Reaching people and managing membership in community-based dementia support groups: the Get Real with Meeting Centres realist evaluation part 1.

OBJECTIVES: There is a need to improve the provision and reach of community services for people living with dementia, a goal in which community-based support groups can play a key role. The Get Real with Meeting Centres project aimed to explore factors involved in the success and sustainability of Meeting Centres (MCs) a form of community-based support proliferating in the UK. This is the first of two linked articles outlining learning from this realist evaluation of MCs, which focusses on findings around reach and membership. METHOD: Semi-structured interviews and focus group discussions were conducted with 77 participants across three case study MC sites in England and Wales, including people living with dementia, informal carers, staff, volunteers, trustees, and supporting professionals/practitioners. Data were themed, then analysed using both soft systems methodology and realist logic of analysis. RESULTS: Fifty-two 'context-mechanism-outcome' statements were generated, explaining how background circumstances might trigger responses/processes to produce wanted or unwanted outcomes regarding four key areas for MC sustainability: Referrals and the dementia care pathway; Reaching people and membership; Carer engagement and benefit; and Venue and location. CONCLUSION: Strong links with formal services and a well-functioning dementia care pathway are essential to sustaining community-based group support such as MCs; group support is also well-placed to assist work to improve pathway issues. Clarity of offer (including benefit to carers), and a wide range of activities, are key to appeal and reach; transport to, and use of, venue are challenges, as are pressures to support people with more advanced dementia.

Strategic and operational issues in sustaining community-based dementia support groups: the Get Real with Meeting Centres realist evaluation part 2.

OBJECTIVES: Support for people with dementia in their communities is neither robust nor consistent in the UK, often bolstered by third sector/grass-roots initiatives facing formidable challenges in sustaining long-term. The Get Real with Meeting Centres project explored factors involved in sustaining one such form of community-based support. This is the second of two linked articles outlining learning from this realist evaluation of Meeting Centres (MCs) for people with dementia and carers, which focusses on findings regarding their operational and strategic running. METHOD: Semi-structured interviews and focus group discussions were conducted with 77 participants across three MC sites in England and Wales, including people living with dementia, informal carers, staff, volunteers, trustees, and supporting professionals/practitioners. Data were themed, then analysed using soft systems methodology and realist logic of analysis. RESULTS: Forty-two 'context-mechanism-outcome' statements were generated, explaining how background circumstances might trigger responses/processes to produce wanted or unwanted outcomes regarding three key areas for MC sustainability: External relationships and collaboration; Internal relationships and practices; and Finances and funding. CONCLUSION: Collaboration is essential to sustaining community-based initiatives such as MCs, particularly between local community and regional level. MCs need to be vigilant in mitigating pressures that create 'mission drift', as targeting a gap in the care pathway and maintaining a person-centred ethos are central to MCs' appeal. Stable, ongoing funding is needed for stable, ongoing community dementia support. More formal recognition of the value of social model community-based initiatives, helped by improved data collection, would encourage more robust and consistent community dementia support.

Identity-Related Factors Protect Well-Being Against Stigma for Transgender and Gender Non-Conforming People.

Relatively little is known about identity-related resilience factors associated with well-being among transgender and gender non-conforming (TGNC) people. Drawing upon theory on stigma-related stress and resilience and work examining group identification as a buffer against discrimination, the aim of the current study was to model perceived discrimination, transgender identification, and gender identity affirmation as predictors of well-being for TGNC people. We also tested whether the positive association between gender identity affirmation and well-being might be explained by the benefits affirmation has for individual self-concept clarity. Participants were 105 TGNC individuals (42% transgender male, 39% transgender female, 19% other gender non-conforming [e.g., non-binary]) recruited through online forums and support groups in the UK and North America who completed an online survey including self-report measures of key constructs. Results from structural equation models demonstrated that: (1) experiences of discrimination were associated with lower well-being overall, but having a stronger transgender identity moderated this association; (2) after adjustment for discrimination and transgender identification, experiences of gender identity affirmation were independently associated with greater well-being for TGNC people. Secondary analyses demonstrated that gender identity affirmation was linked to well-being through reinforcing a strong, internalized sense of clarity about individual self-concept. Results are discussed in terms of the implications for TGNC health and well-being, particularly with regard to the need for supportive, identity-affirming social environments.

