Recent Submissions

  • Engaging young people with sexual health services in general practice surgeries: a qualitative study of health care professionals

    Adakpa, Itodo; Randhawa, Gurch; Ochieng, Bertha; University of Bedfordshire; De Montfort University (Wolters Kluwer, 2024-02-08)
    Evidence to date suggests that young people are becoming more sexually active and are forming relationships during the early stages of their lives, sometimes engaging in sexual risk-taking, which contributes to high rates of conception and sexually transmitted infections (STIs). Young people at risk of adverse sexual health outcomes are the least likely to engage with reproductive and sexual health promotion programmes and services (RSHPPs), especially in mainstream clinics such as general practice (GP) surgeries. The study aimed to explore the views and experiences of service providers. A qualitative approach to explore the views and experiences of designing and implementing RSHPPs for young people in GP surgeries was used. A total of seven participants were interviewed, including four general practitioners (GPs), two of whom were managers at the practice; one nurse; one healthcare and support worker; and one practice manager. The context of RSHPPs such as local health priorities and partnerships to address STIs and unplanned pregnancies among young people contribute to the implementation and engagement of young people with RSHPPs. Training of GPs, nurses, and support workers helps develop confidence and overcome personal factors by promoting effective engagement of young people with RSHPPs. Addressing local health priorities such as reducing teenage pregnancies and STIs requires organisations to provide RSHPPs in both non-clinical and clinical settings to ensure that RSHPPs are accessible to young people. There is room for improvement in access to RSH for young people in GP surgeries by addressing organisational and structural barriers to access.
  • Malaria vaccine efficacy, safety, and community perception in Africa: a scoping review of recent empirical studies

    Chutiyami, Muhammad; Saravanakumar, Priya; Bello, Umar Muhammad; Salihu, Dauda; Adeleye, Khadijat; Kolo, Mustapha Adam; Dawa, Kabiru Kasamu; Hamina, Dathini; Bhandari, Pratibha; Sulaiman, Surajo Kamilu; et al. (Springer, 2024-03-05)
    The review summarizes the recent empirical evidence on the efficacy, safety, and community perception of malaria vaccines in Africa. Academic Search Complete, African Journals Online, CINAHL, Medline, PsychInfo, and two grey literature sources were searched in January 2023, and updated in June 2023. Relevant studies published from 2012 were included. Studies were screened, appraised, and synthesized in line with the review aim. Statistical results are presented as 95% Confidence Intervals and proportions/percentages. Sixty-six (N = 66) studies met the inclusion criteria. Of the vaccines identified, overall efficacy at 12 months was highest for the R21 vaccine (N = 3) at 77.0%, compared to the RTS,S vaccine (N = 15) at 55%. The efficacy of other vaccines was BK-SE36 (11.0-50.0%, N = 1), ChAd63/MVA ME-TRAP (- 4.7-19.4%, N = 2), FMP2.1/AS02A (7.6-9.9%, N = 1), GMZ2 (0.6-60.0%, N = 5), PfPZ (20.0-100.0%, N = 5), and PfSPZ-CVac (24.8-33.6%, N = 1). Injection site pain and fever were the most common adverse events (N = 26), while febrile convulsion (N = 8) was the most reported, vaccine-related Serious Adverse Event. Mixed perceptions of malaria vaccines were found in African communities (N = 17); awareness was generally low, ranging from 11% in Tanzania to 60% in Nigeria (N = 9), compared to willingness to accept the vaccines, which varied from 32.3% in Ethiopia to 96% in Sierra Leone (N = 15). Other issues include availability, logistics, and misconceptions. Malaria vaccines protect against malaria infection in varying degrees, with severe side effects rarely occurring. Further research is required to improve vaccine efficacy and community involvement is needed to ensure successful widespread use in African communities.
  • The effects of adapted mind-body exercises on physical function, quality of life and wellbeing for older people: a systematic review and meta-analysis

