021 PP: Dual theoretical synergy framework: Developing and refining a method for stakeholder engagement in intervention development

Stakeholder engagement and patient and public involvement (PPI) is now a key expectation within healthcare policy and in securing research funding and often needs to be evident throughout the research process. While systematic reviews and meta-analyses synthesise the best evidence for the content of behaviour change interventions, engaging stakeholders in a collaborative process of co-production could identify the best ways of implementing interventions. We developed the Dual Theoretical Synergy (DTS) Framework to work with stakeholders via expert events to identify the major systemic and psychosocial barriers and facilitators to implementing interventions in practice. The method uses facilitated group exercises to assess the acceptability of the design, content and proposed delivery mechanisms of an intervention to examine systemic, psychosocial and/or contextual barriers and facilitators to implementation, using the Theoretical Domains Framework and Normalisation Process Theory. Qualitative content analysis is used to record the key recurrent issues and to map similarities and differences in responses by domain to create a matrix of key barriers and facilitators to implementation of the candidate intervention. The matrix and a narrative summary are sent to participants for review and comment and to seek consensus on the interpretation of the data. The benefit of the method is in empowering stakeholders to think through and detail key ways of enhancing implementation of the candidate intervention, using standard theoretical constructs, and to engage in collaborative co-production of an intervention that is more likely to be adopted in the ‘real world’

Sexually transmitted infection testing and self-reported diagnoses among a community sample of men who have sex with men, in Scotland

Introduction To examine sexually transmitted infection (STI) testing and self-reported diagnoses among men who have sex with men (MSM), in Scotland. Methods Cross-sectional survey of seven Glasgow gay bars in July 2010 (n=822, 62% response rate); 693 are included in the analyses. Results 81.8% reported ever having had an STI test; 37.4% had tested in the previous 6 months; 13.2% reported having an STI in the previous 12 months. The adjusted odds of having ever tested were significantly higher for men who had 6+ sexual partners in the previous 12 months (adjusted OR=2.66), a maximum sexual health knowledge score (2.23), and had talked to an outreach worker/participated in counselling (1.96), and lower for men reporting any high-risk unprotected anal intercourse (UAI) in the previous 12 months (0.51). Adjusted odds of recent testing were higher for men who had 6+ sexual partners (2.10), talked to an outreach worker/participated in counselling (1.66), maximum sexual health knowledge (1.59), and higher condom use knowledge (1.04), and lower for men aged ≥25 years (0.46). Adjusted odds of having had an STI in the previous 12 months were higher for men who had 6+ sexual partners (3.96) and any high-risk UAI in the previous 12 months (2.24) and lower for men aged ≥25 years (0.57). Conclusions STI testing rates were relatively high, yet still below the minimum recommended for MSM at high risk. Consideration should be given to initiating recall systems for men who test positive for STIs, and to developing behavioural interventions which seek to address STI transmission

Has testing been normalized? An analysis of changes in barriers to HIV testing among men who have sex with men between 2000 and 2010 in Scotland, UK

Objectives: This paper examines changes in barriers to HIV testing amongst gay men. We compared data collected in 2000 and 2010 to assess changes in HIV testing behaviours, in community-level perceptions of barriers to HIV testing, and in the relative contributions of barrier measures. Methods: Cross-sectional surveys were conducted within the commercial gay scene in Glasgow with good response rates (78% and 62%) using a form of time and location sampling. Results: Major changes in HIV testing behaviours were observed between 2000 and 2010 (30.6% increase in testing within previous year). At the community level, the perceived benefits of testing [t (1284) = –8.46; P <0.001] and the norm for HIV testing [t (1236) = –11.62; P < 0.001] increased; however, other perceived barriers did not change (fear of a positive result, clinic-related barriers and attitudes to sex with HIV-positive men). Multinomial logistic regression showed that fear of a positive test result remained a key barrier to HIV testing; however, a significant fear × year of survey interaction indicated that fear played a lesser role in differentiating those who had never been tested from those who had been tested in 2010 than it had in 2000. Conclusions: These findings suggest the partial normalization of HIV testing. While some barriers have reduced, other key barriers remain important. Interventions should be designed and evaluated that attend to both the biomedical and the psychosocial aspects of HIV testing (e.g. the meaning of positive test results, the sexual exclusion of positive men, and HIV-related stigma)

The Resilience Of Black Female Leaders In Higher Education And Racial Microaggression

This study explored the experiences of Black female leaders in higher education and their encounters with racial microaggression. Additionally, the opportunity to understand the effects of racial slights within the workplace as either a mid to senior level leadership was also explored. Regardless of the multiple diversity, equity, and inclusion (DEI) trainings within higher education, Black female leaders are experiencing their share of racial inequality based on their race, gender, or both (DeCuir-Gunby et al., 2019). The unique experiences of racial microaggression encountered by Black women, aligned with the framework of both the Black feminist theory and intersectionality theory respectively. These theories were used to illustrate the daily occurrences of racial microaggression, within the workplace settings, where Black female leaders are not always seen as an equal to their White colleagues. Results of the study revealed that stereotypes can create a discomfort within the workplace, especially for a mid or senior level leader who is expected to remain professional regardless of their experiences with racial slights. The educational accomplishments of each participant, in addition to their professional years of experience, have been questioned or undermined either by their colleagues or subordinates. Participants expressed their experience of emotional distress caused by racial microaggression, along with a wage gap as part of their lived experience as they navigate the impact of microaggressions. Recommendations include dismantling racial microaggression within the workplace with more in-depth DEI training, along with promoting accountability towards colleagues who partake in racial slights within the workplace