"Our Country Needs a Strong Leader Right Now": Economic Inequality Enhances the Wish for a Strong Leader.

Societal inequality has been found to harm the mental and physical health of its members and undermine overall social cohesion. Here, we tested the hypothesis that economic inequality is associated with a wish for a strong leader in a study involving 28 countries from five continents (Study 1, N = 6,112), a study involving an Australian community sample (Study 2, N = 515), and two experiments (Study 3a, N = 96; Study 3b, N = 296). We found correlational (Studies 1 and 2) and experimental (Studies 3a and 3b) evidence for our prediction that higher inequality enhances the wish for a strong leader. We also found that this relationship is mediated by perceptions of anomie, except in the case of objective inequality in Study 1. This suggests that societal inequality enhances the perception that society is breaking down (anomie) and that a strong leader is needed to restore order (even when that leader is willing to challenge democratic values).

Stereospecificity of the Hofmann elimination in the gas phase.

The Hofmann elimination of ammonium ions having a single positive charge is demonstrated to exhibit stereospecificity with regard to expulsion of neutral alkene. For the 3-hexyl series of threo and erythro 4-monodeuterated ions (3-hexylammonium ion; N,N,N-trimethyl- d3-3-hexylammonium ion; N-ethyl-3-hexylammonium ion; N-methyl, N-ethyl-3-hexylammonium ion; N,N-dimethyl, N-ethyl-3-hexylammonium ion), the upper limit of the E:Z ratio of the expelled alkene (r) approaches 2 (the stereospecificity) with a deuterium isotope effect close to 2.0, although the effects of isotopic substitution diminish the E:Z ratio somewhat. Two fragmentations compete with that reaction: hydride shift (which gives the same products but with hydrogen scrambling) and loss of a neutral amine to give an alkyl cation. These competing reactions render our calculation approximate, but the results suggest a value not too far from the upper limit.

Hydrogen Liberation from Gaseous 2-Bora-1,3-diazacycloalkanium Cations.

Evidence is presented for cyclization to yield 2-bora-1,3-diazacycloalkanium cations in the gas phase. While the neutral compounds in solution and solid phase are known to possess an acyclic structure (as revealed by X-ray diffraction), the gaseous cations (from which borohydride BH4- ion has been expelled) have a cyclic structure, as revealed by InfraRed Multiple Photon Dissociation (IRMPD) spectroscopy and collisionally activated decomposition (CAD). The IRMPD decomposition of the monocyclic ions proceeds principally via H2 expulsion, although CAD experiments show additional pathways. Pyrolyses of solid monomeric salts and small oligomers produce higher polymers that are consistent with H2 expulsion as the major pathway. Deuterium labeling experiments show that scrambling occurs prior to IRMPD or CAD decomposition in the gas phase.

Low-Frequency CH Stretch Vibrations of Free Alkoxide Ions.

CH stretches in hydrocarbon cations often shift to lower frequencies relative to neutral molecules, because they do not have sufficient electrons to give every bond an electron pair. A parallel effect in negatively charged species has not been previously observed. Here we show that CH bond weakening occurs in alkoxide anions as a consequence of hyperconjugation. The reasoning differs somewhat from the case of positively charged ions, but the net effect is the same: to lower CH stretching frequencies by hundreds of wavenumbers.

NIH Consensus development project on criteria for clinical trials in chronic graft-versus-host disease: II. The 2014 Pathology Working Group Report.

