended' pregnancy to entrap men. Accounts from five participants reporting an unintended pregnancy were selected for illustration. An appreciation of the role such a pregnancy might play in an individual life requires a nuanced understanding of the complexity of human experience and a resistance to simple binary categorisation.

The myth of Prometheus embodied in Mary Shelley's novel Frankenstein, has transformed into a powerful metaphor that has influenced conceptions of science and bioethics, especially of organ transplantation and assisted conception. The authors of this article employ auto-ethnographic accounts that draw on personal experience of organ transplantation and surrogate motherhood with assisted conception to examine the fear that “mad” scientists and audacious people will, through their hubris, attract calamitous consequences. It is evident that the myth of Frankenstein continues to influence constructions of science and technology.