School of Allied Health Sciences

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Now showing 1 - 15 of 15

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A systematic review of the barriers and facilitators impacting patient enrolment in clinical trials for lung cancer
(Elsevier, 2024-03-19) Lond, Benjamin; Dodd, Christopher; Davey, Zoe; Darlison, Liz; McPhelim, John; Rawlinson, Janette; Williamson, I. R.; Merriman, Clair; Waddington, Francesca; Bagnallainslie, Dominic; Rajendran, Balaji; Usman, Jesse; Henshall, Catherine
Purpose Clinical research trials are needed to enhance the medical care and treatment for lung cancer, which remains the leading cause of cancer-related deaths worldwide. While clinical trials allow for the development of novel therapies to treat cancer, the recruitment of lung cancer patients to trials is low. This review aimed to identify and synthesise the available literature concerning barriers and facilitators affecting lung cancer patients’ decisions to enrol in clinical trials to guide future cancer research efforts. Methods Four databases were systematically searched: Academic Search Complete, CINHAL, PubMed, and PsycINFO in August 2023. A supplemental grey literature search was also conducted alongside this. Articles were quality appraised using CASP and JMI checklists, and results were narratively synthesised. Results Eighteen articles of varied design met the inclusion criteria, and results were mapped onto the Capability, Opportunity, and Motivation Behaviour (COM-B) Model to help structure and conceptualise review findings. Evidence suggests that the decision to enrol in a trial is multifaceted and informed by: when and how study information is presented, travel and trial eligibility, and altruistic hopes and fears. Conclusions There is need to address the many different concerns that lung cancer patients have about participating in a clinical trial through the supply of accessible and timely trial information, and via the reduction of travel, expansion of study eligibility criteria, and recognition of a person's altruistic wishes, hopes, fears, and family-oriented concerns. Future research should aim to work alongside lung cancer patients, clinicians, and other stakeholders to increase research accessibility.
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Anticipated and experienced stigma and discrimination in the workplace among individuals with major depressive disorder in 35 countries: qualitative framework analysis of a mixed-method cross-sectional study
(BMJ, 2024-06-19) Van Bortel, Tine; Wickramasinghe, Nuwan Darshana; Treacy, Samantha; Khan, Nashi; Ouali, Uta; Sumathipala, Athula; Svab, Vesna; Nader, Doaa; Kadri, Nadia; Monteiro, Maria Fatima; Knifton, Lee; Quinn, Neil; Audenhove, Chantal Van; Lasalvia, Antonio; Bonetto, Chiara; Thornicroft, Graham; Weeghel, Jaap van; Brouwers, Evelien
Objectives Workplace stigmatisation and discrimination are significant barriers to accessing employment opportunities, reintegration and promotion in the workforce for people with mental illnesses in comparison to other disabilities. This paper presents qualitative evidence of anticipated and experienced workplace stigma and discrimination among individuals with major depressive disorder (MDD) in 35 countries, and how these experiences differ across countries based on their Human Development Index (HDI) level. Design Mixed-method cross-sectional survey. Participants, setting and measures The qualitative data were gathered as part of the combined European Union Anti-Stigma Programme European Network and global International Study of Discrimination and Stigma Outcomes for Depression studies examining stigma and discrimination among individuals with MDD across 35 countries. Anticipated and experienced stigma and discrimination were assessed using the Discrimination and Stigma Scale version 12 (DISC-12). This study used responses to the open-ended DISC-12 questions related to employment. Data were analysed using the framework analysis method. Results The framework analysis of qualitative data of 141 participants identified 6 key ‘frames’ exploring (1) participants reported experiences of workplace stigma and discrimination; (2) impact of experienced workplace stigma and discrimination; (3) anticipated workplace stigma and discrimination; (4) ways of coping; (5) positive work experiences and (6) contextualisation of workplace stigma and discrimination. In general, participants from very high HDI countries reported higher levels of anticipated and experienced discrimination than other HDI groups (eg, less understanding and support, being more avoided/shunned, stopping themselves from looking for work because of expectation and fear of discrimination). Furthermore, participants from medium/low HDI countries were more likely to report positive workplace experiences. Conclusions This study makes a significant contribution towards workplace stigma and discrimination among individuals with MDD, still an under-researched mental health diagnosis. These findings illuminate important relationships that may exist between countries/contexts and stigma and discrimination, identifying that individuals from very high HDI countries were more likely to report anticipated and experienced workplace discrimination.
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Comparing 17β‐estradiol and progesterone concentrations in young, physically active females: Insights from plasma versus serum analysis
(Wiley, 2025-03-12) Rowland, Samantha N.; Da Boit, Mariasole; Tan, Rachel; Heaney, Liam M.; Bailey, Stephen J.
