Sexual Health Needs Among Men Who Engage in Transactional Sex with Men in the UK

Men who engage in transactional sex with men (MTSM) are a high-risk population for HIV and other sexually transmitted infections. Epidemiological data have so far included them in the broad category of men who have sex with men (MSM), while research on transactional sex typically focused on female sex workers. The internet has substantially changed sex work practices and earlier findings concerning the sexual health needs of MTSM may no longer be applicable. We analyzed quantitative data from MSM based in the UK (n = 11629) taking part in the European MSM Internet Survey (EMIS-2017). Compared to non-MTSM, MTSM (n = 230; 2%) were younger, more likely to self-identify as an ethnic minority, be single, have lower education levels, struggle financially, and-controlling for age-more likely to be living with diagnosed HIV. Commonly unmet needs among all MSM were a lack of confidence in accessing HIV post-exposure prophylaxis, uncertainty about HIV status, and ignorance of where to access hepatitis vaccinations. Compared with other MSM, MTSM were notably less satisfied with the safety of their sexual practices, less confident in their ability to maintain sexual boundaries, and more likely to engage in risk because of absent precautionary resources. Given their greater opportunity for sexual risk, as well as fewer resources for negotiating safety, our findings suggest that services should prioritize MTSM in HIV prevention and sexual health promotion, including assertiveness and social skills training, in addition to knowledge-based education.

Interventions, Barriers, and Facilitators to Address the Sexual Problems of Gay, Bisexual and Other Men Who Have Sex with Men Living with HIV: A Rapid Scoping Review

Sexual problems are common among gay, bisexual, and other men who have sex with men (GBM) after diagnosis with HIV. However, these are often overlooked in care and research, where sexual risk reduction and biomedical aspects of sexual health tend to dominate. We conducted a rapid scoping review to investigate which sexual problems of GBM living with HIV are addressed by interventions, and the barriers and facilitators to their implementation. Literature from high-income countries published in English since 2010 was reviewed. Medline, Embase, PsycInfo, and Scopus databases were searched on July 4, 2022. Targeted sexual problems were categorized according to the ten dimensions of Robinson's Sexual Health Model, and barriers and facilitators, according to the five domains of the Consolidated Framework for Implementation Research (CFIR). Interventions focused solely on the dimension of Sexual Health Care/Safer Sex were excluded. Relevant information was extracted from the qualifying documents with NVivo 12 software for content analysis. Fifty-two documents were included, referring to 37 interventions which mainly took place in the United States (n = 29/37; 78%), were group-based (n = 16; 41%), and used counselling techniques (n = 23; 62%; e.g., motivational interviewing, cognitive-behavioral therapy). Their settings were mostly primary care (n = 15; 40%) or community-based (n = 16; 43%). On average, interventions addressed three sexual health dimensions (SD = 2; range: 1-10). The most targeted dimension was Sexual Health Care/Safer Sex (n = 26; 70%), which concerned sexual risk reduction. Next, Challenges (n = 23; 62%), included substance use (n = 7; 19%), sexual compulsivity (n = 6; 16%), sexual abuse (n = 6; 16%), and intimate partner violence (n = 4; 11%). Third was Talking About Sex (n = 22; 59%) which mostly concerned HIV disclosure. About a third of interventions addressed Culture/Sexual identity (n = 14; 38%), Intimacy/Relationships (n = 12; 33%), and Positive sexuality (n = 11; 30%). Finally, few targeted Body Image (n = 4; 11%), Spirituality (n = 3; 8%), Sexual Anatomy Functioning (n = 2; 5%) or Masturbation/Fantasy (n = 1; 3%). Forty-one documents (79%) mentioned implementation barriers or facilitators, particularly about the characteristics of the interventions (41% and 78%, respectively; e.g., cost, excessive duration, acceptability, feasibility) and of the individuals involved (37% and 46%; e.g., perceived stigmatization, provider expertise). The other three CFIR dimensions were less common (5%-17%). The search strategy of this review may not have captured all eligible documents, due to its limit to English-language publications. Overall, most interventions incorporated a focus on Sexual Health Care/Safer Sex, at the expenses of other prevalent sexual problems among GBM living with HIV, such as intimate partner violence (Challenges), erectile dysfunction (Sexual Anatomy Functioning), and Body Image dissatisfaction. These findings suggest they could receive more attention within clinical care and at the community level. They also highlight the importance of cost-effective and acceptable interventions conducted in non-stigmatizing environments, where patients' needs can be met by providers who are adequately trained on sexuality-related topics.