    Tanhamira, Lesley-Anne; Randhawa, Gurch; Hewson, David; University of Bedfordshire (Elsevier, 2024-02-14)
    Participating in physical activity programmes is one way to optimise wellbeing and quality of life in older adults. Mind-body exercises could provide greater benefits than other forms of traditional physical activity and can be easily adapted for older people who are starting to develop functional decline. To synthesise the literature looking at the effects of adapted mind-body interventions on older people. A systematic review and meta-analysis was conducted on articles from Web of Science, MEDLINE, SPORTDiscus, AMED and CINAHL that were searched up to 13 September 2023. Studies were extracted and assessed by two authors and included if they were adapted mind-body quasi experimental trials (QET) or randomised controlled trials (RCT) evaluating physical function, quality of life or wellbeing in community dwelling older adults aged 60 years and over. The Cochrane Risk of Bias 2 scale was used for quality appraisal. Analysis of the results included calculating standardised effect sizes (Hedge's g) and a narrative synthesis of results not included in meta-analysis. 18 studies (8 quasi-experimental trial designs, n = 310; 10 randomised control trials, n = 1829) were included in the systematic review, with 14 studies (9 RCT, n = 1776, 5 QET, n = 100) retained for meta-analysis. For the RCT studies, some improvement was noted in mobility (ES 0.36: 95% CI: 0.01, 0.71), flexibility (ES 0.36: 0.01, 0.70), well-being (ES 0.54: 0.18, 0.91) and quality of life (ES 0.50: 0.21, 0.79). No positive effect was observed for leg power (ES 0.09: -0.33, 0.51), leg endurance (ES 0.16: -0.72, 1.03), back scratch test (ES 0.24: -0.10, 0.59), or balance, (ES 0.05: -0.06, 0.15). Heterogeneity varied from 0%-87% across the different outcomes. For the QET studies, gait velocity was shown to improve (ES 0.54: 0.18, 0.91), while fear of falling showed no significant improvements (ES 0.82: -0.06, 1.69). A meta-regression for quality of life in which the total physical activity of the intervention, in hours, was used as a covariate, showed ES = 1.1 for every 100 h of physical activity. There is scope for adapted mind-body physical activity interventions to play a role in improving quality of life, wellbeing, and physical function in older adults. The provision of adapted interventions for older people might improve uptake of and engagement with physical activity interventions in older people with limited or reduced abilities.
  • Exploring the relationship of cognitive function with and without COVID-19 recovered schizophrenic patients

    Mehmood, Anam; Almajwal, Ali Madi; Addas, Abdullah; Zeb, Falak; Alam, Iftikhar; Sehar, Bismillah; ; Central South University, China; King Saud University; Prince Sattam Bin Abdulaziz University; et al. (Frontiers, 2024-01-03)
    The Coronavirus disease 2019 (COVID-19) is linked to the deterioration of cognitive function among individuals suffering from schizophrenia. The purpose of this study was to compare the cognitive performance of schizophrenic patients before and after COVID-19. A longitudinal cohort study involving a sample of 219 individuals diagnosed with schizophrenia was enrolled between June 2022 and May 2023. The participants were split into two groups infected with COVID-19 (n = 165) and not infected with COVID-19 (n = 54). The data were gathered via a questionnaire on demographic characteristics, the Brief Assessment of Cognition in Schizophrenia (BACS), the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), the Activities of Daily Living (ADL) scale, and the Insomnia Severity Index (ISI). The repeated-measures ANOVA showed that Among patients diagnosed with COVID-19, there was a deterioration in global cognitive function (before COVID-19 = -2.45 vs. after COVID-19 = -3.02, p = 0.007), working memory (before COVID-19 = -2.76 vs. after COVID-19 = -3.34, p < 0.00 1), motor speed (before COVID-19 = -1.64 vs. after COVID-19 = -2.12, p < 0.001), attention and speed of information processing (before COVID-19 = -1.93 vs. after COVID-19 = -1.16, p = 0.008). multi-variable analysis showed that several factors as having a secondary grade of education (β = 0.434), experiencing insomnia (β = 0.411)and the interaction between COVID-19 diagnosis and cognition at baseline (β = 0.796) were significantly associated with cognitive deficits. At the same time, no significant associations were found between global cognition and clinical symptoms, autonomy, or depression (p > 0.05). The COVID-19 pandemic has significantly impacted various cognitive functions, such as verbal memory, working memory, and global cognition. Insomnia has been identified as the predominant determinant of cognitive impairment, alongside the confirmation of a COVID-19 diagnosis. Additional research is imperative to elucidate the diversification of cognitive functionality observed in individuals diagnosed with schizophrenia who have acquired COVID-19.
  • Supporting adult unpaid carers via an online dancing intervention: a feasibility/acceptability study

