School of Allied Health Sciences

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Bridging the Gap
(Routledge, 2024-09-01) Berghs, Maria
When we think of Sickle Cell Disorders (SCD), they become entwined with the history of the African continent in the legacy of the Trans-Atlantic Slave trade, colonialism and present-day health inequalities between low, middle and high-income countries. However, the history of SCD is also one of entanglements between humans, animals, climatic and physical, socio-economic, political and cultural environments, biology and human psychology. The healthcare professionals and healers in African settings, dealing with patients presenting with SCD understood this complexity, and that such a broader perspective was necessary to care for SCD especially when treatments and access to health were not always assured (Konotey-Ahulu, 1974). This is also correlated to why many medical professionals in the field of SCD have been receptive to the contributions of public health, social sciences, humanities, geography, economics, politics, technology and arts, to improve our past, present and future understanding of the condition and quality of life of people with SCD and their families.
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Phenolic Metabolites Protocatechuic Acid and Vanillic Acid Improve Nitric Oxide Bioavailability via the Akt-eNOS Pathway in Response to TNF-α Induced Oxidative Stress and Inflammation in Endothelial Cells
(MDPI, 2024-11-11) Festa, Joseph; Hussain, Aamir; Al-Hareth, Zakia; Bailey, Stephen J.; Singh, Harprit; Da Boit, Mariasole
Background/Objectives: Reduced nitric oxide (NO) bioavailability secondary to excess-superoxide-driven oxidative stress is central to endothelial dysfunction. Previous studies suggest that phenolic metabolites may improve NO bioavailability, yet limited research is available in response to an inflammatory mediator. Therefore, we assessed the effects of cyanidin-3-glucoside (C3G) and its phenolic metabolites protocatechuic acid (PCA) and vanillic acid (VA) on NO bioavailability in a TNF-α induced inflammatory environment. Methods: Primary human umbilical vein endothelial cells (HUVECs) were supplemented with either C3G, PCA, or VA at 1 μM for 24 h before being stimulated with TNF-α 20 ng/mL for an additional 24 h. Measurements included cell viability, apoptosis, reactive oxygen species (ROS), nitrite concentrations, and endothelial nitric oxide synthase (eNOS) and Akt at the mRNA and protein level. Results: Phenolic metabolites did not increase the eNOS expression or nitrite levels in the unstimulated environment; rather, the metabolites mediated NO bioavailability in response to TNF-α induced oxidative stress, with increased viability, eNOS mRNA, phosphorylation, and nitrite levels. Conclusions: Phenolic metabolites, in the presence of TNF-α, can improve NO bioavailability at physiologically relevant concentrations via the Akt-eNOS pathway. This demonstrates that the induction of inflammation is a prerequisite for phenolic metabolites to promote protective properties in endothelial cells by activating the Akt-eNOS pathway.
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.
Open Access
Integrating DNA Barcoding Within an OrthogonalApproach for Herbal Product Authentication:A Narrative Review
(Wiley, 2024-11-12) Nazar, Nazia; Saxena, Akanksha; Sebastian, Anu; Slater, Adrian; Sundaresan, Velusamy; Sgamma, Tiziana
Introduction: Existing methods for morphological, organoleptic, and chemical authentication may not adequately ensure the accurate identification of plant species or guarantee safety. Herbal raw material authentication remains a major challenge in herbal medicine. Over the past decade, DNA barcoding, combined with an orthogonal approach integrating various testing methods for quality assurance, has emerged as a new trend in plant authentication. Objective: The review evaluates DNA barcoding and common alternative testing in plant-related sectors to enhance quality assurance and accurate authentication. Method: Studies were selected based on their relevance to the identification, quality assurance, and safety of herbal products. Inclusion criteria were peer-reviewed articles, systematic reviews, and relevant case studies from the last two decades focused on DNA barcoding, identification methods, and their applications. Exclusion criteria involved studies lacking empirical data, those not peer-reviewed, or those unrelated to the main focus. This ensured the inclusion of high-quality, pertinent sources while excluding less relevant studies. Results: An orthogonal approach refers to the use of multiple, independent methods that provide complementary information for more accurate plant identification and quality assurance. This reduces false positives or negatives by confirming results through different techniques, combining DNA barcoding with morphological analysis or chemical profiling. It enhances confidence in results, particularly in cases of potential adulteration or misidentification of plant materials. Conclusion: This study highlights the persistent challenges in assuring the quality, purity, and safety of plant materials. Additionally, it stresses the importance of incorporating DNA-based authentication alongside traditional methods, to enhance plant material identification.
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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.
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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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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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A CBT-based training module for UK health visitors who support parents with excessively crying babies: development and initial evaluation
(Cambridge University Press, 2024-04-19) St James-Roberts, Ian; Griffiths, Sarah; Watson, Maggie; White, Charlotte; Brown, Jayne
Background: Parents report that around 20% of infants cry a lot without apparent reason during the first four postnatal months. This crying can trigger parental depression, breastfeeding cessation, overfeeding, impaired parent–child relationships and child development, and infant abuse. The Surviving Crying (SC) cognitive behaviour therapy (CBT)-based materials were developed in earlier research to improve the coping, wellbeing and mental health of parents who judge their infant to be crying excessively. Aim: This study set out to: develop a health visitor (HV) training module based on the SC materials, tailored to fit health visiting; assess whether HVs could deliver a SC-based service successfully; confirm whether parents gained similar benefits to those in the earlier study; prepare for a controlled trial of the SC-based service. Methods: A training module was developed to enable HVs to deliver the SC materials, much of it provided online. Ten HVs took the training module (‘SC HVs’). They and the Institute of Health Visiting provided feedback to refine it. SC HV delivery of the CBT sessions to parents with excessively crying babies was assessed using a standardised test. Parental wellbeing was measured using validated questionnaires. Parents and SC HVs evaluated the effectiveness of the SC service using questionnaires or interviews. Findings: The study produced the intended training module. Most SC HVs completed the training, and 50% delivered the SC-based service successfully. Both training and delivery were disrupted by the Covid-19 pandemic, illness and work pressures. Replicating earlier findings: most parents’ anxiety and depression scores declined substantially after receiving the SC service; improvements in parents’ confidence, frustration and sleep were found; and all parents and the SC HVs interviewed found the SC service useful and agreed it should be included in the National Health Service. A controlled trial of the resulting SC service is underway.