Patient-reported outcome measures in adult HIV care: A rapid scoping review of targeted outcomes and instruments used

OBJECTIVE

There is international interest in the integration of patient-reported outcome measures (PROMs) into routine HIV care, but little work has synthesized the content of published initiatives. We conducted a rapid scoping review primarily to identify their selected patient-reported outcomes and respective instruments.

METHODS

Four databases were searched on 4 May 2022 (Medline, Embase, CINAHL and PsychINFO) for relevant English language documents published from 2005 onwards. Dual review of at least 20% of records, full texts and data extraction was performed. Outcomes and instruments were classified with an adapted 14-domain taxonomy. Instruments with evidence of validation were described.

RESULTS

Of 13 062 records generated for review, we retained a final sample of 94 documents, referring to 60 distinct initiatives led mostly in the USA (n = 29; 48% of initiatives), Europe (n = 16; 27%) and Africa (n = 9; 15%). The measured patient-reported outcome domains were: mental health (n = 42; 70%), substance use (n = 23; 38%), self-management (n = 16; 27%), symptoms (n = 12; 20%), sexual/reproductive health (n = 12; 20%), physical health (n = 9; 15%), treatment (n= 8; 13%), cognition (n = 7; 12%), quality of life (n = 7; 12%), violence/abuse (n = 6; 10%), stigma (n = 6; 10%), socioeconomic issues (n = 5; 8%), social support (n = 3; 5%) and body/facial appearance (n = 1; 2%). Initiatives measured 2.6 outcome domains, on average (range = 1-11). In total, 62 distinct validated PROMs were identified, with 53 initiatives (88%) employing at least one (M = 2.2). Overwhelmingly, the most used instrument was any version of the Patient Health Questionnaire to measure symptoms of depression, employed by over a third (26; 43%) of initiatives.

CONCLUSION

Published PROM initiatives in HIV care have spanned 19 countries and disproportionately target mental health and substance use.

Conceptions of sexual health by gay men living with HIV in serodifferent couples in Montreal, Canada: results from a qualitative analysis

BACKGROUND

Gay, bisexual, and other men (GBM) who have sex with men living with HIV in serodifferent couples (one partner living with HIV, the other HIV-negative) may encounter unique sexual health challenges. This study aimed to explore their definition of sexual health that could improve service provision.

METHODS

We interviewed 10 gay-identified men living with HIV from 2017 to 2019 as part of CTNPT013, a study on the sexual health of HIV serodifferent GBM couples conducted at two HIV-specialised clinics in Montreal, Canada. Participants partook in semi-structured interviews on the meaning of sexual health. We performed a content analysis of interview transcripts, coding them according to the 10 dimensions of Robinson's Sexual Health Model.

RESULTS

Mean age of interviewees was 35.4years (s.d.,10.2; range, 20-53). Every dimension of Robinson's model was spontaneously evoked, except for body image and spirituality. All men indicated intimacy/relationships (e.g. sexual agreements) and sexual health care/safer sex (e.g. HIV management, risk behaviours) as relevant aspects of sexual health. Other dimensions included: positive sexuality (n =7), such as pleasure and enjoyment during sex; talking about sex (n =5), which mainly concerned HIV disclosure; sexual functioning (n =4); challenges to sexual health (n =3), including substance abuse; and culture/sexual identity (n =3). Two participants (n =2) cited masturbation/fantasy.

CONCLUSIONS

This study emphasises the multi-faceted nature of sexual health for gay men with HIV in serodifferent couples and the pivotal roles of relationships, HIV, risk management (e.g. via health care, knowledge), and positive sexual experiences. These dimensions could be considered in sexual health promotion interventions targeting this population.