The 2005 National Institute of Health (NIH) Consensus Conference outlined histopathological diagnostic criteria for the major organ systems affected by both acute and chronic graft-versus-host disease (GVHD). The 2014 Consensus Conference led to this updated document with new information from histopathological studies of GVHD in the gut, liver, skin, and oral mucosa and an expanded discussion of GVHD in the lungs and kidneys. The recommendations for final histological diagnostic categories have been simplified from 4 categories to 3: no GVHD, possible GVHD, and likely GVHD, based on better reproducibility achieved by combining the previous categories of "consistent with GVHD" and "definite GVHD" into the single category of "likely GVHD." Issues remain in the histopathological characterization of GVHD, particularly with respect to the threshold of histological changes required for diagnostic certainty. Guidance is provided for the incorporation of biopsy information into prospective clinical studies of GVHD, particularly with respect to biomarker validation.

Negative Hyperconjugation versus Electronegativity: Vibrational Spectra of Free Fluorinated Alkoxide Ions in the Gas Phase.

CO stretching frequencies of free, gaseous, fluorinated alkoxide ions shift substantially to the blue, relative to those of corresponding alcohols complexed with ammonia. Free α-fluorinated ions, pentafluoroethoxide and heptafluoroisopropoxide anions, display further blue shifts relative to cases with only ß-fluorination, providing experimental evidence for fluorine negative hyperconjugation. DFT analysis with the atoms in molecules (AIM) method confirms an increase in CO bond order for the α-fluorinated ions, demonstrating an increase in carbonyl character for the free ions.

Proteomic analysis of saliva from patients with oral chronic graft-versus-host disease.

Chronic graft-versus-host disease (cGVHD) is an immune-mediated disorder and is the major long-term complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). The oral mucosa, including the salivary glands, is affected in the majority of patients with cGVHD; however, at present there is only a limited understanding of disease pathobiology. In this study, we performed a quantitative proteomic analysis of saliva pooled from patients with and without oral cGVHD-cGVHD(+) and cGVHD(-), respectively-using isobaric tags for relative and absolute quantification labeling, followed by tandem mass spectrometry. Among 249 salivary proteins identified by tandem mass spectrometry, 82 exhibited altered expression in the oral cGVHD(+) group compared with the cGVHD(-) group. Many of the identified proteins function in innate or acquired immunity, or are associated with tissue maintenance functions, such as proteolysis or the cytoskeleton. Using ELISA immunoassays, we further confirmed that 2 of these proteins, IL-1 receptor antagonist and cystatin B, showed decreased expression in patients with active oral cGVHD (P < .003). Receiver operating curve characteristic analysis revealed that these 2 markers were able to distinguish oral cGVHD with a sensitivity of 85% and specificity of 60%, and showed slightly better discrimination in newly diagnosed patients evaluated within 12 months of allo-HSCT (sensitivity, 92%; specificity 73%). In addition to identifying novel potential salivary cGVHD biomarkers, our study demonstrates that there is coordinated regulation of protein families involved in inflammation, antimicrobial defense, and tissue protection in oral cGVHD that also may reflect changes in salivary gland function and damage to the oral mucosa.

An investigation of politicians' responses to urban diversity and disadvantage: The case of the Danish 'parallel societies'.

We examine how Danish politicians articulate views on the 'parallel society agreement' (aka, the 'ghetto-laws'), a controversial legislative intervention aiming to manage urban migration-related diversity. Through nationwide urban redevelopment aimed at facilitating residential 'mixing', the goal of the legislation is to eliminate so-called 'parallel societies'-socio-economically deprived neighbourhoods characterized by high concentrations of ethnic minorities. In-depth interviews with Danish politicians (n = 11) explored how this proposal was supported, contested or rejected in situated discourse. Following social representations theory, we focus on how 'parallel societies' were constructed in relation to differing ideas about 'mainstream society' and value-laden oppositional meaning-categories (i.e. themata). In particular, we highlight processes of socio-ethical reasoning that occurred through thematization of a shared oppositional meaning-category: 'freedom-constraint'. Views on the intervention were articulated around this oppositional meaning-category. Moreover, a connection was observed between the views articulated by individual politicians and sets of congruent ideas and images mobilized to represent 'parallel societies'. We discuss the theoretical value of taking a social representations approach to urban policy debates, and the practical limitations of dominant representations for successfully promoting intercultural dialogue and engagement-the stated goal of this intervention.

