Bringing Creative Psychotherapies to Primary NHS Mental Health Services in the UK:A Feasibility Study on Patient and Staff Experiences of Arts for the Blues Workshops Delivered at Improving Access to Psychological Therapies (IAPT) services

There have been several arguments for the need to generate evidence-based creative forms of psychological interventions in Improving Access to Psychological Services (IAPT), the main primary mental health provider in hospitals in England, UK. In this feasibility study, we sought to identify helpful and unhelpful factors of a new creative group psychotherapy, titled Arts for the Blues. We also wanted to find out whether the research tools used were acceptable and sensitive. We therefore engaged a group of seven patients attending an IAPT service in the North West of England, and a group of six staff working in the same service, to attend one creative workshop each, followed by a focus group. The two focus groups were transcribed and analysed using thematic analysis. We also collected pre- and post-measures of depression (PHQ-9) and anxiety (GAD-7), measures commonly used in IAPT services, plus measures of well-being (WHO-5), the PANAS, and goal-setting, which were considered for acceptability and sensitivity. We received largely positive responses from service users and staff in the use of creative methods in psychotherapy. Although the measures used had limitations due to the short duration of one-off creative workshops, we found that they were sensitive enough, easy to complete and, thus, were acceptable. We concluded that Arts for the Blues is a promising intervention in IAPT, especially since it is shaped by service users and staff working in these services. Further work is needed to establish the effectiveness of this new intervention

HIV Infection, Immunosuppression, and Age at Diagnosis of Non-AIDS-Defining Cancers

Background: It is unclear whether immunosuppression leads to younger ages at cancer diagnosis among people living with human immunodeficiency virus (PLWH). A previous study found that most cancers are not diagnosed at a younger age in people with AIDS, with the exception of anal and lung cancers. This study extends prior work to include all PLWH and examines associations between AIDS, CD4 count, and age at cancer diagnosis. Methods: We compared the median age at cancer diagnosis between PLWH in the North American AIDS Cohort Collaboration on Research and Design and the general population using data from the Surveillance, Epidemiology and End Results Program. We used statistical weights to adjust for population differences. We also compared median age at cancer diagnosis by AIDS status and CD4 count. Results: After adjusting for population differences, younger ages at diagnosis (P < .05) were observed for PLWH compared with the general population for lung (difference in medians = 4 years), anal (difference = 4), oral cavity/pharynx (difference = 2), and kidney cancers (difference = 2) and myeloma (difference = 4). Among PLWH, having an AIDS-defining event was associated with a younger age at myeloma diagnosis (difference = 4; P = .01), and CD4 count <200 cells/µL (vs ≥500) was associated with a younger age at lung cancer diagnosis (difference = 4; P = .006). Conclusions: Among PLWH, most cancers are not diagnosed at younger ages. However, this study strengthens evidence that lung cancer, anal cancer, and myeloma are diagnosed at modestly younger ages, and also shows younger ages at diagnosis of oral cavity/pharynx and kidney cancers, possibly reflecting accelerated cancer progression, etiologic heterogeneity, or risk factor exposure in PLWH

Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000–2010

Background. There are few recent data on the rates of AIDS-defining opportunistic infections (OIs) among human immunodeficiency virus (HIV)–infected patients in care in the United States and Canada

End-Stage Renal Disease Among HIV-Infected Adults in North America

Background. Human immunodeficiency virus (HIV)-infected adults, particularly those of black race, are at high-risk for end-stage renal disease (ESRD), but contributing factors are evolving. We hypothesized that improvements in HIV treatment have led to declines in risk of ESRD, particularly among HIV-infected blacks