    Horne, Joanna Kathryn; Donald, Louisa; Gracia, Rosaria; Kentzer, Nichola; Pappas, Yannis; Trott, Mike; Vseteckova, Jitka; ; Open University; University of Bedfordshire; et al. (PLOS, 2024-01-19)
    Unpaid carers often experience poor mental and physical health linked to their caring role. Engagement in physical activity has been shown to alleviate these negative health outcomes, but it is harder for carers to find the time, energy and space to exercise. This qualitative study, based in the UK, explored the feasibility of an online, dance-based physical activity intervention with six female unpaid carers. Five themes resulted from the thematic analysis of the pre- and post-intervention interviews: Perceived physical health benefits of the intervention; Perceived mental health benefits of the intervention; Satisfactoriness of the dance classes; Impact of caring responsibilities on participation; and Suggestions for future classes. Further research is required to measure the effectiveness of the dance intervention in improving mental and physical wellbeing with larger samples including a wider mix of carers in terms of gender, age and health conditions of the care recipients, as well as international samples. Future research should also consider the barriers that some carers may face when accessing an online intervention, and alternative forms of exercise that may appeal to other groups of carers (e.g., male carers, older adult carers).
  • A horizon scan of issues affecting UK forest management within 50 years

    Tew, Eleanor R.; Ambrose-Oji, Bianca; Beatty, Malcolm; Buentgen, Ulf; Butterworth, Holly; Clover, Gerard; Cook, Dan; Dauksta, Dainis; Day, William; Deakin, John; et al. (Oxford University Press, 2023-11-08)
    Forests are in the spotlight: they are expected to play a pivotal role in our response to society’s greatest challenges, such as the climate and biodiversity crises. Yet, the forests themselves, and the sector that manages them, face a range of interrelated threats and opportunities. Many of these are well understood, even if the solutions remain elusive. However, there are also emerging trends that are currently less widely appreciated. We report here the results of a horizon scan to identify developing issues likely to affect UK forest management within the next 50 years. These are issues that are presently under-recognized but have potential for significant impact across the sector and beyond. As the forest management sector naturally operates over long timescales, the importance of using good foresight is self-evident. We followed a tried-and-tested horizon scanning methodology involving a diverse Expert Panel to collate and prioritize a longlist of 180 issues. The top 15 issues identified are presented in the Graphical Abstract. The issues represent a diverse range of themes, within a spectrum of influences from environmental shocks and perturbations to changing political and socio-economic drivers, with complex emerging interactions between them. The most highly ranked issue was ‘Catastrophic forest ecosystem collapse’, reflecting agreement that not only is such collapse a likely prospect but it would also have huge implications across the sector and wider society. These and many of the other issues are large scale, with far-reaching implications. We must be careful to avoid inaction through being overwhelmed, or indeed to merely focus on ‘easy wins’ without considering broader ramifications. Our responses to each of the challenges and opportunities highlighted must be synergistic and coherent, involving landscape-scale planning. A more adaptive approach to forest management will be essential, encouraging continual innovation and learning. The 15 horizon scan issues presented here are a starting point on which to build further research, prompt debate and action, and develop evidence-based policy and practice. We hope that this stimulates greater recognition of how our forests and sector may need to change to be fit for the future. In some cases, these changes will need to be fundamental and momentous.
  • Factors influencing urban greenspace use among a multiethnic community in the UK: the Chalkscapes Study