Solidarity with whom? Minority perspectives on allyship in Danish queer spaces.

Social psychological research has witnessed a burgeoning interest in advantaged group allies acting in solidarity with disadvantaged groups to challenge systems of inequality. While solidarity from advantaged group members is often deemed critical for social change, the perceptions of disadvantaged group members regarding ally participation are seldom addressed. This research delved into how LGBTQIA+ individuals in Denmark conceptualize allyship. Through 26 semi-structured interviews with participants and organizers of queer pride events, a thematic analysis identified three themes addressing how allyship materializes, what risks it bears and who it involves. Specifically, we present a three-levelled framework of allyship, which captures practices of allyship on a personal, relational and structural level. Our analysis also reveals the risk of allyship when it is not perceived as genuine and complexities of group boundaries when discussing allyship, shedding light on intersectional challenges within minority communities. These findings illustrate the nuances involved in providing and receiving allyship within and across various social (sub)groups.

You've Got E-Mail: A Pilot Study Examining the Feasibility and Impact of a Group-Based Technology-Training Intervention Among Older Adults Living in Residential Care.

Older adults living in residential care often experience challenges in sustaining meaningful social relationships, which can result in compromised health and well-being. Online social networking has the potential to mitigate this problem, but few studies have investigated its implementation and its effectiveness in maintaining or enhancing well-being. This pilot study used a cluster-randomized pre-post design to examine the feasibility of implementing a 12-week group-based technology-training intervention for older adults (n = 48) living in residential care by exploring how cognitive health, mental health, and confidence in technology were impacted. Analysis of variance revealed significant increases in life satisfaction, positive attitudes toward computer use, and self-perceived competence among participants who received the intervention, but increased depressive symptoms for the control group. These findings suggest that, despite challenges in implementing the intervention in residential care, group-based technology training may enhance confidence among older adults while maintaining or enhancing mental health.

Proton-bound dimers of 1-methylcytosine and its derivatives: vibrational and NMR spectroscopy.

Vibrational spectroscopy and NMR demonstrate that the proton-bound dimer of 1-methylcytosine, 1, has an unsymmetrical structure at room temperature. In the gas phase, investigation of isolated homodimer 1 reveals five fundamental NH vibrations by IR Multiple Photon Dissociation (IRMPD) action spectroscopy. The NH···N stretching vibration between the two ring nitrogens exhibits a frequency of 1570 cm(-1), as confirmed by examination of the proton-bound homodimers of 5-fluoro-1-methycytosine, 2, and of 1,5-dimethylcytosine, 3, which display absorptions in the same region that disappear upon deuterium substitution. (13)C, and (15)N NMR of the solid iodide salt of 1 confirm the nonequivalence of the two rings in the anhydrous proton-bound homodimer at room temperature. IRMPD spectra of the three possible heterodimers also show NH···N stretches in the same domain, and at least one of the heterodimers, the proton-bound dimer of 1,5-dimethylcytosine with 1-methylcytosine, exhibits two bands suggestive of the presence of two tautomers close in energy.

Proton-bridge motions in amine conjugate acid ions having intramolecular hydrogen bonds to hydroxyl and amine groups.

