Browsing by Author "Dunford, Louise"

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    Do Undergraduate Students Change Their Attitudes to People with Obesity After Following a Healthy Lifestyle Challenge?
    (Oxford University Press, 2020-05-29) Jin, Yannan; Buczak, Agata; Dunford, Louise
    Objectives To test whether following a healthy lifestyle challenge for 21 days led to a change in student attitudes to people with obesity. Methods Students on an undergraduate BMedSci (Hons) Medical Science program were invited to take part in a healthy lifestyle challenge, and each of the participants selected one positive change to either their diet or physical activity levels, which they had to follow for 21 days. All challenges were approved by nutritionists to ensure their challenges were risk-free. During this period participants joined a social media group to support each other and discuss their progress. Before and after the 21 days participants were asked to complete a validated questionnaire ‘Attitudes to obese persons’ (Allison et al. 1991) which consists of 20 Likert scale questions, where they indicated how much they agreed or disagreed with each statement. Data were anonymised and analysed using Paired Samples T-Test, with the level of significance set at P < 0.05. Results Thirty-seven students completed the first questionnaire however only 29 of them (78%) completed the second one. The drop-out rate was due to the second questionnaires being collected after a teaching session which was less well-attended than the first. Despite students reporting that they felt following their challenge made them more empathetic to the struggles that people with obesity may face when trying to lose weight and improve activity levels, their underlying attitudes did not change, and there were no significant differences in their questionnaire answers between before and after their challenge. Conclusions Taking part in a 21-day healthy lifestyles challenge did not change student attitudes to people with obesity. Developing more empathy did not seem to change underlying attitudes in this cohort, and it may be that such a short period of time is not enough to lead to significant changes.
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    ItemOpen Access
    An investigation into the impact of diet and lifestyle on the management of lipoedema
    (Elsevier, 2022-04-05) Jin, Yannan; Benzine, Rawdha; Dunford, Louise; Fetzer, Sharie; Warrilow, Mary
    Objectives Lipoedema is a chronic fat disorder involving an excessive abnormal deposition of subcutaneous fat in the thighs, legs, hips and buttocks mainly (Wounds UK, 2017). The importance of healthy eating in lipoedema management has been recognised (Wounds UK, 2017), yet dietary guidelines specific for lipoedema are lacking (Bertsch et al., 2020). The study aimed to investigate the self-reported dietary and lifestyle impact on lipoedema management among a representative lipoedema population in the UK. Methods The study used an online questionnaire that consisted of multiple-choice and open-response questions to collect data on symptoms and diagnostic status of lipoedema and self-reported dietary and lifestyle impact on lipoedema management among participants. The questionnaire was constructed using the Survey Monkey software. The active online survey link was sent to Lipoedema UK's members and contacts via e-mail and also made accessible via the study flyer advertised on Lipoedema UK's website and newsletters. Ethical approval was obtained from the De Montfort University Faculty Research Ethics Committee of Health and Life Sciences prior to the study. Participants had given their consents before starting the survey. Data collection was anonymous. Data were analysed using SPSS v26.0. Results The results showed that 165 out of 257 participants (66.3%) had tried diet as a mean to improve their lipoedema symptoms in the past. Anti-inflammatory diet was reported to be one of the three most effective diets that improved their symptoms (either single or multiple). The other two diets were ketogenic diet and rare adipose disorder diet. Noticeably, 95% of the 257 participants were classified as either overweight or obese based on their Body Mass Index (BMI) measure. And 20% of the participants who tried weight loss diets had found improvements in their lipoedema conditions. Conclusions The study results will help inform the development of future research on finding a dietary solution to effective lipoedema management for the UK lipoedema population. Funding Sources De Montfort University funded the recruitment of a Research Assistant to support part of the data analysis work.