    Cook, Erica Jane; Kabasinguzi, Isabella; Randhawa, Gurch; Ali, Nasreen; University of Bedfordshire (Elseiver, 2024-01-15)
    In the UK, there are disparities in the use of urban greenspaces, particularly among lowincome, ethnically diverse communities. Determining how populations interact with greenspaces and the barriers and facilitators that influence use remains pertinent to improve access. This study aimed to examine how people who reside in an ethnically diverse community use and engage with urban greenspaces and, drawing on the COM-B model (capability, opportunity, motivation, and behaviour), aimed to assess the potential barriers Journal Pre-proofand facilitators that influence use. A cross-sectional survey, conducted across two ethnically diverse towns in southeast England investigated greenspace usage, including activities and reasons for using greenspaces and included the Brief Measure of Behavior Change (COM-B). The survey was shared online via Qualtrics and widely disseminated in the local community via bilingual fieldworkers and community networks. The sample comprised 906 participants (60.7% female; mean age 38 ±16.37 years). The findings revealed that the use of greenspaces was low with around 33% visiting greenspaces frequently (at least once a week). Older people, those with higher levels of deprivation and/or those from a minority ethnic background were all shown to be the lowest users of greenspaces. The findings also confirmed that the types of activities and reasons for visiting greenspaces were shown to vary by a range of socio-demographic characteristics. The COM-B model was shown to be a useful explanatory framework with physical capability and motivation identified as significant predictors of frequency of greenspace use. We now encourage future research to consider what factors underpin motivation and the opportunities to use greenspaces, and how these vary across the wider population.
  • How to use leadership to spark innovation

    Sagoo, Rohit; University of Bedfordshire (RCN Publishing Company Ltd., 2023-08-01)
    Evidence and practice
  • Strategies to improve the magnetic resonance imaging experience for autistic individuals: a cross-sectional study exploring parents and carers' experiences

    Stogiannos, Nikolaos; Pavlopoulou, Georgia; Papadopoulos, Chris; Walsh, Gemma; Potts, Ben; Moqbel, Sarah; Gkaravella, Antigoni; McNulty, Jonathan P.; Simcock, Clare; Gaigg, Sebastian B.; et al. (BMC, 2023-12-07)
    Autistic individuals encounter numerous barriers in accessing healthcare, including communication difficulties, sensory sensitivities, and a lack of appropriate adjustments. These issues are particularly acute during MRI scans, which involve confined spaces, loud noises, and the necessity to remain still. There remains no unified approach to preparing autistic individuals for MRI procedures. A cross-sectional online survey was conducted with parents and carers of autistic individuals in the UK to explore their experiences, barriers, and recommendations concerning MRI scans. The survey collected demographic information and experiential accounts of previous MRI procedures. Quantitative data were analysed descriptively, while key themes were identified within the qualitative data through inductive thematic analysis. Sixteen parents/carers participated. The majority reported difficulties with communication, inadequate pre-scan preparation, and insufficient adjustments during MRI scans for their autistic children. Key barriers included an overwhelming sensory environment, radiographers' limited understanding of autism, and anxiety stemming from uncertainties about the procedure. Recommended improvements encompassed accessible communication, pre-visit familiarisation, noise-reduction and sensory adaptations, staff training on autism, and greater flexibility to meet individual needs. There is an urgent need to enhance MRI experiences for autistic individuals. This can be achieved through improved staff knowledge, effective communication strategies, thorough pre-scan preparation, and tailored reasonable adjustments. Co-producing clear MRI guidelines with the autism community could standardise sensitive practices. An individualised approach is crucial for reducing anxiety and facilitating participation. Empowering radiographers through autism-specific education and incorporating insights from autistic individuals and their families could transform MRI experiences and outcomes.
  • Risk of low birthweight and late antenatal care initiation in an ethnically diverse maternal cohort