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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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Public Restroom Access and Mental Health Among Gender-Minoritized Individuals in China
(American Medical Association, 2024-05-03) Wang, Yuanyuan; Liu, Dongyu; Han, Meng; Li, Jiaqi; Yu, Hui
This cross-sectional study assesses the adequacy of gender-neutral public restrooms and examines the association of public restroom–related stress with mental health among gender-diverse individuals in China.
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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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DMU E-PARASITOLOGY: A TOOL TO TEACH CELL AND PARASITE CULTURE
(Oxford University Press, 2019) Pena-Fernandez, A; Hurtado, C.; Singh, Neena; Anjum, U.; Evans, M. D.
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The Cytotoxic Potential of Mesoporous Silica Loaded Anticancer Drug on 3D Model of HCT116 Colon Cancer Cell Line
(Wiley, 2022-08-19) Otele, Ibemusu Michael; Ahmad, Z.; Sayed, Elshaimaa; Ruparelia, K. C.; Singh, Neenu
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Toxicological Assessment of Porous Silica Nanoparticles: Cytotoxicity, Genotoxicity and Immunogenicity
(Elsevier, 2024-09-01) Patel, Trisha; Venkatraman Girija, U.; Ahmad, Z.; Singh, Neenu
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Toxicological assessment of porous silica nanoparticles: Cytotoxicity, genotoxicity, immunogenicity.
(Oxford Academic, 2024-09-27) Trisha, Patel; Ahmad, Z.; Venkatraman Girija, U.; Sahota, T. S.; Singh, Neenu
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Assessing the Toxicity of Functionalised Porous Silica Nanoparticles.
(Wiley, 2022) Singh, Neenu; Patel, Trisha R. Y.; Girija, U. V.; Ahmad, Z.
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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Editorial: Intersections of ageing and disability during the COVID-19 pandemic
(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.
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A structure-based virtual high-throughput screening, molecular docking, molecular dynamics and MM/PBSA study identified novel putative drug-like dual inhibitors of trypanosomal cruzain and rhodesain cysteine proteases
(Springer, 2023-01-08) Bhambra, Avninder S.; Eurtivong, Chatchakorn; Zimmer, Collin; Schirmeister, Tanja; Butkinaree, Chutikarn; Saruengkhanphasit, Rungroj; Niwetmarin, Worawat; Ruchirawat, Somsak
Virtual screening a collection of ~ 25,000 ChemBridge molecule collection identified two nitrogenous heterocyclic molecules, 12 and 15, with potential dual inhibitory properties against trypanosomal cruzain and rhodesain cysteine proteases. Similarity search in DrugBank found the two virtual hits with novel chemical structures with unreported anti-trypanosomal activities. Investigations into the binding mechanism by molecular dynamics simulations for 100 ns revealed the molecules were able to occupy the binding sites and stabilise the protease complexes. Binding affinities calculated using the MM/PBSA method for the last 20 ns showed that the virtual hits have comparable binding affinities to other known inhibitors from literature suggesting both molecules as promising scaffolds with dual cruzain and rhodesain inhibition properties, i.e. 12 has predicted ΔGbind values of − 38.1 and − 38.2 kcal/mol to cruzain and rhodesain, respectively, and 15 has predicted ΔGbind values of − 34.4 and − 25.8 kcal/mol to rhodesain. Per residue binding free energy decomposition studies and visual inspection at 100 ns snapshots revealed hydrogen bonding and non-polar attractions with important amino acid residues that contributed to the ΔGbind values. The interactions are similar to those previously reported in the literature. The overall ADMET predictions for the two molecules were favourable for drug development with acceptable pharmacokinetic profiles and adequate oral bioavailability.
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Novel 4-[4-(4-methylpiperazin-1-yl)phenyl]-6-arylpyrimidine derivatives and their antitrypanosomal activities against T.brucei
(Elsevier, 2024-06-05) Bhambra, Avninder S.; Taylor, Annie; Hering, Moritz; Elsegood, Mark R. J.; Teat, Simon J.; Weaver, George W.; Arroo, R. R. J.; Kaiser, Marcel; Maeser, Pascal
Human African trypanosomiasis, or sleeping sickness, is a neglected tropical disease caused by Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiense and is invariably fatal unless treated. Current therapies present limitations in their application, parasite resistance, or require further clinical investigation for wider use. Our work, informed by previous findings, presents novel 4-[4-(4-methylpiperazin-1-yl)phenyl]-6-arylpyrimidine derivatives with promising antitrypanosomal activity. In particular, 32 exhibits an in vitro EC50 value of 0.5 µM against Trypanosoma brucei rhodesiense, and analogues 29, 30 and 33 show antitrypanosomal activities in the <1 µM range. We have demonstrated that substituted 4-[4-(4-methylpiperazin-1-yl)phenyl]-6-arylpyrimidines present promising antitrypanosomal hit molecules with potential for further preclinical development.

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