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    Patients access to medicines – A critical review of the healthcare system in Kenya
    (Dove Medical Press Limited, 2022-03-01) Toroitich, Anthony Martin; Dunford, Louise; Armitage, Rachel; Tanna, Sangeeta
    Access to affordable, safe, effective, and quality-assured medicines by a patient is important for good health outcomes. Unfortunately, there is sparse literature published on the pharmaceutical enablers that may increase the sale of a substandard and falsified (SF) medicine to a patient in Kenya. The review highlights some of the factors that may facilitate the entry of SF medicines into the legitimate pharmaceutical supply chain and discusses their impact on patient access to medicines. Lack of essential medicines in public health facilities is an important factor that may contribute to increased demand for medicine-related out-of-pocket expense from private health facilities thus a likelihood for a patient purchasing SF medicine from unlicensed and illegal medicine outlets or unregulated websites. The need to increase medicine availability in the public sector by the Ministry of Health (MOH) is emphasized in addition to the strengthening of public procurement to cushion it from corruption and mismanagement. In addition, the MOH should promote local pharmaceutical manufacturing and implement a medicine pricing containment policy to avoid abuse and prevent overexploitation of patients, increase medicine price transparency, and reduce pharmaceutical supply chain distortion. Recommended regulatory reviews include accreditation of unlicensed illegal medicine outlets to facilitate accountability, regulatory oversight, and active surveillance. The national post-market surveillance regulatory capacity should be strengthened to improve rational medicine use. A three-year diploma course should be replaced with a shorter one- or two-year pharmaceutical support staff training not eligible to superintend a pharmacy. The recommended legislative review includes a mandatory clause to enforce generic prescribing and the implementation of generic substitution by health workers. Unethical manipulative pharmaceutical marketing practices should carry stiffer penalties to deter malpractice. Future research areas include investigation of medicine prescribing and dispensing practices, medicine consumption studies, medicine price differences within different health sub-sectors, and between licensed pharmacies and unlicensed illegal medicine outlets.
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    Utilizing quantitative dried blood spot analysis to objectively assess adherence to cardiovascular pharmacotherapy among patients at Kenyatta National Hospital, Nairobi, Kenya
    (PLOS, 2023-01-20) Wata, David; Ogwu, John; Dunford, Louise; Lawson, Graham; Tanna, Sangeeta
    The burden of cardiovascular disease (CVD) is rising in Kenya and non-adherence to cardiovascular pharmacotherapy is a growing global public health issue that leads to treatment failure, an increased risk of cardiac events and poor clinical outcomes. This study assessed adherence to selected cardiovascular therapy medications among CVD patients attending outpatient clinics at Kenyatta National Hospital, Kenya by determining drug concentration(s) in patient dried blood spot (DBS) samples. Patients who had been taking one or more of the five commonly prescribed CVD medications (amlodipine, atenolol, atorvastatin, losartan, and valsartan) for at least six months were enrolled. Each patient completed a short questionnaire about their medication history and then provided a finger-prick blood spot sample from which drug concentrations were determined by liquid chromatography-high resolution mass spectrometry analysis. Two hundred and thirty-nine patients (62.3% female) participated in the study. The median number of medications used by patients was 2 (IQR 75%-25% is 3-1). Less than half (117; 49.0%) of patients were adherent to their prescribed CVD pharmacotherapy. Binary regression analysis revealed a significant correlation between non-adherence and the number of medications in the treatment regimen (Odds Ratio (OR) 1.583; 95%CI: 0.949-2.639; P-value = 0.039) and that gender was not an independent predictor of medication adherence (OR 1.233; 95%CI: 0.730-2.083; P-value = 0.216). Valuable information about adherence to each medication in the patient’s treatment regimen was obtained using quantitative DBS analysis showing that adherence to CVD medications was not uniform. DBS sampling, due its minimally invasive nature, convenience and ease of transport is a useful alternative matrix to monitor adherence to pharmacotherapies objectively, when combined with hyphenated mass spectrometry analytical techniques. This information can provide physicians with an evidence-based novel approach towards personalization and optimization of CVD pharmacotherapy and implementing interventions in the Kenyan population, thereby improving clinical outcomes.