Vibrational spectra of two gaseous cations having NH···O intramolecular ionic hydrogen bonds and of nine protonated di- and polyamines having NH···N internal proton bridges, recorded using IR Multiple Photon Dissociation (IRMPD) of mass-selected ions, are reported. The band positions of hydroxyl stretching frequencies do not shift when a protonated amine becomes hydrogen bonded to oxygen. In three protonated diamines, lower frequency bands (550-650 cm(-1)) disappear upon isotopic substitution, as well as several bands in the 1100-1350 cm(-1) region. By treating the internal proton bridge as a linear triatomic, theory assigns the lowest frequency bands to N-H···N asymmetric stretches. A 2-dimensional model, based on quantization on a surface fit to points calculated using a double hybrid functional B2-P3LYP/cc-pVTZ//B3LYP/6-31G**, predicts their positions accurately. In at least one case, the conjugate acid of 1,5-cis-bis(dimethylamino)cyclooctane, a N-H···N bend shows up in the domain predicted by DFT normal mode calculations, but in most other cases the observed bands have frequencies 20-25% lower than expected for bending vibrations. Protonated Me(2)NCH(2)CMe(2)CH(2)CH(2)CH(2)NMe(2) shows three well-resolved bands at 620, 1200, and 1320 cm(-1), of which the lowest can be assigned to the asymmetric stretch. Other ions observed include doubly protonated 1,2,4,5-(Me(2)NCH(2))(4)-benzene and 1,2,4-(Me(2)NCH(2))(3)-benzene-5-CH(2)OH. Apart from the aforementioned rigid ion derived from the alicyclic diamine, the other ions enjoy greater conformational mobility, and coupling to low-frequency C-C bond torsions may account for the shift of vibrations with N-H···N character to lower frequencies. Low-barrier hydrogen bonding (LBHB) accounts for the fact that N-H···N asymmetric stretching vibrations of near linear proton bridges occur at frequencies below 650 cm(-1).

Why trust? A mixed-method investigation of the origins and meaning of trust during the COVID-19 lockdown in Denmark.

Trust is highlighted as central to effective disease management. During the COVID-19 pandemic, Denmark seemed to embody this understanding. Characterizing the Danish response were high levels of public compliance with government regulations and restrictions coupled with high trust in the government and other members of society. In this article, we first revisit prior claims about the importance of trust in securing compliant citizen behaviour based on a weekly time-use survey that we conducted during the first weeks of the COVID-19 pandemic (2 April-18 May 2020). Analysis of activity episodes, rather than merely self-reported compliance, both reconfirms the importance of institutional trust and nuances prior suggestions of detrimental effects of trust in other citizens. These survey-based results are further augmented through thematic analysis of 21 in-depth interviews with respondents sampled from the survey participants. The qualitative analysis reveals two themes, the first focusing on trust in others in Danish society and the second on the history of trust in Denmark. Both themes are based on narratives layered in cultural, institutional and inter-personal levels and further underline that institutional and social trust are complementary and not countervailing. We conclude by discussing how our analysis suggests pathways towards an increased social contract between governments, institutions and individuals that might be of use during future global emergencies and to the overall functioning of democracies.

User perspectives on long-term remote active electronic self-monitoring of mood symptoms in bipolar spectrum disorders.

BACKGROUND: User feedback is crucial in the development of electronic self-monitoring tools for bipolar spectrum disorders (BSD). Previous studies have examined user experiences in small samples self-monitoring over relatively short time periods. We aimed to explore the experiences of a large sample of individuals with BSD engaged in long-term remote active electronic self-monitoring. METHODS: An online survey, containing closed and open questions, was sent to participants with BSD enrolled on the Bipolar Disorder Research Network (BDRN) True Colours mood-monitoring system. Questions related to experiences of using True Colours, including viewing mood graphs, and sharing data with healthcare professionals (HCPs) and/or family/friends. RESULTS: Response rate was 62.7 % (n = 362). 88.4 % reported finding using True Colours helpful. Commonly reported benefits were having a visual record of mood changes, patterns/triggers and identifying early warning signs. Limitations included questions not being comprehensive or revealing anything new. One third had shared their graphs, with 89.9 % finding it helpful to share with HCPs and 78.7 % helpful to share with family/friends. Perceived benefits included aiding communication and limitations included lack of interest/understanding from others. LIMITATIONS: Responder bias may be present. Findings may not be generalisable to all research cohorts. CONCLUSIONS: The majority of participants valued long-term self-monitoring. Personalisation and ease of use were important. A potential challenge is continued use when mood is long-term stable, highlighting the need for measures to be sensitive to small changes. Sharing self-monitoring data with HCPs may enhance communication of the lived experience of those with BSD. Future research should examine HCPs' perspectives.