Efficient prediction of airborne noise propagation in a non-turbulent urban environment using Gaussian beam tracing method

This paper presents a noise propagation approach based on the Gaussian beam tracing (GBT) method that accounts for multiple reflections over three-dimensional terrain topology and atmospheric refraction due to horizontal and vertical variability in wind velocity. A semi-empirical formulation is derived to reduce truncation error in the beam summation for receivers on the terrain surfaces. The reliability of the present GBT approach is assessed with an acoustic solver based on the finite element method (FEM) solutions of the convected wave equation. The predicted wavefields with the two methods are compared for different source-receiver geometries, urban settings, and wind conditions. When the beam summation is performed without the empirical formulation, the maximum difference is more than 40 dB; it drops below 8 dB with the empirical formulation. In the presence of wind, the direct and reflected waves can have different ray paths than those in a quiescent atmosphere, which results in less apparent diffraction patterns. A 17-fold reduction in computation time is achieved compared to the FEM solver. The results suggest that the present GBT acoustic propagation model can be applied to high-frequency noise propagation in urban environments with acceptable accuracy and better computational efficiency than full-wave solutions.

Simulating the acoustic response of cavities to improve microphone array measurements in closed test section wind tunnels

Cavities placed along wind tunnel walls can attenuate the turbulent boundary layer (TBL) fluctuations as they propagate into the cavity. Placing microphones within the cavities can thus improve the signal-to-noise ratio of acoustic data. However, standing waves form within these cavities distorting the acoustic measurements. This work uses a finite element (FE) solver to evaluate how cavity geometry (depth, diameter, and wall angle) and wall material (hard-walled and melamine foam) affect the amplitude and eigenfrequency of standing waves when excited by an incident acoustic plane wave. Good agreement between predicted and measured acoustic transfer functions is shown. Compared to cylindrical cavities, countersunk and conical cavities improve the overall response, i.e., reducing the quality factor quantifying the resonance and damping characteristics. Stainless steel coverings also reduce the quality factor. A finding is that the shape of the external foam holder rather than the cavity shape drives the standing wave characteristics for the melamine foam cavities. The optimization problem of minimizing the acoustic response while also attenuating the TBL is thus decoupled by using the melamine foam. Consequently, these considerations can be addressed independently by optimizing the outer cavity shape for acoustics and the melamine foam insert for TBL attenuation.

Objective Knowledge Mediates the Relationship between the Use of Social Media and COVID-19-Related False Memories

The exposure to relevant social and/or historical events can increase the generation of false memories (FMs). The Coronavirus Disease 2019 (COVID-19) pandemic is a calamity challenging health, political, and journalistic bodies, with media generating confusion that has facilitated the spread of fake news. In this respect, our study aims at investigating the relationships between memories (true memories, TMs vs. FMs) for COVID-19-related news and different individual variables (i.e., use of traditional and social media, COVID-19 perceived and objective knowledge, fear of the disease, depression and anxiety symptoms, reasoning skills, and coping mechanisms). One hundred and seventy-one university students (131 females) were surveyed. Overall, our results suggested that depression and anxiety symptoms, reasoning skills, and coping mechanisms did not affect the formation of FMs. Conversely, the fear of loved ones contracting the infection was found to be negatively associated with FMs. This finding might be due to an empathy/prosociality-based positive bias boosting memory abilities, also explained by the young age of participants. Furthermore, objective knowledge (i) predicted an increase in TMs and decrease in FMs and (ii) significantly mediated the relationships between the use of social media and development of both TMs and FMs. In particular, higher levels of objective knowledge strengthened the formation of TMs and decreased the development of FMs following use of social media. These results may lead to reconsidering the idea of social media as the main source of fake news. This claim is further supported by either the lack of substantial differences between the use of traditional and social media among participants reporting FMs or the positive association between use of social media and levels of objective knowledge. The knowledge about the topic rather than the type of source would make a difference in the process of memory formation.

