Background Testing for HIV, linkage to treatment, and access to pre-exposure prophylaxis (PrEP) (medication that reduces the risk of acquiring HIV) is essential for early HIV diagnosis, treatment, and prevention. General practice could play a key role in maximising HIV testing opportunities and supporting access to PrEP. Aim To develop an intervention for general practice to increase HIV testing and facilitate access to PrEP. Design and setting This was a person-based approach (PBA) intervention development study using the capability, opportunity, motivation, behaviour model in South West England. Method A scoping review and semistructured interviews with healthcare professionals (HCPs) and local organisation representatives with an interest in HIV prevention/health care were conducted to understand the challenges and find potential solutions to increase HIV testing and facilitate access to PrEP in general practice. Intervention development used focus groups with HCPs and the public. Purposive sampling ensured diversity of practices and participants. Data were analysed using the PBA table of planning and the collaborative and intensive pragmatic qualitative approach. Results Barriers identified included lack of clinician knowledge of HIV and PrEP, concern about stretched resources, and a lack of systematic testing methods. Proposed strategies included simpler testing approaches to normalise testing and reduce HIV stigma. The intervention developed consists of: education, a prompt to test, simplified and standardised testing, PrEP signposting processes, patient information, and practice champions. Conclusion Research is needed to explore the feasibility and the effectiveness of this multicomponent intervention to increase testing and access to PrEP within general practice. Funding barriers also need to be addressed.
Abstract Background Patient and Public Involvement and Engagement (PPIE) is increasingly recognised as essential to the relevance, feasibility, and impact of paediatric intensive/critical care research. However, reporting of PPIE processes and outcomes, particularly in child health studies, remains limited, often lacking detail on sustained involvement and its influence across the research lifecycle. Case study This case study presents the PPIE approach embedded within the OCEANIC Study, a multi-centre longitudinal mixed-methods investigation into the outcomes and support needs of children and families following paediatric intensive care unit (PICU) discharge. The study uniquely sustained engagement with a Children, Young People and Parent Advisory Group (CYPPAG) over eight years, aligning with the National Institute for Health and Care Research (NIHR) standards for public involvement. We detail the strategies used to foster inclusive, respectful, and impactful collaboration, including co-development of study materials, iterative feedback on recruitment and retention strategies, and involvement in qualitative data interpretation and dissemination. The advisory group’s contributions shaped study design, enhanced recruitment, and informed dissemination, including co-authorship and conference presentations. PPIE impact was explored qualitatively through CYPPAG feedback, tracking of study changes informed by the CYPPAG, and ongoing reflection within the research team. Conclusion The OCEANIC Study demonstrates the feasibility and value of longitudinal, embedded PPIE in paediatric critical care research. It offers a novel model for sustained advisory group involvement, evidencing how meaningful collaboration can improve research relevance, rigour, and reach. This case study provides actionable insights for researchers seeking to integrate PPIE across the research continuum and highlights the therapeutic and empowering impact of involvement for contributors.
Aims Intraventricular hemorrhage (IVH) has a high mortality and disability rate and poses significant clinical challenges, which often leads to hydrocephalus and neurological dysfunction. Emerging evidence implicates dysfunction of the glymphatic-meningeal lymphatic-deep cervical lymphatic system in the pathogenesis of post-IVH hydrocephalus. Therapeutic hypothermia (TH) holds promise for mitigating these sequelae. This study investigates the potential of TH to ameliorate IVH-induced hydrocephalus and neurological dysfunction, while elucidating its underlying mechanisms.Methods Rat models of IVH are established by intraventricular injection of autologous blood. TH, deep cervical lymph nodes (dCLNs) ligation, and intraperitoneal injection of AMPK inhibitor are used to intervene.Results In rat models of IVH, TH alleviates neurological dysfunction and attenuates hydrocephalus and pathology damage. TH protects physiological function and maintains normal structure of the glymphatic system. TH improves function and structure of the meningeal lymphatic system and promotes drainage of the deep cervical lymphatic system. TH upregulates RTN3, facilitates phosphorylation of AMPK, and suppresses ERS. All the above effects are reversed by ligation of dCLNs and AMPK inhibitor.Conclusion TH alleviates hydrocephalus and neurological dysfunction post IVH by enhancing drainage of the glymphatic-meningeal lymphatic-deep cervical lymphatic system. The RTN3/AMPK/ERS pathway may be the proposed mechanism mediating this effect. TH is expected to become a novel therapeutic strategy for IVH.
Providing multiple vaccinations to adults at a single appointment, known as co-administration, could help increase vaccine coverage by making the process more convenient for the public. Despite vaccine co-administration policies, there are many missed opportunities to offer multiple vaccines. A qualitative understanding of the public attitude to co-administration may allow the development of interventions to increase implementation of co-administration policies. We undertook a scoping review following the Joanna Briggs Institute framework to collate the available qualitative literature to identify barriers, and facilitators to vaccine co-administration as well as potential research gaps. We created and used an iterative search strategy to retrieve articles published between 1/10/2010 and 11/12/2024 in three scientific databases. None of the articles retrieved fulfilled the inclusion criteria. There were nine articlesthat used quantitative surveys to measure attitudes, barriers and facilitators. Qualitative studies to understand barriers and facilitators to vaccine co-administration are needed to inform future policy implementation.