Serum measurements of 17β-estradiol and progesterone are widely used to verify menstrual cycle status and confirm contraceptive use, often through commercially available immunoassay kits. However, no studies have investigated whether blood collection tube chemistries influence hormone concentrations in young females, despite assays permitting the use of different biofluids with similar reference ranges. In this study, venous blood was sampled from physically active females (n = 25) using Ethylenediaminetetraacetic acid (EDTA) and serum vacutainers, and 17β-estradiol and progesterone concentrations were measured using competitive immunoenzymatic assays. Median plasma concentrations of 17β-estradiol and progesterone were 44.2% (plasma 40.75 vs. serum 28.25 pg/ml) and 78.9% (plasma 1.70 vs. serum 0.95 ng/ml) higher than serum concentrations, respectively (P < 0.001 for both). Strong positive correlations were observed between plasma and serum concentrations for 17β-estradiol (r = 0.72; P < 0.001) and progesterone (r = 0.89; P < 0.001). The mean bias and limits of agreement for plasma versus serum were 12.5 pg/ml (−20.6 to 45.5 pg/ml) for 17β-estradiol and 1.01 ng/ml (−5.6 to 7.6 ng/ml) for progesterone. Ovarian hormone levels were consistently higher in EDTA plasma compared with serum, with these matrices not yielding statistically equivalent results. Despite these differences, the strong correlations and good agreement suggest that both matrices are suitable for biomarker analysis. Researchers using EDTA plasma should account for the higher hormone concentrations when applying inclusion or exclusion criteria, because adjustments might be necessary to ensure appropriate participant classification.
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Editorial: Intersections of ageing and disability during the COVID-19 pandemic
(Frontiers, 2024-10-14) Simmonds, Bethany; Berghs, Maria
The pandemic exposed the loss of human rights of older and disabled people and illustrated the critical commonalities these two groups have. As sociologists with personal and professional experience of ageing and disability, we were concerned with the proliferation of such “care-less” spaces (Rogers, 2017) and wanted to explore what could be learnt. Considering the general population's positive trajectory in increased life expectancy, not enough has been written about experiences of ageing with, and into, disability. This Research Topic brings together a range of epistemological and methodological perspectives in five papers to understand how to situate a better future of care.
Open Access
Global Public Health: Sustainability Development Challenges for Mental Health
(Wiley, 2025-02-28) Illingworth, Paul
This paper is based on a Keynote address the author gave at the 9 th International Global Public Health Conference, in Manila, Philippines July 2024. The paper explores how mental health care has been, and continues to be viewed through dominant models. And suggests that by taking an intersectional view of mental health, it demonstrates that mental health has not been given the same degree of importance and has not had fair and equitable attention in policy, strategies and resources. The author offers solutions which emphasises a seismic shift is needed by the UN, WHO and Governments to move from a dominant western medical model.
Open Access
Help-seeking and access to care for stroke and heart attack during the COVID-19 pandemic: a qualitative study.
(Wiley, 2024-08-23) Weis, Christina; Spiliopoulos, Georgia; Ignatowicz, Agnieszka; Conroy, Simon; Mannion, Russell; Lasserson, Daniel; Tarrant, Carolyn
In this paper we explore how people who experienced a stroke, transient ischaemic attack (TIA), or heart attack sought health care during the COVID-19 lockdown periods. Semi-structured interviews were conducted with 27 patients admitted to hospital between March 2020 and May 2021, and one carer, recruited from cardiac and stroke rehabilitation services in two large acute NHS trusts in England. Drawing on concepts of candidacy, illness and moral work, we discuss how people’s sense-making about their symptoms fundamentally shaped both their decisions about seeking help, and the impact of COVID-19 on help seeking. Risk perception and interactional ritual chain theory allow further exploration of constructing symbols of national identity in times of crises, managing risk and levels of acceptable risk, and critique of ambiguous national messaging over accessing healthcare services for people with emergency healthcare needs. Our findings have wider implications for supporting access into healthcare for those with life-threatening conditions under highly publicised strain on the health system, including winter pressure and staff strikes, also policy-making and public messaging.
