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    How is men’s mental health affected within male professional football?
    (Taylor and Francis, 2024-06-26) Souter, Gary; Serrant, Laura; Haines-Delmont, Alina
    Research question: How is men’s mental health affected within male professional football? Research methods: Within this qualitative study, eighteen current first-team professional footballers were interviewed from across the English Football League (EFL) to explore how male professional footballers are affected by mental health. Braun and Clarke’s thematic analysis (2006) was applied along with “The Silences Framework” [Serrant-Green, L. (2010). The sound of “silence”: A framework for researching sensitive issues or marginalised perspectives in health. Journal of Research in Nursing, 16(4), 347–360] to allow the voices of this marginalised group to be heard. Results and findings: The five key themes of social networks, environment, masking vulnerabilities, help-seeking and support, and mental health emerged from the data. The mental health theme is split into two sub themes: impact on self and reaction of others. Implications: This study makes an original contribution to the knowledge base as it is the first study to innovatively apply The Silences Framework to a sporting context. This study has applied The Silences Framework to show that professional footballers are affected by their mental health, and without appropriate access to support they continue to suffer in silence. This is likely to have negative consequences in their personal life, their football career, and their eventual transition away from being a professional footballer
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    Emerging leaders, your universities need you
    (Times Higher Education, 2024-07-03) Allman, Zoe; Souter, Gary
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    Understanding Female Genital Mutilation (FGM)
    (The University of Nottingham, 2024-05-20) Hinsliff-Smith, K.; McGarry, Julie; Ejiroghene ogigbah Adogho, Agatha; Konstantinidis, Stathis; Langmack, Gill; Nkoyo, Valentine; Recchia, Natasha; Wathoni, Angela; Wightman, Helen; Windle, Richard
    It is estimated that more than 200 million girls and women alive today have undergone female genital mutilation in the countries where the practice is concentrated. The majority of girls are cut before they turn 15 years old. Over 200 million women and girls alive today have experienced female genital mutilation. In 2023, an estimated 4.3 million girls are at risk of being subjected to female genital mutilation , and UNFPA estimates show COVID-19-related disruptions to programming could enable 2 million more cases of female genital mutilation to occur over the next decade unless concerted and accelerated action is taken. (UNFPA-UNICEF, 2023) This statement comes directly from the World Health Organisation and whilst it remains a major issue in countries where it is traditionally practiced, increased globalisation and population movement has seen a rise in women and girls living with Female Genital Mutilation (FGM) throughout the world, including in the UK. This poses a challenge for health care professionals who must look beyond the rhetoric to provide culturally competent care, and as such need to understand FGM, its cultural background and impact, fully.
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    Frailty identification and management among Brazilian healthcare professionals: a survey
    (Springer Nature, 2024-06-03) Hinsliff-Smith, K.; Gordon, A.; Schmidt Azevedo, P.; Melo, R.; Souza, J. T.; Frost, R.; Gavin J.; Robinson, K.; José Fortes Villas Boas, P.; Ferreira Minicucci, M.; Aprahamian, I.; Wachholz, P.
    Background: National and international guidelines on frailty assessment and management recommend frailty screening in older people. This study aimed to determine how Brazilian healthcare professionals (HCPs) identify and manage frailty in practice. Methods: An anonymous online survey on the assessment and management of frailty was circulated virtually through HCPs across Brazil. Results: Most of the respondants used non-specific criteria such as gait speed (45%), handgrip strength (37.6%), and comprehensive geriatric assessment (33.2%). The use of frailty-specific criteria was lower than 50%. The most frequently used criteria were the Frailty Index (19.1%), Frailty Phenotype (13.2%), and FRAIL (12.5%). Only 43.5% felt confident, and 40% had a plan to manage frailty. In the multivariate-adjusted models, training was the most crucial factor associated with assessing frailty, confidence, and having a management plan (p<0.001 for all). Those with fewer years of experience were more likely to evaluate frailty (p=0.009). Being a doctor increased the chance of using a specific tool; the opposite was true for dietitians (p=0.03). Those who assisted more older people had a higher likelihood of having a plan (p=0.011). Conclusion: Frailty assessment was heterogeneous among healthcare professions groups, predominantly using non-specific criteria. Training contributed to frailty assessment, use of specific criteria, confidence, and having a management plan. This data informs the need for standardized screening criteria and management plans for frailty, in association with increasing training at the national level for all the HCPs who assist older people.
