Increasing condom use in heterosexual men: development of a theory-based interactive digital intervention

Increasing condom use to prevent sexually transmitted infections is a key public health goal. Interventions are more likely to be effective if they are theory- and evidence-based. The Behaviour Change Wheel (BCW) provides a framework for intervention development. To provide an example of how the BCW was used to develop an intervention to increase condom use in heterosexual men (the MenSS website), the steps of the BCW intervention development process were followed, incorporating evidence from the research literature and views of experts and the target population. Capability (e.g. knowledge) and motivation (e.g. beliefs about pleasure) were identified as important targets of the intervention. We devised ways to address each intervention target, including selecting interactive features and behaviour change techniques. The BCW provides a useful framework for integrating sources of evidence to inform intervention content and deciding which influences on behaviour to target

Protocol for a national monthly survey of alcohol use in England with 6-month follow-up: 'The Alcohol Toolkit Study'.

Timely tracking of national patterns of alcohol consumption is needed to inform and evaluate strategies and policies aimed at reducing alcohol-related harm. Between 2014 until at least 2017, the Alcohol Toolkit Study (ATS) will provide such tracking data and link these with policy changes and campaigns. By virtue of its connection with the 'Smoking Toolkit Study' (STS), links will also be examined between alcohol and smoking-related behaviour

Is the Fast Evolution Scenario for Virialized Compact Groups Really Compelling? The Role of a Dark Massive Group Halo

We report on results of N-body simulations aimed at testing the hypothesis that galaxies in X-ray emitting (i.e., virialized) Compact Groups are not tidally stripped when they are embedded in a common, massive, quiescent dark matter halo. To disentangle the effects of interactions from spurious effects due to an incorrect choice of the initial galaxy model configurations, these have been chosen to be tidally-limited King spheres, representing systems in quasi-equilibrium within the tidal field of the halo. The potential of the halo has been assumed to be frozen and the braking due to dynamical friction neglected. Our results confirm the hypothesis of low rates of tidal stripping and suggest a scenario for virialized Compact Group evolution in their quiescent phases with only very moderate tidally induced galaxy evolution can be generally expected. This implies the group stability, provided that the dynamical friction timescales in these systems are not much shorter than the Hubble time. We discuss briefly this possibility, in particular taking account of the similarity between the velocity dispersions of a typical virialized Compact Groups and the internal velocity dispersion of typical member galaxies. A number of puzzling observational data on Compact Groups can be easily explained in this framework. Other observations would be better understood as the result of enhanced merging activity in the proto-group environment, leading to virialized Compact Group formation through mergers of lower mass halos, as predicted by hierarchical scenarios of structure formation.Comment: 18 pages, 1 postscript file, 2 tables, to be published in ApJLet

Developing quality fidelity and engagement measures for complex health interventions

Objectives: To understand whether interventions are effective, we need to know whether the interventions are delivered as planned (with fidelity) and engaged with. To measure fidelity and engagement effectively, high‐quality measures are needed. We outline a five‐step method which can be used to develop quality measures of fidelity and engagement for complex health interventions. We provide examples from a fidelity study conducted within an evaluation of an intervention aimed to increase independence in dementia. // Methods: We propose five steps that can be systematically used to develop fidelity checklists for researchers, providers, and participants to measure fidelity and engagement. These steps include the following: (1) reviewing previous measures, (2) analysing intervention components and developing a framework outlining the content of the intervention, (3) developing fidelity checklists and coding guidelines, (4) obtaining feedback about the content and wording of checklists and guidelines, and (5) piloting and refining checklists and coding guidelines to assess and improve reliability. // Results: Three fidelity checklists that can be used reliably were developed to measure fidelity of and engagement with, the Promoting Independence in Dementia (PRIDE) intervention. As these measures were designed to be used by researchers, providers, and participants, we developed two versions of the checklists: one for participants and one for researchers and providers. // Conclusions: The five steps that we propose can be used to develop psychometrically robust and implementable measures of fidelity and engagement for complex health interventions that can be used by different target audiences. By considering quality when developing measures, we can be more confident in the interpretation of intervention outcomes drawn from fidelity and engagement studies

Exploring the behavioural drivers of veterinary surgeon antibiotic prescribing: a qualitative study of companion animal veterinary surgeons in the UK