    Puthussery, Shuby; Tseng, Pei-Ching; Li, Leah; (Oxford University Press, 2023-10-24)
    Background Babies born with low birthweight (LBW,< 2500 g) are vulnerable to infant mortality, restricted growth, poorer development, and long-term health complications. Antenatal care (ANC) can improve maternal and infant outcomes; women are recommended to have first antenatal visit by 10 weeks’ gestation. Ethnic minority women are significantly more likely to initiate ANC later than recommended gestational week compared to white women. This study examined associations between late ANC initiation (first appointment >10 weeks gestation) and LBW in an ethnically diverse maternal cohort in the UK. Methods A retrospective cross sectional study using routinely collected anonymous data of singleton births during April 2015 - October 2022 from a large UK National Health Service maternity unit in an ethnically diverse area. Logistic regression models were used to examine associations between late ANC initiation and prevalence of low (<2500 g); very low (VLBW, <1500 g) and extremely low (ELBW, <1000g) birth weight. Results Of 39,785 singleton births recorded, more than one third (34.6%) were to mothers from Black African, Black Caribbean, Indian, Pakistani, and Bangladeshi backgrounds. Birthweight was reported for 39,698 (99.78%) neonates; among them 8.9% had LBW, including 1.0% VLBW and 1.1% ELBW. More than one third (34.8%) of mothers had first appointment at > 10 weeks, including 26% during 11-19 weeks and 8.8% at > 20 weeks. Late ANC initiation was associated with increased risk of LBW for neonates: OR = 1.15 [95% CI: 1.07, 1.23] and 1.60 [1.44, 1.78] for ANC initiation at > 10 weeks and ≥20 weeks respectively (vs ≤ 10 weeks). Mothers who started care at ≥ 20 weeks were 5.37 times (95% CI: 4.31, 6.70) more likely to have a baby born with ELBW (vs ≤ 10 weeks). Conclusions Neonates born to mothers who started antenatal care late in ethnically diverse neighborhoods are more likely to have low birthweight, highlighting the need for targeted primary and secondary interventions.
  • Promoting a global culture of respectful maternity care

    Puthussery, Shuby; Bayih, Wubet Alebachew; Brown, Hilary; Aborigo, Raymond Akawire; ; University of Bedfordshire; Debre Tabor University; Monash University; University of Toronto; Navrongo Health Research Centre (BMC, 2023-11-17)
    Respectful maternity care (RMC) - a fundamental human right for all women - prioritizes autonomy and rights of pregnant and birthing women throughout the entire childbirth journey. Despite increasing acknowledgment of the importance of RMC for optimal maternal and new-born outcomes, women often experience disrespectful and abusive practices during pregnancy and childbirth. This Editorial points to the need for development of international guidelines for the implementation of RMC programs globally.
  • Investigating the impact of London's ultra low emission zone on children's health: children's health in London and Luton (CHILL) protocol for a prospective parallel cohort study

    Tsocheva, Ivelina; Scales, James; Dove, Rosamund E.; Chavda, Jasmine; Kalsi, Harpal; Wood, Helen E.; Colligan, Grainne; Cross, Louise; Newby, Chris; Hall, Amy; et al. (2023-11-04)
    Air pollution harms health across the life course. Children are at particular risk of adverse effects during development, which may impact on health in later life. Interventions that improve air quality are urgently needed both to improve public health now, and prevent longer-term increased vulnerability to chronic disease. Low Emission Zones are a public health policy intervention aimed at reducing traffic-derived contributions to urban air pollution, but evidence that they deliver health benefits is lacking. We describe a natural experiment study (CHILL: Children's Health in London and Luton) to evaluate the impacts of the introduction of London's Ultra Low Emission Zone (ULEZ) on children's health. CHILL is a prospective two-arm parallel longitudinal cohort study recruiting children at age 6-9 years from primary schools in Central London (the focus of the first phase of the ULEZ) and Luton (a comparator site), with the primary outcome being the impact of changes in annual air pollutant exposures (nitrogen oxides [NOx], nitrogen dioxide [NO2], particulate matter with a diameter of less than 2.5micrograms [PM2.5], and less than 10 micrograms [PM10]) across the two sites on lung function growth, measured as post-bronchodilator forced expiratory volume in one second (FEV1) over five years. Secondary outcomes include physical activity, cognitive development, mental health, quality of life, health inequalities, and a range of respiratory and health economic data. CHILL's prospective parallel cohort design will enable robust conclusions to be drawn on the effectiveness of the ULEZ at improving air quality and delivering improvements in children's respiratory health. With increasing proportions of the world's population now living in large urban areas exceeding World Health Organisation air pollution limit guidelines, our study findings will have important implications for the design and implementation of Low Emission and Clean Air Zones in the UK, and worldwide. GOV: NCT04695093 (05/01/2021).
  • Mapping trust relationships in organ donation and transplantation: a conceptual model