  • ItemOpen Access
    A systems approach in the prevention of undernutrition among children under five in Tanzania: Perspectives from key stakeholders
    (MDPI, 2024-05-21) Frumence, Gasto; Jin, Yannan; Kasangala, Amalberga; Bakar, Saidah; Mahiti Reuben Gladys; Ochieng, Bertha
    Undernutrition among under-fives is one of the major public health challenges in Tanzania. However, there are limited studies assessing the contribution of cultural-related strategies in the prevention of child undernutrition in Tanzania. This study aimed at exploring participants’ experiential views regarding developing culturally sensitive strategies for the elimination of child undernutrition for under-fives in Rukwa, Iringa, Ruvuma, Songwe and Njombe regions located in the Southern Highlands in Tanzania. This study applied focus group discussions (FGDs) with forty practitioners to explore culturally-sensitive strategies for effectively preventing child undernutrition in Tanzania. The study participants were purposively selected, and thematic analysis was used to identify themes within the data. This study revealed that district- and lower-level administrative systems should prioritize nutrition interventions in their plans, allocating adequate resources to implement culturally sensitive nutrition interventions, while national-level organs need to strengthen institutional capacity and ensure the availability of funds, skilled human resources and a legal framework for the effective implementation and sustainability of nutrition interventions at the district and lower-levels. This study highlights that for the successful implementation of culturally sensitive strategies towards the elimination of child undernutrition, there is a need to use a systems approach that allows for collaborative governance whereby different sectors act together to address the persistent malnutrition epidemic.
  • ItemOpen Access
    Researching Local Public Health Priorities in The Locked Down City Using Online Community Focus Groups: Reflections and Recommendations
    (Elseiver, 2024-05-14) Williamson, I.; Lond, Benjamin J.; Hart, Tania; Clifton, Andrew; Ochieng, B.
    In this commentary paper we reflect on our experiences of conducting two qualitative public health projects in Leicester UK around health inequalities and marginalised groups during the Covid 19 pandemic in 2020 and 2021. To contextualise the commentary, we first provide information about Leicester and how and why it was disproportionately affected by the pandemic, as well as describing the origins, aims, and methodologies of the two projects. In the second half, we describe and evaluate some of the adaptations we made to our studies and conclude with suggestions for future qualitative community health research as we adapt to the post-pandemic research landscape.
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    Creative approaches towards protecting the planet in clinical skills and simulation in nursing education
    (Elseiver, 2024-03-12) Arden, Catherine; Taylor-Rollings, Hannah; Tremayne, Penny; Padley, Wendy; Hinsliff-Smith, K.
    As we ponder the bigger picture of environmental issues, sustainability and global challenges as a society, we note that planetary health and sustainability is a theme at the next NET/NEP conference to be held in Singapore, Oct 2024 (Elsevier 2024). We have been reviewing some of our practices, particularly within our undergraduate nursing programmes and the materials we use in our clinical skills labs to set one context and to hopefully trigger some discussion for the reader. We are also responding to the Royal College of Nursing positioning statement (2019) “recognising climate change undermines the very foundations of our health” linked to the WHO equally stating that climate change is the “defining health challenge of our time” (WHO, 2023). Within all UK undergraduate nursing programmes, the Nursing and Midwifery Council (NMC), our professional body requires all candidates to undertake 50% theory and 50% clinical practice in their curricula and this approach is common across a wide range of programmes outside of the UK (Morgan et al., 2024). We are all aware that within our programmes an element of preparation is required for the acquisition of clinical skills prior to learners going into their mandatory clinical placements. Many Faculties also provide opportunities in purpose-built simulation or clinical skills labs (Borneuf & Haigh, 2010).
  • ItemOpen Access
    Engaging young people with sexual health services in general practice surgeries – A qualitative study of health care professionals
    (Wolters Kluwer, 2024-02-09) Adakpa, Itodo; Randhawa, Gurch; Ochieng, Bertha
    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. Materials and Methods: 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. Results: 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. Conclusion: 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.