Background: Multi-drug resistant bacteria are an increasing concern in both human and veterinary medicine. Inappropriate prescribing and use of antibiotics within veterinary medicine may be a contributory factor to antimicrobial resistance (AMR). The ‘One Health’ Initiative aims to work across species and environments to reduce AMR, however; little is currently known about the factors which influence antibiotic prescribing among veterinary surgeons in companion animal practice. This paper reports on qualitative data analysis of interviews with veterinary surgeons whose practice partially or wholly focuses on companion animals (N = 16). The objective of the research was to explore the drivers of companion animal veterinary surgeons’ antibiotic prescribing behaviours. The veterinary surgeons interviewed were all practising within the UK (England (n = 4), Scotland (n = 11), Northern Ireland (n = 1)). A behavioural thematic analysis of the data was undertaken, which identified barriers and facilitators to specific prescribing-related behaviours. Results: Five components of prescribing behaviours were identified: 1) confirming clinical need for antibiotics; 2) responding to clients; 3) confirming diagnosis; 4) determining dose, duration and type of antibiotic; and 5) preventing infection around surgery (with attendant appropriate and inappropriate antibiotic prescribing behaviours). Barriers to appropriate prescribing identified include: business, diagnostic, fear, habitual practice and pharmaceutical factors. Facilitators include: AMR awareness, infection prevention, professional learning and regulation and government factors. Conclusion: This paper uses a behavioural lens to examine drivers which are an influence on veterinary surgeons’ prescribing behaviours. The paper contributes new understandings about factors which influence antibiotic prescribing behaviours among companion animal veterinary surgeons. This analysis provides evidence to inform future interventions, which are focused on changing prescribing behaviours, in order to address the pressing public health concern of AMR

Simplified reactor design for mixed culture-based electrofermentation toward butyric acid production

Mixed microbial culture (MMC) electrofermentation (EF) represents a promising tool to drive metabolic pathways toward the production of a specific compound. Here, the MMC-EF process has been exploited to obtain butyric acid in simplified membrane-less reactors operated by applying a difference of potential between two low-cost graphite electrodes. Ten values of voltage difference, from -0.60 V to -1.5 V, have been tested and compared with the experiment under open circuit potential (OCP). In all the tested conditions, an enhancement in the production rate of butyric acid (from a synthetic mixture of glucose, acetate, and ethanol) was observed, ranging from 1.3- to 2.7-fold relative to the OCP. Smaller enhancements in the production rate resulted in higher values of the calculated specific energy consumption. However, at all applied voltages, a low flow of current was detected in the one-chamber reactors, accounting for an average value of approximately -100 µA. These results hold a substantial potential with respect to the scalability of the electrofermentation technology, since they pinpoint the possibility to control MMC-based bioprocesses by simply inserting polarized electrodes into traditional fermenters

Developing strategies to improve fidelity of delivery of, and engagement with, a complex intervention to improve independence in dementia: a mixed methods study

Background: It is important to evaluate fidelity of delivery and engagement during feasibility trials. However, there is little guidance on how to systematically develop strategies to improve implementation if problems arise. We aimed to: 1) Assess fidelity of delivery and engagement, 2) Identify factors influencing fidelity of delivery and engagement, and 3) Develop strategies to improve fidelity of delivery of, and engagement with, a complex intervention to improve independence in dementia, within a feasibility trial. Methods: A mixed methods evaluation of an intervention that aimed to improve independence in dementia. To assess fidelity of delivery and engagement, observation and self-report methods were used: 60% of audio-recorded intervention sessions were transcribed and reliably rated for fidelity. Providers (n = 12) and people with dementia/supporters (n = 34) were asked to complete checklists after each session. Descriptive statistics were used to analyse the data. To identify factors influencing fidelity and engagement, one-to-one semi-structured interviews were conducted with providers (n = 8), people with dementia (n = 7) and supporters (n = 7). Thematic analysis and content analysis were used to analyse data. To develop strategies, we followed four steps proposed by the authors of the Behaviour Change Wheel (1. Understanding the behaviour, 2. Identifying intervention functions, 3. Specifying intervention content, 4. Identifying mode of delivery). Results: Researcher ratings indicated moderate fidelity and provider/participant ratings indicated high fidelity of delivery. Knowledge, providers’ attributes, ease of adaptation of the intervention in relation to participants’ needs and logistical considerations influenced fidelity. We developed four strategies to improve fidelity of delivery of PRIDE: 1) showing a video, 2) giving an instruction sheet, 3) giving time to practice and 4) providing continued support. Participants reported high levels of engagement. Participants’ attributes, capability and opportunity influenced engagement. We developed four strategies to improve engagement with PRIDE: 1) a session summary document, 2) clear instructions, 3) time to practice activity and 4) providing regular compulsory telephone support. Conclusion: Fidelity of delivery and engagement are complex behaviours. This manuscript provides an example of how the Behaviour Change Wheel can be used during a feasibility trial to systematically develop strategies to improve implementation of complex interventions