    Martínez-López, María Victoria; McLaughlin, Leah; Molina-Pérez, Alberto; Pabisiak, Krzysztof; Primc, Nadia; Randhawa, Gurch; Rodríguez-Arias, David; Suárez, Jorge; Wöhlke, Sabine; Delgado, Janet; et al. (BMC, 2023-11-01)
    The organ donation and transplantation (ODT) system heavily relies on the willingness of individuals to donate their organs. While it is widely believed that public trust plays a crucial role in shaping donation rates, the empirical support for this assumption remains limited. In order to bridge this knowledge gap, this article takes a foundational approach by elucidating the concept of trust within the context of ODT. By examining the stakeholders involved, identifying influential factors, and mapping the intricate trust relationships among trustors, trustees, and objects of trust, we aim to provide a comprehensive understanding of trust dynamics in ODT. We employ maps and graphs to illustrate the functioning of these trust relationships, enabling a visual representation of the complex interactions within the ODT system. Through this conceptual groundwork, we pave the way for future empirical research to investigate the link between trust and organ donation rates, informed by a clarified understanding of trust in ODT. This study can also provide valuable insights to inform interventions and policies aimed at enhancing organ donation rates.
  • A systematic review and thematic synthesis of inpatient nursing staff experiences of working with high-risk patient behaviours

    Velmans, Samuel Richardson; Joseph, Christiana; Wood, Lisa; Billings, Jo; (Wiley, 2023-10-24)
    Introduction Nursing staff are frequently exposed to high-risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours. Aim The aim of the study was to examine nursing staff experiences of high-risk behaviours in inpatient mental health settings. Methods Four electronic databases (CINAHL, Medline, PsycINFO, EMBASE) were searched. The protocol for this review was prospectively registered in PROSPERO (Ref: CRD42022334739). A meta-synthesis of nursing staff's experiences of high-risk behaviours in inpatient mental health settings was conducted. Results We identified 30 eligible studies. Six themes were constructed from the meta-synthesis: the social contract of care; the function of risk behaviours; the expectation of risk; risk as a relational concept; navigating contradictions in care; the aftermath. Discussion Nursing staff conceptualize risk as a meaningful behaviour shaped by patient, staff and environmental factors. Managing risk is an ethical dilemma for nursing staff and they require more training and support in ethical risk decision-making. Implications for Practice Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours. Relevance Statement Nursing staff are frequently exposed to high-risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours. This systematic review offers insights into how high-risk behaviours are experienced by nursing staff and makes recommendations about how to improve the understanding and management of them. Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours.
  • An innovative state-of-the-art health storytelling technique for better management of type 2 diabetes

    Ali, Sumbal; Bakht, Shumaila; Ullah Jan, Atta; Alam, Iftikhar; Almajwal, Ali Madi; Osaili, Tareq; Obaid, Reyad Shakir; Faris, MoezAllslam Ezzat; Cheikh Ismail, Leila; Najah, Farah; et al. (Frontiers, 2023-09-29)
    Type 2 diabetes (T2D) is a chronic lifelong disease that requires long-term prevention and management strategies in a community setting. A health story is a novel technique that may be used as an effective tool for better prevention and management of T2D. The main objective of this study is to develop a story to be used as a social health technique based on contemporary scientific knowledge that may be used at a community level for better communication and management of T2D. A community-academic partnership was formed with a not-for-profit Nutrition Education, Awareness, and Training (NEAT) organization in Khyber Pakhtunkhwa, Pakistan. We agreed to develop a story that may be used as a health and nutrition education communication tool for better management of patients with T2D. The following phases were followed during the story creation process: (1) the theory phase, (2) the modeling phase, and (3) the evaluation phase. Raters evaluated the story to determine its literary and scientific quality, comprehensiveness, and T2D specificity. The title of the story translated into English is "The Story of Diabetes-The Story of Success." It is text based and contains 86 pages in the local language, "Pashto," with an English translation. The story is divided into five chapters and describes the initial diagnosis, fear associated with the disease, issues related to referral to certified practitioners, the importance of a balanced diet, and related lifestyle habits. After story evaluation, the raters suggested its literary and scientific quality, comprehensiveness, and T2D specificity (Pearson correlation scores of >0.8). This unique story was created for T2D and found to be of significant quality in terms of its literary and scientific quality, as well as its comprehensiveness and diabetes specificity. As a result, it may be suggested that it can be used in subsequent studies to improve T2D management among adult patients.
  • Experience and views of healthcare professionals towards people who use new psychoactive substances: evidence from statutory, non-statutory, and private mental health and addiction healthcare services