  • ItemOpen Access
    Improving students’ engagement during synchronous teaching sessions using interactive quiz tools: A case study of undergraduate Nursing students in DMU
    (2024-02-07) Oviasu, Osaretin
    A component of student engagement is the students’ willingness to respond to questions or ask questions during live teaching sessions. However, there is limited evidence that identifies how anonymous participation using interactive tools influences students’ engagement during teaching sessions. Therefore, this study examined how anonymous engagement with interactive tools impacts students’ willingness to respond to questions or ask questions during a face-to-face or virtual teaching session. The theoretical basis for the study is the Landers’ Theory of Gamified Learning. The study used a mixed-method approach as data were collected from undergraduate nursing students using a questionnaire. Also, a sample of some interaction reports from an interactive tool (Slido) on how students have engaged with an interactive tool during face-to-face and virtual teaching sessions were analysed. Overall, 141 students responded, majority were female (87.9%). Most participants said they will likely ask (73%) and answer (87.2%) questions using interactive tools if their responses were anonymous. Their reasons were around their confidence, avoiding embarrassment, avoiding being judged by their peers, and the fear of asking silly questions or giving wrong answers. The results indicates that students will engage more during teaching sessions when their questions or responses are anonymous. This is especially relevant when trying to get shy or non-engaging students to engage during teaching sessions.
  • ItemOpen Access
    Adherence to the Eatwell Guide and Population and Planetary Health: A Rank Prize Forum Repor
    (Wiley, 2024-01-31) Shannon, Oliver; Townsend, Rebecca; Malcomson, Fiona; Matu, Jamie; Griffiths, Alex; Jennings, Amie; Ward, Nicola; Papier, Keren; Best, Nicola; French, Chloe; Scheelbeek, Pauline; Kim, Curie; Ochieng, Bertha; Jay, Fareeha; Shepherd, Kaydee; Corfe, Bernard; Fairley, Andrea; McEvoyd, Claire; Minihane, Ann-Marie; Sim, Yi Jia; Stevenson, Emma; Gregory, Sarah
    This report summarises a Forum conducted in June 2023 to explore the current state of the knowledge around the Eatwell Guide, which is the UK Government’s healthy eating tool, in relation to population and planetary health. The 1.5-day Forum highlighted the limited, albeit promising evidence linking higher adherence to the Eatwell Guide with favourable health outcomes, including reduced overall mortality risk, lower abdominal obesity in post-menopausal women, and improved cardiometabolic health markers. Similarly, evidence was presented to suggest that higher adherence to the Eatwell Guide is associated with reduced greenhouse gas emissions. Presentations were given around cultural adaptations of the Eatwell Guide, including African Heritage and South Asian versions, which are designed to increase acceptability and uptake of the Eatwell Guide in these communities in the UK. Presentations highlighted ongoing work relevant to the applications of the Eatwell Guide in randomised controlled trials and public health settings, including the development of a screening tool to quantify Eatwell Guide adherence. The Forum ended with a World Café-style event, in which strengths and limitations of the Eatwell Guide were discussed, and directions for future research were identified. This Forum report serves as a primer on the current state of the knowledge on the Eatwell Guide and population and planetary health and will be of interest to researchers, healthcare professionals, and public health officials.
  • ItemOpen Access
    Cognitive impairment in post-acute COVID-19 syndrome: a scoping review Comprometimento cognitivo na síndrome pós-COVID-19 aguda: uma revisão de escopo
    (Arquivos de Neuro-Psiquiatria, 2023-12-11) Hinsliff-Smith, K.; Cipolli, G.; Alonso, V.; Yasuda, C.; Cachioni, Meire; Melo, R.; Yssuda, M.; Assumpo, D.
    Emerging studies indicate the persistence of symptoms beyond the acute phase of COVID 19. Cognitive impairment has been observed in certain individuals for months following infection. Currently, there is limited knowledge about the specific cognitive domains that undergo alterations during the post-acute COVID-19 syndrome and the potential impact of disease severity on cognition. The aim of this review is to examine studies that have reported cognitive impairment in post-acute COVID-19, categorizing them into subacute and chronic phases. The methodology proposed by JBI was followed in this study. The included studies were published between December 2019 and December 2022. The search was conducted in PubMed, PubMed PMC, BVS – BIREME, Embase, SCOPUS, Cochrane, Web of Science, Proquest, PsycInfo, and EBSCOHost. Data extraction included specific details about the population, concepts, context, and key findings or recommendations relevant to the review objectives. A total of 7,540 records were identified and examined, and 47 articles were included. The cognitive domains most frequently reported as altered 4 to 12 weeks after acute COVID-19 were language, episodic memory, and executive function, and after 12 weeks, the domains most affected were attention, episodic memory, and executive function. The results of this scoping review highlight that adults with post-acute COVID-19 syndrome may have impairment in specific cognitive domains.