Open Access
Linking Sustainable Development Goals for Global Mental Health. Keynote Address
(2024-10-26) Illingworth, Paul
The paper explores the development of SDGs and how Mental Health has not always been central. Taking an adapted intersectional approach, dominant models are explored as to why mental health isn't still central. The paper also suggests how and why the UN, WHO & Governments should incorporate more localized, affordable and sustainable mental health
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Portion Estimation, Satiety Perception and Energy Intake Following Different Breakfast Portion Sizes in Healthy Adults
(Wiley, 2025-02-05) Kwiecien, Kinga; Santos-Merx, Lourdes; Sahota, Tarsem; Coulthard, Helen; Da Boit, Mariasole
Expected satiety is a key element in predicting meal portion size and food consumption; however, how this can be affected by different breakfast portion sizes is unknown. The study examined the impact of different breakfast portions on satiety, portion size, and energy intake and comprised an online survey and an experimental intervention. Sixteen adults (9 women, BMI: 24.9 ± 4.3 kg/m2) rated images of three portion sizes (small, standard, large) of the same breakfast using an ordinal scale. Subsequently, they were asked to self-prepare and consume ad libitum the three breakfast portions in a randomised order on different days and to complete a food diary. Satiety and portion size perception were re-measured upon consumption of each breakfast. For both the visual image and breakfast consumption, the small breakfast portion was rated as the smallest and least filling, while the large portion was rated as the largest and most filling (p < 0.05). When consuming the small breakfast, participants reported being hungrier and less full between breakfast and lunch (p < 0.05) and had a higher energy intake from lunch onward, due to more snacking (p < 0.05). However, the total daily energy intake was not different among the three breakfast portion sizes. Individuals seemed accustomed to predicting satiety and portion size from images. The consumption of the small breakfast was judged as not filling enough and was accompanied by a higher energy intake via energy-dense snacks. Based on these preliminary findings, breakfast size reduction may lead to unhealthy compensatory energy intake by snacking on energy-dense foods.
Open Access
Reproductive timing and social egg freezing within British South Asian communities: a qualitative study
(Taylor and Francis, 2024-11-23) Loyal, Sasha
Background Social egg freezing (SEF) is a technology that enables women to preserve and store healthy, unfertilised eggs for non-medical reasons, for use later on in life. Despite the growing number of women using this technology, very little research has explored the perceptions of SEF among women from ethnically minoritised backgrounds. Method The main aim of this study was to advance understandings of perceptions of reproductive timing within British South Asian communities, and in part, focus on women’s perceptions of assisted reproductive technologies in shaping the timing of motherhood. Data collection took place over two qualitative phases: four focus groups (n = 31) and individual interviews (n = 28) and data were analysed using interpretative thematic analysis. Results The findings in this study demonstrate existence of varied and contrasting perceptions concerning reproductive timing and SEF amongst participants. The analysis developed two overarching themes: (1) Perceptions of SEF as a means of ‘achieving’ motherhood and (2) SEF as challenging normative expectations of reproduction. Conclusion These findings provide novel insights into how perceptions of SEF are mediated by women’s familial, religious and cultural contexts, shaped by perceptions about the ‘right time’ to have children and normative expectations of how women pursue motherhood.
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“Sickness has no time”: Awareness and perceptions of health care workers on universal health coverage in Uganda
(PLOS, 2024-07-18) Ifeagwu, Susan C.; Nakaboga Kikonyogo, Ruth; Nakkazi, Suzan; Beinomugisha, Joshua; Ojiambo Wandera, Stephen; Kiwanuka, Suzanne N.; King, Rachel; Bortel, Tine Van; Brayne, Carol; Parkes-Ratanshi, Rosalind; Patrick Christian Ilboudo
Introduction Each person having access to needed health services, of sufficient quality, and without suffering financial hardship, defined as universal health coverage (UHC) by the World Health Organization, is critical to improve population health, particularly for vulnerable populations. UHC requires multisectoral collaboration and good governance, and this will require buy-in of key stakeholders; but their views are under-documented. The aim of this stakeholder analysis was to explore the awareness and perceptions of UHC by health care workers (HCWs) in Uganda. Methods A mixed-methods study was conducted based on primary data from HCWs including an online QualtricsXM survey of 274 HCWs (from a database of persons who had received training at an academic institution), 23 key informant semi-structured interviews, and one eight-person focus group discussion. Data was collected from February to April 2022. Microsoft Excel and R Programme were used for quantitative analyses and NVivo version 12 for qualitative analyses. Results HCWs attributed a high level of importance to UHC in Uganda. Participants discussed national communication and management practices, organisational roles, health financing and power dynamics, health care demand and the impact of and learnings from COVID-19. Four main themes–each with related sub-themes–emerged from the interview data providing insights into: (1) communication, (2) organisation, (3) power, and (4) trust. Conclusion There is a critical need for better communication of UHC targets by policymakers to improve understanding at a grassroots level. Results indicated that ensuring trust among the population through transparency in metrics and budgets, strong accountability measures, awareness of local cultural sensitivities, sensitisation of the UHC concept and community inclusion will be essential for a multisectoral roll out of UHC. Further provision of quality health services, a harmonisation of efforts, increased domestic health financing and investment of HCWs through fair remuneration will need to underpin the delivery of UHC.