    Solomon, David; Grierson, Jeffrey; Godier-McBard, Lauren; Guirguis, Amira; University of Bedfordshire; Anglia Ruskin University; Swansea University Medical School (Wiley, 2023-10-16)
    It is unclear how healthcare professionals (HCPs) experience and view the challenges of working with people who use New Psychoactive Substances (PWUNPS), in different healthcare services (HCS). The aim of the study was to explore HCPs' experiences of working with individuals who use NPS across statutory, non-statutory, and private mental health and addiction HCSs. HCPs completed in-depth semi-structured interviews. Audio recordings were transcribed verbatim with a mean duration of 30 min 55 s. Data were analysed through thematic analysis. A purposive sample of 14 HCPs (6 men, 8 women) with a mean age of 42.5 years were interviewed in 2019. Organisational issues, including funding, impacted the treatment for PWUNPS and HCPs perceived a lack of support dependent on their qualifications. They reported a lack of assessment, policy, harm reduction, and awareness of NPS-related symptoms including mental health problems and stigma faced by PWUNPS. HCPs need better training, education, and assessment processes to manage acute NPS intoxications and address the stigma associated with PWUNPS. There is a need for policy-making opportunities across different HCSs to ensure better healthcare outcomes for PWUNPS.
  • Development, acceptability and feasibility of a community-based intervention to increase timely initiation of antenatal care in an area of high ethnic diversity and low socio-economic status in the UK

    Sharma, Esther; Puthussery, Shuby; Tseng, Pei-Ching; Harden, Angela; Li, Leah; ; University of Bedfordshire; City, University of London; University College London (Elsevier, 2023-09-01)
    Background Antenatal care plays an important role in preventing adverse maternal and new-born outcomes. Women from ethnic minority backgrounds and of low socio-economic status are at greater risk of initiating antenatal care later than the recommended 10 weeks. There is a paucity of research exploring the development and evaluation of community-based interventions to increase the timely initiation of antenatal care. Objective To develop and evaluate the acceptability and feasibility of a co-produced community-based intervention to increase uptake of antenatal care in an area with high ethnic diversity and low socio-economic status. Design The intervention was developed using co-production workshops and conversations with 20 local service users and 14 stakeholders, underpinned by the theory of Diffusion of Innovation. The intervention was evaluated, on the domains of acceptability, adoption, appropriateness, and feasibility. Questionnaires (n=36), interviews (n=10), and focus groups (n=13) were conducted among those who received the intervention. Observations (n=13) of intervention sessions were conducted to assess intervention fidelity. Quantitative and qualitative data were analysed using SPSS and NVivo software respectively. Results Over 91% of respondents positively ranked the intervention. Qualitative findings with respect to ‘acceptability’ included four subthemes: how the intervention was communicated, the characteristics of the person delivering the intervention and their knowledge, and the reassurance offered by the intervention. The ‘adoption’ theme included three sub-themes: being informed helps women to engage with antenatal care, the intervention provides information for future use, and onwards conveyance of the intervention information. The ‘appropriateness’ theme included three sub-themes: existing gap in information, nature of information given as part of the intervention, and talking about pregnancy in public. The ‘feasibility’ theme included two sub-themes: value of delivering the intervention in areas of high footfall and relational aspect of receiving the intervention. Observations showed intervention fidelity of 100%. Conclusion The community-based intervention, coproduced with women and maternity care stakeholders, was positively evaluated, and offered an innovative and promising approach to engage and educate women about the timely initiation of antenatal care in an ethnically diverse and socio-economically deprived community.
  • The critical factors in producing high quality and policy-relevant research: insights from international behavioural science units