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    Obstetric and neonatal outcomes in pregnant women with and without a history of specialist mental healthcare: a national population-based cohort study using linked routinely collected data in England.
    (Lancet, 2023-08-14) Langham, J.; Gurol-Urganci, I.; Muller, P.; Webster, K.; Tassie, E.; Heslin, M.; Byford, S.; Khalil, A.; Harris, T.; Sharp, H.; Pasupathy, D.; van der Meulen, J.; Howard, L.; O'Mahen, H.
    Background: Pregnant women with pre-existing mental illness have increased risks of adverse obstetric and neonatal outcomes. We estimated these difference in risks according to the highest level of pre-pregnancy specialist mental healthcare, defined as psychiatric hospital admission, crisis resolution team (CRT) contact, or specialist community care only, and the timing of the most recent care episode within 7 years before pregnancy. Methods: Hospital and birth registration records of women with singleton births between 2014 and 2018 in England were linked to records of babies and records from specialist mental health services, provided by the English National Health Service, a publicly funded healthcare system. Composite indicators captured neonatal adverse outcomes and maternal morbidity. We calculated odds ratios (ORs), adjusted for maternal characteristics. Outcomes: Of 2,081,043 included women (mean age 30.0 years; range 18 to 55 years; 77.7% White, 11.1% South Asian, 4.7% Black and 6.2% other ethnic background), 151,770 (7·3%) had at least one pre-pregnancy specialist mental healthcare contact. 7,247 (0·3%) had been admitted, 29,770 (1·4%) had CRT contact, and 114,753 (5·5%) had community care only. With a pre-pregnancy mental healthcare contact, risk of stillbirth or neonatal death within seven days was not significantly increased (0·45% to 0·49%; OR 1·11, 95%CI 0·99–1·24). Risk of preterm birth (<37 weeks) increased (6·5% to 9·8%; OR 1·53, 1·35–1·73) as did risk of small for gestational age (birthweight <10th percentile) (6·2% to 7·5%; OR 1·34, 1·30–1·37), and neonatal adverse outcomes (6·4% to 8·4%; OR 1·37, 1·21–1·55). With a pre-pregnancy mental healthcare contact, maternal morbidity increased slightly from 0·9% to 1·0% (OR 1·18, 1·12–1·25). Overall, risks were highest for women who had a psychiatric hospital admission any time or a mental healthcare contact in the year before pregnancy. Interpretation: Information about level and timing of pre-pregnancy specialist mental healthcare contacts can support identifying pregnant women at increased risk of adverse obstetric and neonatal outcomes, most likely to benefit from integrated perinatal mental health and obstetric care.
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    Accessing care services after sexual violence: A systematic review exploring experiences of women in South Africa
    (AOSIS, 2023-10-25) Hinsliff-Smith, K.; McGarry, Julie; Griffiths, Sarah; Randa, Moreoagae
    Background: Sexual violence against women is a global phenomenon. This is a particular issue in South Africa, where it is estimated with evidence provided that up to half of all women will encounter gender-based and/or sexual violence from a partner during their lifetime. Therefore, evidence suggests that addressing the needs of women in South Africa is a priority. Objective: This qualitative review aimed to explore the experiences of women seeking care from first contact healthcare facilities in South Africa after sexual violence and during follow-up care. Method: This systematic review was conducted using the PRISMA checklist for systematic reviews and in line with a published protocol (PROSPERO, CRD42019121580) and searched six relevant databases in 2022. A total of 299 sources were screened, with 5 forming the overall synthesis. Results: Two synthesised themes of women’s experiences emerged at the time of reporting and during attendance at follow-up healthcare services. Conclusion: South Africa does have an established legal framework for prosecution and can provide support for survivors of sexual violence through established Thuthuzela Care Centres (TCCs). The review identifies that survivors’ needs are not clearly established when seeking medical attention initially nor identifying support or appropriate pathways. Contribution: The review has the potential to characterise the support available for women, the type and nature of sexual violence and interventions that may be used by healthcare professionals to support survivors especially during follow-up care.