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Supporting the mental health of young people from ethnically diverse groups during the transition from primary to secondary school
(Sage, 2024-05-03) Cunningham, Emily; Raman, Sneha; Taylor, Andrea; Svirydzenka, N.; Siddiqi, Abdul-Moiz; Abdinasir, Kadra; Raghavan, Raghu
Background: The transition from primary to secondary school is a pivotal period in young people’s lives and can significantly impact their mental health. However, the experiences of young people from ethnically diverse groups during this crucial period of physical, social and emotional development are under-researched, limiting the evidence base for meaningful support. Objectives: This study explored the experiences of young people from ethnically diverse groups during primary-secondary school transition and co-designed ideas for culturally sensitive support. It explicitly focused on the intersection between ethnic and cultural identity, primary-secondary transition and mental health. Methods: The study employed participatory design to collaborate with seven young people from ethnically diverse groups and a peer researcher. Four online workshops mapped participant experiences and ideas concerning the primary-secondary transition, identity and mental health. These were developed into implications for practice, policy and research. Results: Participants highlighted feeling unprepared for the transition, with some experiencing poor mental health and difficulty navigating their ethnic and cultural identity during this time. Participants’ ideas for future transition experiences included: supporting a longer transition period, schools promoting diversity among students and staff, enabling education on ethnicity and culture, breaking stereotypes, enabling mutual learning among staff and students and enabling an open and caring environment to support mental health. Conclusions: The study provides an in-depth understanding of experiences of young people from ethnically diverse groups during primary-secondary transition and suggests ways of supporting multi-faceted transitions and mental health, with a key focus on ethnic and cultural identity formation.
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The influence of childhood trauma and chronotype on suicide attempts in Chinese emerging adults with severe depressive symptoms
(Springer, 2024-01-03) Yu, Yi; Feng, Yi; Xu, Shicun; Wilson, Amanda; Chen, Chang; Ling, Xi; Chen, Runsen; Wang, Yuanyuan
Background Studies have investigated how adults with severe depressive symptoms are more likely to attempt suicide, and these adults often have traumatic experiences and chaotic sleep/wake rhythms. Thus, this study using Latent class analysis aimed to investigate the relationship between childhood trauma class, chronotype, and suicide attempts among emerging adults with severe depressive symptoms. Methods This study was conducted among emerging adults with severe depressive symptoms covering 63 Universities in Jilin Province, China. A total of 1,225 emerging adults (mean age = 19.6 ± 1.78) constructed the final sample. In addition to measuring socio-demographic characteristics, the Childhood Trauma Questionnaire-Short Form, the Single-Item Chronotyping, and a single item for suicide attempts were used to evaluate childhood trauma, chronotype, and suicide attempts, respectively. Latent class analysis was applied to identify the classes of childhood trauma within emerging adults who had severe depressive symptoms. Hierarchical logistic regression models were run to investigate the effects of socio-demographic characteristics, chronotype, and childhood trauma class on suicide attempts. Results Three latent classes were identified: the Low-risk for childhood trauma class, the Neglect class, and the High-risk for childhood abuse class. Those who suffered sexual, emotional, and physical abuse at the same time were divided into the High-risk for childhood abuse class, and were significantly more likely to experience suicide attempts than those in the Neglect class (OR = 1.97, 95%CI = 1.34–2.89, p < 0.001) and the Low-risk for childhood trauma class (OR = 2.28, 95% CI = 1.50-3.46, p < 0.001). In terms of chronotype, the results showed that the chaotic type was a risk factor for suicide attempts when compared with the evening type (OR = 0.46, 95%CI = 0.27–0.78, p < 0.01), the moderately active type (OR = 0.53, 95%CI = 0.31–0.89, p < 0.05), and the daytime type (OR = 0.42, 95%CI = 0.21–0.86, p < 0.05). Overall, the significant risk factors for suicide attempts included being female, living in an urban area, having experienced sexual, emotional, and physical abuse simultaneously, and having a chaotic chronotype. Conclusion Emerging adults suffering sexual, emotional, and physical abuse at the same time and identifying with chaotic chronotype showed a higher risk of attempting suicide. The findings provided a clinical reference to quickly identify those at high risk of suicide attempts among emerging adults with severe depressive symptoms.