Unquestioned answers or unanswered questions: beliefs about science guide responses to uncertainty in climate change risk communication.

In two experimental studies we investigated the effect of beliefs about the nature and purpose of science (classical vs. Kuhnian models of science) on responses to uncertainty in scientific messages about climate change risk. The results revealed a significant interaction between both measured (Study 1) and manipulated (Study 2) beliefs about science and the level of communicated uncertainty on willingness to act in line with the message. Specifically, messages that communicated high uncertainty were more persuasive for participants who shared an understanding of science as debate than for those who believed that science is a search for absolute truth. In addition, participants who had a concept of science as debate were more motivated by higher (rather than lower) uncertainty in climate change messages. The results suggest that achieving alignment between the general public's beliefs about science and the style of the scientific messages is crucial for successful risk communication in science. Accordingly, rather than uncertainty always undermining the effectiveness of science communication, uncertainty can enhance message effects when it fits the audience's understanding of what science is.

Coming together after standing apart: What predicts felt safety in the post-coronavirus crowd?

RATIONALE: Over a year after the outbreak of SARS-CoV-2, and the ensuing COVID-19 pandemic with its lockdowns and social distancing requirements, being together with others again seems possible. Against this backdrop, important questions arise about how to safely manage gatherings of large numbers of unrelated people - like festivals, concerts and sporting matches - and how individuals contemplating involvement in such events feel about the risks presented. METHODS: To begin answering these questions, the current research surveyed would-be attendees at one of Europe's largest outdoor music festivals (n = 18353). Drawing on social psychological theories of crowd behavior and risk perception, we explored the identity processes that contributed to individual feelings of safety within the planned event. RESULTS: The results show that shared identity with other festival goers and the perception of collectivistic (versus individualistic) values as defining of that festival, contributed to more trust in relevant others, stronger expectations that others would behave with safety rather than risk, and through these increased comfort with, and acceptance of the risks presented by, the planned festival. CONCLUSION: These results highlight identity forces that might be leveraged for crowd management in the context of disease risk.

A randomized trial testing the effectiveness of virtual reality as a tool for pro-environmental dietary change.

This study investigates the impact of an efficacy-focused virtual reality (VR) intervention designed according to instructional design principles on eating behavior. In the preregistered intervention study, psychology students were randomly assigned to nine seminar blocks. Employing parallel design, they were allocated to either a VR intervention to experience the environmental impact of food behavior (1) and alter the future by revising food choices (2) or to a passive control condition. The data from 123 participants (78% female, mean age 25.03, SD = 6.4) were analyzed to investigate the effect of the VR intervention on dietary footprint measured from 1 week before to 1 week after the intervention. The VR intervention decreased individual dietary footprints (d = 0.4) significantly more than the control condition. Similarly, the VR condition increased response efficacy and knowledge to a larger extent compared to the control. For knowledge, the effect persisted for 1 week. The VR intervention had no impact on intentions, self-efficacy, or psychological distance. Additional manipulation of normative feedback enhanced self-efficacy; however, manipulation of geographical framing did not influence psychological distance. This research received no financial support from any funding agency and was registered on 15/09/2021 at Open Science Foundation with the number https://doi.org/10.17605/OSF.IO/2AXF3 .