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    Identifying and Managing Frailty: A Survey of UK Healthcare Professionals
    (Sage, 2023-10-20) Hinsliff-Smith, K.; Gordon, Adam; Frost, Rachael; Gavin, James; Gaiolla, Paula; Robinson, Katie; Caldeira De Melo, Ruth; Villas Boas, P. J. F.
    Frailty is a common condition that leads to multiple adverse outcomes. Frailty should be identified and managed in a holistic, evidence-based and patient-centered way. We aimed to understand how UK healthcare professionals (HCPs) identify and manage frailty in comparison with UK Fit for Frailty guidelines, their frailty training, their confidence in providing support and organizational pathways for this. An online mixed-methods survey was distributed to UK HCPs supporting older people through professional bodies, special interest groups, key contacts, and social media. From 137 responses, HCPs valued frailty assessment but used a mixture of tools that varied by profession. HCPs felt confident managing frailty and referred older people to a wide range of supportive services, but acknowledged a lack of formalized training opportunities, systems, and pathways for frailty management. Clearer pathways, more training, and stronger interprofessional communication, appropriate to each setting, may further support HCPs in frailty management.
  • ItemOpen Access
    End-of-Life Care in The Patient’s Home: Experiences of Nursing Staff Caring for Patients from the ethnic minorities in the United Kingdom
    (Mark Allen Group, 2023) Manyimo, Pretty; de Vries, Kay
    Background Providing end-of-life care in the patient’s home is challenging, especially if the nurse is from a different ethnic background from the patient. Evidence shows that Black, Asian Minority Ethnic background people often experience poorer end-of-life care due to care providers not understanding their care needs. Aim To describe the experiences of the United Kingdom nursing staff caring for community ethnic minorities patients at the end-of-life. Methods Using a qualitative descriptive approach, 16 semi-structured interviews were conducted, and the data was thematically analysed. Findings Participants dealt with large tight-knit families, paternalism and controlling behaviours. There was mistrust of Western palliative medicine. Language barriers and challenges were faced by the nursing staff, resulting in difficult conversations with the families. Different levels of the nursing staff’s spiritual/cultural competencies were also identified. The COVID-19 pandemic intensified the challenges. Conclusion This research has shed light on the challenges of individualising end-of-life care in a culturally diverse community in the United Kingdom. The nursing staff’s cultural/spiritual competencies were challenged.
  • ItemOpen Access
    Exploring nurses’ well-being and strategies to support self-care
    (Royal College of Nursing, 2023-10-01) Tremayne, P.; De Bourg, L.
    Nurses experience a range of challenges in their practice that can adversely affect their well-being, for example work-related stress and workforce issues. These challenges may have been intensified by various factors, such as the coronavirus disease 2019 (COVID-19) pandemic and shift working. This article considers the concept of well-being and explores nurses’ well-being in the context of ongoing stressors and workforce issues. It also examines some of the effects of shift work on nurses’ well-being and how these could be mitigated. The authors outline a range of self-care practices that nurses could engage in and consider how they may be supported in this by their line managers and healthcare organisations
  • ItemOpen Access
    Facilitators and barriers to early diagnosis of malignant mesothelioma (FILMM): a qualitative study of patient experiences living in England, UK
    (16th International Conference of the international Mesothelioma interest group, 2023-06-26) Oviasu, Osaretin; Coleby, Dawn; Padley, Wendy; Hinsliff-Smith, K.