Emergency personnel neuroticism, health and lifestyle : a UK biobank study

Background: Emergency personnel face unpredictable and challenging incidents and their resilience and ability to cope influences their well-being. Personality traits, such as neuroticism, are postulated to be robust predictors of health and health behaviours. Despite evidence in the general population that neuroticism can positively impact health and health behaviours; to date neuroticism in emergency personnel has primarily been associated with adverse health outcomes. Aims: To assess whether neuroticism has a negative or positive impact on subjective and objective health and health behaviours in emergency personnel. Methods: This study used cross-sectional UK Biobank baseline data of emergency personnel (police, firemen and paramedics). Logistic regression models examined the strength of the associations of neuroticism tertiles with subjective (self-reported overall health and chronic conditions) and objective health (abdominal obesity) and self-reported smoking, sleeping, alcohol use and exercise levels. Results: High neuroticism was positively associated with poorer subjective health outcomes in all emergency personnel (n = 2483). The association between neuroticism and chronic disease/s was significant for police in the second (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.15-1.94) and third (OR = 1.62, 95% CI = 1.21-2.16) neuroticism tertiles. Neuroticism in firemen was associated with reduced abdominal obesity (OR = 0.49, 95% CI = 0.25-0.96) and increased exercise (OR = 2.14, 95% CI = 1.07-4.25). Conclusions: We observed positive and negative associations between neuroticism and health outcomes and behaviours. While differences were observed across the emergency personnel groups, more research is needed to better understand how personality traits may impact health in workers with physically and mentally intense jobs

Bulk viscosity in superfluid neutron star cores. I. Direct Urca processes in npe\mu matter

The bulk viscosity of the neutron star matter due to the direct Urca processes involving nucleons, electrons and muons is studied taking into account possible superfluidity of nucleons in the neutron star cores. The cases of singlet-state pairing or triplet-state pairing (without and with nodes of the superfluid gap at the Fermi surface) of nucleons are considered. It is shown that the superfluidity may strongly reduce the bulk viscosity. The practical expressions for the superfluid reduction factors are obtained. For illustration, the bulk viscosity is calculated for two models of dense matter composed of neutrons, protons,electrons and muons. The presence of muons affects the bulk viscosity due to the direct Urca reactions involving electrons and produces additional comparable contribution due to the direct Urca reactions involving muons. The results can be useful for studying damping of vibrations of neutron stars with superfluid cores.Comment: 14 pages, 7 figures, latex, uses aa.cls, to be published in Astronomy and Astrophysic

Key factors in the acceptability of treatment as prevention (TasP) in Scotland : a qualitative study with communities affected by HIV

Objectives There is a clear need to understand the factors that might prevent and/or facilitate the effective use of HIV treatment as prevention (TasP) at an individual level. This paper reports on findings from the first qualitative study in the UK exploring the acceptability of TasP among gay, bisexual and/or men who have sex with men (MSM) and migrant African communities in Scotland. Methods We conducted seven exploratory focus group discussions (FGDs) with convenience samples of MSM (five FGDs, n=22) and mixed-gender African (two FGDs, n=11) participants. Of these, three FGDs were conducted with HIV-positive MSM (n=14) and one FGD with HIV-positive Africans (n=8). We then conducted 34 in-depth interviews (IDIs) with a purposive sample of MSM (n=20) and Africans (n=14, women=10). Half were HIV-positive (MSM, n=10; African, n=7). FGD and IDI data were analysed thematically drawing on predetermined and emergent themes. Results We found that inequalities in HIV literacy could be a barrier to TasP, as could social constraints, such as criminalisation of transmission, increased risk of sexually transmitted infection and increased burden of treatment. We also identified psychological barriers such as perceptions of risk. However, relationships and shared decision making were identified as potential facilitators for TasP. Conclusions Our results suggest that potential use and management of TasP may not be straightforward. It could be contingent on reducing inequalities in HIV literacy, minimising the perceived burden of treatment and other potential risks, and addressing the dynamics of existing and socially acceptable risk management strategies, especially in relation to long-term serodiscordant relationships

Dynamical symmetry of isobaric analog 0+ states in medium mass nuclei

An algebraic sp(4) shell model is introduced to achieve a deeper understanding and interpretation of the properties of pairing-governed 0+ states in medium mass atomic nuclei. The theory, which embodies the simplicity of a dynamical symmetry approach to nuclear structure, is shown to reproduce the excitation spectra and fine structure effects driven by proton-neutron interactions and isovector pairing correlations across a broad range of nuclei.Comment: 7 pages, 5 figure

Description of single and double analog states in the f7/2 shell: The Ti isotopes

The excitation energies of single analog states in even-odd Ti isotopes and double analog states in even-even Ti isotopes are microscopically described in a single j-shell formalism. A projection procedure for generalized BCS states has been used. As an alternative description a particle-core formalism is presented. The latter picture provides a two-parameter expression for excitation energies, which describes fairly well the data in four odd and three even isotopes of Ti.Comment: 14 pages,7 figures, 2 tables. To appear in Phys. Rev.