Toward inclusion of atmospheric effects in the aircraft community noise predictions

This paper presents an atmospheric propagation model, based on ray acoustics, that accounts for realistic weather conditions in the evaluation of the noise footprint of an aircraft. Noise sources, obtained using the Ffowcs Williams and Hawkings acoustic analogy applied to scale-resolved flow simulation data, are stored on a hemisphere surrounding the vehicle. These noise sources are propagated using a propagation model that takes into account the vertical variability of air temperature and wind velocity. The electric vertical takeoff and landing aircraft, presented by Casalino, van der Velden, and Romani [(2019). in Proceedings of the AIAA Scitech 2019 Forum, January 7-11, San Diego, CA, pp. 1834-1851], is used as a case study; noise footprints, obtained considering various vertically varying temperature and wind velocity distributions, are compared. It is shown that weather conditions in the acoustic wave propagation can contribute to mismatch up to 4 dBA in the illuminated zone and a significant drop in the refractive shadow zone caused by the vertical air temperature and wind velocity gradients. This work constitutes the first accomplishment in including realistic atmospheric effects in aircraft community noise prediction based on scale-resolved flow simulations.

Forced Cohabitation during Coronavirus Lockdown in Italy: A Study on Coping, Stress and Emotions among Different Family Patterns

Background: At the beginning of 2020, a pandemic caused by a new strain of coronavirus occurred. On March 9th, the Italian population was forced to lockdown to prevent the spread of this new virus. This event forced families and cohabitants to spend their entire days and weeks in the same physical space, interacting with partners and children with a very different degree of intimacy than in the earlier situation. The present study investigated the effects of being forced to live together on different family patterns, on various dimensions such as stress, coping strategies, time perception and quality evaluation of cohabitation. Method: A total sample consisting of 1750 individuals was recruited through a random sample of probability across the Italian country. Due to the lockdown condition, an online questionnaire was set up; several validated scales were chosen, and some open-ended items were included for the thoughts of the participants. Results: The results showed statistically significant differences between the three family patterns examined. Conclusion: During the forced period of living together, a positive effect could be inferred as given by the presence of children and the collaborative coping strategies that have been adopted; the results have been discussed according to the literature on the topic.

Role of Polymeric Coating on Metallic Foams to Control the Aeroacoustic Noise Reduction of Airfoils with Permeable Trailing Edges

Studies on porous trailing edges, manufactured with open-cell Ni-Cr-Al foams with sub-millimeter pore sizes, have shown encouraging results for the mitigation of turbulent boundary-layer trailing-edge noise. However, the achieved noise mitigation is typically dependent upon the pore geometry, which is fixed after manufacturing. In this study, a step to control the aeroacoustics effect of such porous trailing edges is taken, by applying a polymeric coating onto the internal foam structure. Using this method, the internal topology of the foam is maintained, but its permeability is significantly affected. This study opens a new possibility of aeroacoustic control, since the polymeric coatings are temperature responsive, and their thickness can be controlled inside the foam. Porous metallic foams with pore sizes of 580, 800, and 1200 μm are (internally) spray-coated with an elastomeric coating. The uncoated and coated foams are characterized in terms of reduced porosity, average coating thickness and air-flow resistance. Subsequently, the coated and uncoated foams are employed to construct tapered inserts installed at the trailing edge of an NACA 0018 airfoil. The noise mitigation performances of the coated metal foams are compared to those of uncoated metal foams with either similar pore size or permeability value, and both are compared to the solid trailing edge reference case. Results show that that the permeability of the foam can be easily altered by the application of an internal coating on the metallic foams. The noise reduction characteristics of the coated foams are similar to equivalent ones with metallic materials, provided that the coating material is rigid enough not to plastically deform under flow conditions.

[Organizational wellbeing and psychosocial risk factors in a sample of Italian Public Administration work environments]

BACKGROUND

It has been recognized both by the scientific community and within the framework of social policies in Europe that the physical and psychosocial working environments pose potential risks for workers and organizational wellbeing. In particular psychosocial risks concern aspects of the design and management of work and its social and organizational contexts which have the potential for causing psychological or physical problems.