    BACKGROUND Partly due to late presentation and diagnosis of malignant mesothelioma (MM), UK’s survival rate is below the European average [1]. To date, there has been little attention given to patients’ experiences prior to MM diagnosis as available studies have focused on their lived experiences after diagnosis [2], [3]. Therefore, to improve survival through earlier diagnosis, there is an urgent need to understand decision-making points prior to patients’ MM diagnosis. OBJECTIVES This UK based study aims to explore patients’ experiences from the moment they notice the first symptom until they receive a MM diagnosis. Primary objective • To explore the factors which affect mesothelioma patients’ diagnosis pathway from their first symptom to confirmed diagnosis from their perspective. Secondary objective • To explore patients’ understanding of the development of their symptoms, reasons for seeking medical help and the process of interaction with health care professionals METHODS This is a qualitative study using one-to-one interviews and was conducted with participants who live in England, UK. Recruitment was via two regional specialist MM outpatient clinics using a purposive sample. A total of 17 patients were recruited, consented and interviewed. The data from the interviews were analysed using framework analysis. We utilised a model of pathway to treatment [4] as a conceptual framework for conducting the interviews and for the analysis of the findings. This model identifies four stages/intervals where delay can occur in the pathway to diagnosis - Appraisal, Help-seeking, Diagnostic, and Pre-treatment intervals and provides a useful framework to describe the participants’ journey to diagnosis and clinical interventions. RESULTS Preliminary findings indicates that there were barriers and facilitators within each interval identified along the MM patients’ journey to diagnosis. Within the appraisal and diagnostic intervals, the presentation of vague symptoms that were mistaken for a less serious illness were found to be a barrier. Both the patients that presented with these symptoms and their health care professional (HCP) failed to investigate for MM at the onset thereby leading to a delayed diagnosis. CONCLUSION Our findings identify, from the patients’ perspective, areas for improvement in the interactions and decision points along the clinical pathways to confirmed MM diagnosis. Earlier symptom recognition by both patient and HCP including GPs can be used to target significant and avoidable delays along patients’ MM diagnosis pathway, thereby promoting earlier diagnosis and treatment options. REFERENCE LIST [1] Cancer Research UK, “Mesothelioma statistics,” Statistics by cancer type, 2018. (accessed Feb. 24, 2020). [2] A. Arber et al., “A research study exploring the patient’s experience during the first three months following a diagnosis of Malignant Pleural Mesothelioma,” Surrey, 2010. [Online]. Available: [3] C. Warnock, K. Lord, B. Taylor, and A. Tod, “Patient experiences of participation in a radical thoracic surgical trial: Findings from the Mesothelioma and Radical Surgery Trial 2 (MARS 2),” Trials, vol. 20, no. 598, 2019, doi: 10.1186/s13063-019-3692-x. [4] F. Walter, A. Webster, S. Scott, and J. Emery, “The Andersen Model of Total Patient Delay: a systematic review of its application in cancer diagnosis,” J Heal. Serv Res Policy, vol. 17, no. 2, pp. 110–118, 2012, doi: 10.1258/jhsrp.2011.010113.
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    Transitioning to trauma care: A phenomenological study of non-trauma foreign-trained nurses
    (Elsevier, 2023) Al-Sheikh Hassan, Mohammed; de Vries, Kay; Rutty, Jane
    Background: The increasing global nursing workforce shortage creates higher demands for recruiting foreign-trained nurses, especially in high-income countries that depend on them to fill their nursing workforce gaps. Specifically, Saudi Arabia, a high-income country that possesses one of the highest trauma rates globally, recruits two-thirds of its total nursing workforce from other foreign countries. However, a significant number of newly recruited foreign-trained nurses are allocated to major trauma care settings without gaining previous trauma care experience in their home countries. This exposes them to intolerable workloads and higher rates of dissatisfaction affecting their transition and integration into their new care settings. Aim: To explore and describe the lived experiences of moving to major trauma care in Saudi Arabia as non-trauma foreign-trained nurses. Methods: The study employed a descriptive phenomenological approach guided by Husserl's phenomenology. In-depth, unstructured one-to-one interviews were conducted to gather data about the participants' transition journeys through real-life examples and stories from their own lived experiences. A total of nine foreign nurses were recruited to the study. The nurses were interviewed twice on two different occasions. The data were analysed using Colaizzi's descriptive phenomenological method. Findings: Three main themes were identified, (1) facing a new reality, (2) adjusting towards growth, and (3) achieving belonging. The themes depict the nurses' journey from their arrival in a foreign country as novice trauma nurses through to attaining a higher-level proficiency. Moreover, the themes highlight the phenomenon behind the significant transition the nurses went through at the personal, emotional, and professional levels. Conclusion: Extreme cultural, social, and religious differences and the need to provide nursing care in a challenging practice area were significant factors in the nurses' transition, which exposed them to culture and practice shocks. However, by practising emotional labour throughout their transition, the nurses moved forward and achieved belonging within the care setting. Therefore, the study provides practice and future research recommendations for enhancing foreign-trained nurses' recruitment and retention, which can lead to improvements in the pre-and post-arrival experiences of other nurses in similar contexts.
