A service mapping exercise of four health and social care staff mental health and wellbeing services, Resilience Hubs, to describe health service provision and interventions.

BACKGROUND: NHS England funded 40 Mental Health and Wellbeing Hubs to support health and social care staff affected by the COVID-19 pandemic. We aimed to document variations in how national guidance was adapted to the local contexts of four Hubs in the North of England. METHODS: We used a modified version of Price's (2019) service mapping methodology. Service level data were used to inform the analysis. A mapping template was adapted from a range of tools, including the European Service Mapping Schedule, and reviewed by Hub leads. Key data included service model; staffing; and interventions. Data were collected between March 2021 - March 2022 by site research assistants. Findings were accuracy-checked by Hub leads, and a logic model developed to theorise how the Hubs may effect change. RESULTS: Hub goals and service models closely reflected guidance; offering: proactive outreach; team-based support; clinical assessment; onward referral, and rapid access to mental health support (in-house and external). Implementation reflected a service context of a client group with high mental health need, and high waiting times at external mental health services. Hubs were predominantly staffed by experienced clinicians, to manage these mental health presentations and organisational working. Formulation-based psychological assessment and the provision of direct therapy were not core functions of the NHS England model, however all Hubs incorporated these adaptations into their service models in response to local contexts, such as extensive waiting lists within external services, and/or client presentations falling between gaps in existing service provision. Finally, a standalone clinical records system was seen as important to reassure Hub users of confidentiality. Other more nuanced variation depended on localised contexts. CONCLUSION: This study provides a map for setting up services, emphasising early understandings of how new services will integrate within existing systems. Local and regional contexts led to variation in service configuration. Whilst additional Hub functions are supported by available literature, further research is needed to determine whether these functions should comprise essential components of staff wellbeing services moving forward. Future research should also determine the comparative effectiveness of service components, and the limits of permissible variation. STUDY REGISTRATION: researchregistry6303.

HPV vaccination among eligible HIV-positive adults: a best practice implementation project.

OBJECTIVE: The aim of this best practice implementation project was to promote evidence-based practices (EBPs) for human papilloma virus (HPV) vaccination among eligible HIV-positive patients. INTRODUCTION: HPV-induced cancers are largely preventable by prophylactic vaccination of HPV-naïve individuals. Immunosuppression in HIV-positive patients prevents clearance of HPV, which increases the risk of developing cancer. Health care agencies caring for individuals living with HIV must implement interventions to enhance uptake of HPV vaccination. METHODS: This project was guided by the JBI Model of Evidence-Based Healthcare and JBI's Getting Research into Practice (GRiP) tool. A baseline audit was conducted to assess current practice against EBPs and to identify areas for improvement. A follow-up audit was used post-implementation to determine whether compliance with EBPs improved. RESULTS: The baseline audit revealed an average compliance rate of 46% with the two EBPs for increasing vaccination uptake. Three barriers to compliance were identified and strategies were implemented to address these barriers. The follow-up audit revealed 71% average compliance with the EBPs, a 25% increase from baseline. CONCLUSIONS: Interventions aimed at promoting HPV vaccination among HIV-positive individuals can reduce the risk of specific cancers. This project revealed an increase in compliance with EBPs for HPV vaccination for eligible HIV-positive patients when a vaccination reminder and recall system was placed in a frequently visited section of the electronic health record. However, a more sustainable solution would be to collaborate with the information technology staff to ensure that the health maintenance section in the electronic health record is configured correctly.

The N-end rule pathway regulates ER stress-induced clusterin release to the cytosol where it directs misfolded proteins for degradation.

Previous work suggests that cell stress induces release of the normally secreted chaperone clusterin (CLU) into the cytosol. We analyzed the localization of CLU in healthy and stressed cells, the mechanism of its cytosolic release, and its interactions with cytosolic misfolded proteins. Key results of this study are the following: (1) full-length CLU is released to the cytosol during stress, (2) the CLU N-terminal D1 residue is recognized by the N-end rule pathway and together with the enzyme ATE1 is essential for cytosolic release, (3) CLU can form stable complexes with cytosolic misfolded proteins and direct them to the proteasome and autophagosomes, and (4) cytosolic CLU protects cells from hypoxic stress and the cytosolic overexpression of an aggregation-prone protein. Collectively, the results suggest that enhanced cytosolic release of CLU is a stress response that can inhibit the toxicity of misfolded proteins and facilitate their targeted degradation via both autophagy and the proteasome.

Prevalence and incidence of anal cancer in HIV-positive men: a systematic review protocol.

OBJECTIVE: The objective of this review is to synthesize the best evidence available to determine the prevalence and incidence of anal cancer in HIV-positive men. INTRODUCTION: Worldwide, an estimated 50,685 people were diagnosed with anal cancer in 2020 and an estimated 19,293 people died from the disease during the same year. From 2001 to 2015, the overall incidence of anal cancer increased by 2.7% per year, while mortality jumped by 3.1% each year. Evidence has shown that anal intraepithelial neoplasia can progress to cancer over time, particularly within the immunocompromised population. INCLUSION CRITERIA: This review will consider studies conducted in any setting, in any geographical location that report on the prevalence and incidence of adult males aged 18 years or older from any racial or ethnic background who are HIV positive and diagnosed with any type of anal cancer. Participants will be included regardless of stage of anal cancer, type of cancer treatment used, or length of time diagnosed. METHODS: CINAHL, MEDLINE, Embase, LBGTQ+ Source (EBSCO), Web of Science Core Collection, MedNar, WorldWideScience, and ProQuest Dissertations and Theses databases will be searched from 1990 till the present. Analytical and descriptive observational studies will be included and critically appraised by 2 independent reviewers. Data will be extracted using JBI standardized data extraction tools. If sufficient data are available, a meta-analysis will be conducted; otherwise, the findings will be presented in narrative format, including tables and figures to aid in data presentation. REVIEW REGISTRATION: PROSPERO CRD42022327933.

Measuring the ability to perceive the emotional connotations of written language.

Emotionally laden writing is essential to our personal and professional lives. The purpose of this article was to design and evaluate a new test of the ability to decode the emotional connotations of written material. A series of 3 studies (totaling 457 participants) were used to demonstrate that the Metaphors Test measures a single construct, has strong internal consistency, has strong convergent validity with tests related to emotional and social intelligence, and has strong discriminant validity with vocabulary and personality. Confirmatory factor analyses demonstrated that the Metaphors Test is more closely associated with emotion perception than emotional understanding. Unlike most other tests that tap this skill, the stimuli for the Metaphors Test do not include any explicit emotion words; it is therefore a unique and valuable measure of emotion perception.