Binding Energy and the Fundamental Plane of Globular Clusters

A physical description of the fundamental plane of Galactic globular clusters is developed which explains all empirical trends and correlations in a large number of cluster observables and provides a small but complete set of truly independent constraints on theories of cluster formation and evolution in the Milky Way. Within the theoretical framework of single-mass, isotropic King models, it is shown that (1) 39 regular (non--core-collapsed) globulars with measured core velocity dispersions share a common V-band mass-to-light ratio of 1.45 +/- 0.10, and (2) a complete sample of 109 regular globulars reveals a very strong correlation between cluster binding energy and total luminosity, regulated by Galactocentric position: E_b \propto (L^{2.05} r_{\rm gc}^{-0.4}). The observational scatter about either of these two constraints can be attributed fully to random measurement errors, making them the defining equations of a fundamental plane for globular clusters. A third, weaker correlation, between total luminosity and the King-model concentration parameter, c, is then related to the (non-random) distribution of globulars on the plane. The equations of the FP are used to derive expressions for any cluster observable in terms of only L, r_{\rm gc}, and c. Results are obtained for generic King models and applied specifically to the globular cluster system of the Milky Way.Comment: 60 pages with 19 figures, submitted to Ap

Antimicrobial resistance: a biopsychosocial problem requiring innovative interdisciplinary and imaginative interventions

To date, antimicrobials have been understood through largely biomedical perspectives. There has been a tendency to focus upon the effectiveness of pharmaceuticals within individual bodies. However, the growing threat of antimicrobial resistance demands we reconsider how we think about antimicrobials and their effects. Rather than understanding them primarily within bodies, it is increasingly important to consider their effects between bodies, between species and across environments. We need to reduce the drivers of antimicrobial resistance (AMR) at a global level, focusing on the connections between prescribing in one country and resistance mechanisms in another. We need to engage with the ways antimicrobials within the food chain will impact upon human healthcare. Moreover, we need to realise what happens within the ward will impact upon the environment (through waste water). In the future, imaginative interventions will be required that must make the most of biomedicine but draw equally across a wider range of disciplines (e.g. engineering, ecologists) and include an ever-increasing set of professionals (e.g. nurses, veterinarians and farmers). Such collective action demands a shift to working in new interdisciplinary, inter-professional ways. Mutual respect and understanding is required to enable each perspective to be combined to yield synergistic effects

Predictors of subgroups based on maximum drinks per occasion over six years for 833 adolescents and young adults in COGA.

ObjectiveA person's pattern of heavier drinking often changes over time, especially during the early drinking years, and reflects complex relationships among a wide range of characteristics. Optimal understanding of the predictors of drinking during times of change might come from studies of trajectories of alcohol intake rather than cross-sectional evaluations.MethodThe patterns of maximum drinks per occasion were evaluated every 2 years between the average ages of 18 and 24 years for 833 subjects from the Collaborative Study on the Genetics of Alcoholism. Latent class growth analysis identified latent classes for the trajectories of maximum drinks, and then logistic regression analyses highlighted variables that best predicted class membership.ResultsFour latent classes were found, including Class 1 (69%), with about 5 maximum drinks per occasion across time; Class 2 (15%), with about 9 drinks at baseline that increased to 18 across time; Class 3 (10%), who began with a maximum of 18 drinks per occasion but decreased to 9 over time; and Class 4 (6%), with a maximum of about 22 drinks across time. The most consistent predictors of higher drinking classes were female sex, a low baseline level of response to alcohol, externalizing characteristics, prior alcohol and tobacco use, and heavier drinking peers.ConclusionsFour trajectory classes were observed and were best predicted by a combination of items that reflected demography, substance use, level of response and externalizing phenotypes, and baseline environment and attitudes