  • ItemEmbargo
    The impact of Covid-19 on the mental health of professional footballers
    (Taylor and Francis, 2021-01-25) Souter, Gary; Tonge, Alan; Culvin, Alex
    The Covid-19 pandemic has had huge ramifications on professional football. This commentary focuses on the impact of the pandemic on the mental health of professional footballers. Specifically, footballers within the English Premier League, English Football League, FA Women’s Super League and FA Women’s Championship. This commentary considers a holistic approach to mental health, the environment of professional football, and the impact of career transitions and critical moments on mental health. The intention is to stimulate discussion and further research of mental health and wellbeing within professional football. This paper considers the impact of Covid-19 and makes recommendations for professional football clubs to develop a holistic mental health strategy. We recommend that professional clubs increase the level of emotional support for professional footballers, and that this should not be a temporary measure due to the pandemic. Clubs should develop a long-term strategy to encourage players to seek emotional support.
  • ItemOpen Access
    Induction of labour at 39 weeks and adverse outcomes in low-risk pregnancies according to ethnicity, socioeconomic deprivation and parity: a national cohort study in England.
    (PLOS Medicine, 2023-07-20) Muller, P.; Karia, A. M.; Webster, K.; Carroll, F.; Dunn, G.; Frémeaux, A.; Harris, T.; Knight, H.; Oddie, S.; Khalil, A.; van der Meulen, J.; Gurol-Urganci, I.
    Background: Ethnic and socioeconomic inequalities in obstetric outcomes are well established. However, the role of induction of labour (IOL) to reduce these inequalities is controversial, in part due to insufficient evidence. This national cohort study aimed to identify adverse perinatal outcomes associated with IOL with birth at 39 weeks of gestation (“IOL group”) compared to expectant management (“expectant management group") according to maternal characteristics in women with low-risk pregnancies. Methods and Findings: All English National Health Service (NHS) hospital births between January 2018 and March 2021 were examined. Using the Hospital Episode Statistics (HES) dataset, maternal and neonatal data (demographic, diagnoses, procedures, labour, and birth details) were linked, with neonatal mortality data from the Office for National Statistics (ONS). Women with a low-risk pregnancy were identified by excluding pregnancies with pre-existing comorbidities, previous caesarean section, breech presentation, placenta previa, gestational diabetes, or a baby with congenital abnormalities. Women with premature rupture of membranes, placental abruption, hypertensive disorders of pregnancy, amniotic fluid abnormalities, or antepartum stillbirth were excluded only from the IOL group. Adverse perinatal outcome was defined as stillbirth, neonatal death or neonatal morbidity, the latter identified using the English composite neonatal outcome indicator (E-NAOI). Binomial regression models estimated risk differences (with 95% confidence intervals) between the IOL group and the expectant management group, adjusting for ethnicity, socioeconomic background, maternal age, parity, year of birth, and birthweight centile. Interaction tests examined risk differences according to ethnicity, socioeconomic background, and parity. Of the 1 567 004 women with singleton pregnancies, 501 072 women with low-risk pregnancies and with sufficient data quality were included in the analysis. 3.3% of births in the IOL group (1 555/47 352) and 3.6% in the expectant management group (16 525/453 720) had an adverse perinatal outcome. After adjustment, a lower risk of adverse perinatal outcomes was found in the IOL group (risk difference -0.28%; 95% confidence interval -0.43%, -0.12%; p=0.001). This risk difference varied according to socioeconomic background from 0.38% ( 0.08%, 0.83%) in the least deprived to -0.48% ( 0.76%, -0.20%) in the most deprived national quintile (p value for interaction =0.01), and by parity with risk difference of -0.54% (-0.80%, -0.27%) in nulliparous women and -0.15% (-0.35%, 0.04%) in multiparous women (p-value for interaction = 0.02). There was no statistically significant evidence that risk differences varied according to ethnicity (p=0.19). Key limitations included absence of additional confounding factors such as smoking, BMI, and the indication for induction in the HES datasets, which may mean some higher risk pregnancies were included. Conclusions: IOL with birth at 39 weeks was associated with a small reduction in the risk of adverse perinatal outcomes, with 360 inductions in low-risk pregnancies needed to avoid one adverse outcome. The risk reduction was mainly present in women from more socioeconomically deprived areas and in nulliparous women. There was no significant risk difference found by ethnicity. Increased uptake of IOL at 39 weeks, especially in women from more socioeconomically deprived areas, may help reduce inequalities in adverse perinatal outcomes.