    Lecouturier, Jan; Vlaev, Ivo; Chadwick, Paul; Chater, Angel M.; Kelly, Michael P.; Goffe, Louis; Meyer, Carly; Tang, Mei Yee; Antonopoulou, Vivi; Graham, Fiona; et al. (2023-09-14)
    Background There has been a rapid increase in the number of, and demand for, organisations offering behavioural science advice to government over the last 10 years. Yet we know little of the state of science and the experiences of these evidence providers. Aims and objectives To identify current practice in this emerging field and the factors that impact on the production of high quality and policy-relevant research. Methods A qualitative study using one-to-one interviews with representatives from a purposeful sample of 15 units in the vanguard of international behavioural science research in policy. The data were analysed thematically. Findings Relationships with policymakers were important in the inception of units, research conduct, implementation and dissemination of findings. Knowledge exchange facilitated a shared understanding of policy issues/context, and of behavioural science. Sufficient funding was crucial to maintain critical capacity in the units’ workforces, build a research portfolio beneficial to policymakers and the units, and to ensure full and transparent dissemination. Discussion and conclusion Findings highlight the positive impact of strong evidence-provider/user relationships and the importance of governments commitment to co-produced research programmes to address policy problems and transparency in the dissemination of methods and findings. From the findings we have created a framework ‘STEPS’ (Sharing, Transparency, Engagement, Partnership, Strong relationships) of five recommendations for units working with policymakers. These findings will be of value to all researchers conducting research on behalf of government.
  • Taking a "care pathway/whole systems" approach to equality diversity inclusion (EDI) in organ donation and transplantation in relation to the needs of "ethnic/racial/migrant" minority communities: a statement and a call for action

    Grossi, Alessandra Agnese; Randhawa, Gurch; Jansen, Nichon Esther; Paredes-Zapata, David; University of Insubria; University of Bedfordshire; Dutch Transplant Foundation; University of Barcelona (Frontiers, 2023-07-31)
    International evidence shows variation in organ donation and transplantation (ODT) based upon a range of patient characteristics. What is less well understood is the impact of patient "ethnicity/race/immigration background," as these terms are defined and intended differently across countries. We also know that these characteristics do not operate in isolation but intersect with a range of factors. In this paper, we propose a framework that seeks to clarify the definition of the key terms "ethnicity/race/migrant" and to review how these communities are operationalized across European studies about inequities in ODT. Further, patients and the public wish to see Equality Diversity Inclusion (EDI) approaches in their everyday lives, not just in relation to ODT. We propose a 'care pathway/whole-systems' approach to ODT encompassing culturally competent public health interventions for a) the prevention and management of chronic diseases, b) improvements in public engagement for the promotion of the culture of ODT and enhancements in end-of-life care, through to c) enhanced likelihood of successful transplant among migrant/ethnic minority communities. Our framework recognizes that if we truly wish to take an EDI approach to ODT, we need to adopt a more social, human and holistic approach to examining questions around patient ethnicity.
  • The systematic development of guidance for parents on talking to children of primary school age about weight

    Gillison, Fiona B.; Grey, Elisabeth B.; Baber, Fran; Chater, Angel M.; Atkinson, Lou; Gahagan, Alison; University of Bath; University of Bedfordshire; Warwick University; OHID (BMC, 2023-09-04)
    Background: The prevalence of overweight and obesity in children is increasing, alongside increases in rates of children’s anxiety and worry about their weight. In many countries children’s weight is measured, and parents are made aware if a child has been classified as having overweight or obesity. However, many parents are concerned that raising their child’s awareness of their weight, and talking to children about their weight could harm their wellbeing. The aim of this project was to develop guidance for parents on constructive ways to talk to children of primary school age about weight when they need to. Methods: The project followed a mixed-methods design: Phase 1 involved the collation of evidence including (a) two previously published systematic literature reviews to identify the associations between parent-child weight talk, and broader health discussions, and children’s wellbeing, (b) interviews with children, and (c) development and refinement of narrative messaging (previously published). In Phase 2 we developed a conceptual model and mapped primary findings to techniques and content within a draft guidance document for parents on talking to children about weight. Phase 3 involved a modified Delphi process with 29 stakeholders to refine and agree a final version. Results: An acceptable draft guidance was agreed following two stages of feedback from Delphi participants. Key areas for debate and adaptation included: encouraging discussion about health and growth with lesser focus on weight; finding ways to reduce stigma and perceptions of blame; emphasising a whole-family approach; inclusive representation of diversity among children and families. Conclusions: Consensus on the content of guidance for parents on talking to children about weight was achieved through a process of evidence review and stakeholder and expert engagement. The next steps are to measure the impact of the resource on improving the experience of parents and children in communicating about weight.

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