OBJECTIVES

This article examines the psychosocial risk factors of several types of Italian Public Administration offices (municipal, provincial, regional, central government, university, police headquarters, chamber of commerce, etc.) with the aim of obtaining a picture of the most problematic risk factors for each type.

METHODS

The participants of this survey consisted of about 23,500 employees of different types of Public Administration offices. The Multidimensional Organizational Health Questionnaire (MOHQ, 3) was used to collect the data.

RESULTS AND CONCLUSIONS

Results from ANOVA indicated that perceptions of fairness and job demands were the most problematic risk factors. Perception of safety at work was another problematic risk factor in specific types of work. The results revealed a high perception of stress in all workers over the entire range of the public administration offices studied.

[Operating theatre and medical ward nurses: two different ways of perceiving one's organizational health]

BACKGROUND

It is widely recognized that the working environment is crucial in the genesis of stress and other disorders that may affect nurses' health. The specific job context and the tasks performed by nurses in different clinical settings can be positive or negative predictors of organizational health.

OBJECTIVES

The aim of this study was to describe and compare organizational health among nurses working in operating theaters and medical wards.

METHODS

For the study 670 nurses from six university hospitals in Italy were asked to participate and a total of 542 nurses constituted the final sample. The Nursing Organizational Health Questionnaire was used to collect the data and was administered from January to March 2010. A descriptive/comparative design was used.

CONCLUSIONS

The results showed that nurses assigned to medical wards perceived their working environment as healthy and were significantly more satisfied and had less psychosomatic complaints than their colleagues working in operating theaters.

[Perception of organizational climate and burnout amongst health care workers: the role of alexithymia as a moderator]

This paper reports a study on 238 health care workers from an hospital in central Italy. We examined: 1) how some dimensions regarding perceived quality of the organizational and relational climate (social warmth and quality of working life both in the ward and in the organization) influence various indicators of burnout (emotional exhaustion, depersonalization, personal accomplishment); 2) if it was possible to improve the previous regressive models by including the personality construct, alexithymia. Controlling for age and gender, results of the hierarchical regression showed significant two-way interactions between organizational/relational climate and alexithymia in predicting emotional exhaustion (p = .005 for both the ward and the organization) and personal fulfillment (for ward, p = .020; for perceived relational climate, p = .037). Depersonalization was accounted by the main effect of alexithymia (p = .000). In conclusion, results demonstrate the need to include the alexithymia construct in models predicting the various dimensions of burnout.

Pneumococcal septic arthritis of the shoulder. Case report and literature review

Septic arthritis due to Streptococcus Pneumoniae appears to be relatively uncommon. Single- or clustered-case histories constitute the majority of reports on pneumococcal septic arthritis. A 70-year-old man presented with a 7-day history of pain, erythema and swelling of the left shoulder. Physical examination of the left shoulder revealed a warm, swollen, erythematous, and markedly tender to light palpation. The patient was unable to elevate his arm more than 30 degrees without pain. Arthrocentesis performed on admission produced 30 cc of grossly purulent fluid whose culture demonstrated S. Pneumoniae. The septic arthritis was treated with intravenous vancomycin and imipenem. The antibiotics were substituted when the sensitivities were known with oral ciprofloxacin and rifampycin to complete 8 weeks' total treatment. On follow-up examination 1 year later, the patient has remained afebrile and asymptomatic without evidence of increasing joint effusion or acute joint inflammation. Pneumococcal arthritis is classically described as a painful monoarticular arthritis complicating an active pneumococcal infection, generally a primary pulmonary infection. Pneumococcal arthritis appears to be predominantly a disease affecting the elderly. Clinical presentation ranges from septicemia to indolent infection with few systemic symptoms. With adequate antibiotic therapy and aspiration or drainage of the joint, the prognosis for return of normal joint function appears to be excellent. Although pneumococcal organisms are not likely causes, this bacteria should certainly be considered as a possible cause of arthritis or prosthetic infection.