Open Access
The psychological preparation of patients for amputation surgery: A narrative review of the literature
(Sage, 2024-10-07) Loyal, Sasha; Hanna, Esmee
Amputation is a clinical intervention which can have substantial impacts on the patient’s quality of life and wellbeing, and the existing literature demonstrates how adjustment to amputation can be a long process for some patients. However, we know little about how patients are prepared psychologically or emotionally for undergoing amputation surgery. This paper examines the extant literature in relation to preparation for amputation surgery to explore the current knowledge and practices within this area. Through a narrative review (n=14 studies) we have generated three key themes related to the psychological preparation of patients for amputation surgery; ‘Emotionality in preparation for surgery’, ‘Information provision and support’ and ‘The role of Health Care Professionals (HCPs) and the multidisciplinary team (MDT) in preparation for surgery’. The pre-amputation period is one of great emotion for patients, and information and support is often seen as lacking in relation to preparation. Healthcare professionals, and specifically the MDT were seen as central in helping facilitate the preparation of patients, including delivering the appropriate quality and quantity of information to patients. This review offers insights and direction into how better psychological preparation of the amputation patient could be considered and included in clinical care.
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Unprofessional vision? Politics, (video)evidence and accountability after the work of Michael Lynch
(Cantonal and University Library Fribourg, 2025-01-14) Elsey, Christopher; Holder, Alexander; Kolanoski, Martina; Mair, Michael; Allen, Olive
As part of an ongoing critical dialogue with Charles Goodwin’s work on “professional vision” (1994), Michael Lynch has observed on a number of occasions that ‘viral’ videos—often those depicting instances of police and military misconduct—are publicly circulated artifacts that “vulgarise” and thus render perspicuous issues of ‘evidence’, ‘expertise’, ‘accountability’, and ‘visibility’ as matters of practical rather than philosophical concern (Lynch 1993, 146; see Lynch 1999, 2014, 2018, 2002; Lindwall and Lynch 2021). Alongside the video of Rodney King’s beating and, more recently, the murder of George Floyd, one such video to have gained particular global notoriety is WikiLeaks’ 2010 “Collateral Murder”, which presented leaked gun camera footage from a 2007 US Army Apache helicopter combat patrol in a Baghdad suburb in the course of which, among others, two journalists were killed, two children shot and seriously wounded, and a building in a residential area destroyed with missiles. As with the King and Floyd cases, Collateral Murder, in the form of WikiLeaks’ edited version of the video, was watched in revulsion by millions as a transparent example of egregious wrongdoing—the killing, wounding, and harming of innocents. In this contribution we revisit the unedited footage, extending consideration to its less examined second half in which the Apache team attacks and destroys a building, where we are among the first to do so in any detailed manner. We do that to explore Lynch’s ethnomethodological insights into politics, evidence and accountability as they are rendered—or fail to be rendered—perspicuous by this case. Rather than seeking to establish our own form of ‘professional vision’ as a competitor to the Apache crews’, we suggest that Lynch’s work, if taken seriously, asks us to embrace its ‘vulgar’ counterpart by working through whatwe can make of the video by drawing on our vernacular competencies as ordinary members and the problems we encounter in doing so. We will tease out what might be at stake ethnomethodologically—not an ‘unprofessional’ but practical understanding—with reference to the ‘raw’ Collateral Murder footage and what, as video, it does and does not make available to the viewer. We end by reflecting on “ethnomethodology’s program” (Garfinkel 2002) in light of the issues this strand in Lynch’s work raises, more specifically the care we need to exhibit when we seek to gain instruction in worldly practices and their equally worldly evaluation.
Open Access
"You don’t realise what a big change it is": A reflexive thematic analysis of patients' experiences of amputation preparation, information provision and support
(Sage, 2024-09-18) Gonzalez-Aguado, Maria; Wilde, Lucina; Hanna, Esmee
The objective of this research was to extend current knowledge on the psychological and emotional aspects around patients’ preparation for amputation surgery. This research explored amputees’ perspectives on their preparation for amputation surgery and how patients can be better supported for this procedure. Data was collected through semi-structured interviews and online qualitative questionnaires with 17 amputees who underwent upper or lower limb amputation within the United Kingdom. The interviews were analysed using reflexive thematic analysis. The analysis generated three themes describing participants’ experiences of being prepared for this surgery and their ideas on how this process could be improved: 1) Making sense of amputation surgery, 2) Patients’ experiences of information and support from healthcare staff, and 3) Patients’ views on approaches to preparation. This research highlighted the importance of information provision and support from healthcare staff, along with the potential benefits of utilising experiential knowledge through peer support to enhance feelings of preparedness for amputation surgery.

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