The Faculty of Health and Social Care has a long history at University of Chester, being established in the early 1990s as the School of Nursing and Midwifery. A wide variety of programmes are delivered by the Faculty including foundation degrees, undergraduate degrees and postgraduate degrees. All branches (adult, mental health, learning disability and child) of pre-registration nursing can be undertaken, as well as pre-qualification courses in Midwifery and Social Work. Social Work programmes are available at both undergraduate and masters levels. The Faculty also offers a wide ranging and exciting portfolio of post-qualifying programmes with an inter-professional focus. Within the Faculty, research is viewed as integral to the working life of staff, in partnership with local and regional providers of care. The Faculty has a research office which coordinates the activity of the Faculty. The strategic focus is on further development in community/primary care, users and carers support and inter-professional learning. There are opportunities to register for a PhD, with supervision from recognised experts in their field. Individual Professors, Readers and Teaching Fellows lead their own research developments in subjects closely related to practice-based care. These include clinical interventions in eating disorders, supporting individuals with learning disabilities in the penal system, interventions in forensic mental health, supporting carers and users of services, safety factors for single practitioners in the community and pedagogical research.

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  • Patient experience of electroconvulsive therapy (ECT): A systematic review

    Whyler, Jonathon; Bradley, Kirsty; Chapman, Hazel Margaret; Shaw, Elizabeth; Shetty, Amrith; Health Education England North West; Cheshire and Wirral Partnership NHS Foundation Trust; University of Chester
    In the United Kingdom, electroconvulsive therapy (can be administered according to NICE guidelines for depression, catatonia or severe/prolonged mania (2003 NICE, 2009). ECT was first used in the United Kingdom in 1939 Kalinowsky 1939 and its application and practice has been developed and modernised since. There is a considerable body of research into the efficacy of ECT, and the Royal College of Psychiatrists report that in 2018/2019 68 of patients were much or very much improved following ECT (RCPsych, 2020). It is known however that both public perception and media portrayal of ECT is generally negative (Griffiths and O’Neill Kerr, 2019). Discussion This review highlights patient experiences of ECT through the identification of seven themes The findings suggest that patient experience of ECT includes themes of fear, consent, decision making and autonomy. Patients were found to experience fear and anxiety in regards to the procedure, and studies described patients being poorly informed about ECT. Issues around the consent process were highlighted including those in which patients did not feel they had a choice with regards to treatment ECT was associated with memory loss and cognitive impairment which were captured in patient experience following treatment. In many studies however, ECT was also found to be a tolerable and effective treatment with an improvement in symptoms and patient satisfaction reported The experience of ECT was affected by knowledge and information provision and high standards of service provision, including supportive nursing.
  • An investigation into intellectual disability nursing interventions and their impact

    Mafuba, Kay; Chapman, Hazel M.; Kiernan, Joann; Kupara, Dorothy; Chester, Rebecca; Kudita, Chiedza; City University, London; University of Chester; Edge Hill University; Berkshire Healthcare NHS Foundation Trust
    Aims To identify nursing-led and / or nursing centred interventions that are in place to address the challenging and changing needs of people with intellectual disabilities (IDs). To identify areas of good care delivery, innovative practices, and possible gaps in the provision of care for individuals with IDs. Research questions The research sought to answer the following questions; What nursing led / nursing centred interventions are in place to respond to the changing needs of people with ID in the UK? Are there examples of service redesign to meet future needs? How could ID nurses better contribute to these interventions? Where in the UK are these interventions taking place? What is the impact of these interventions? Impacts of ID nursing interventions We used Braun and Clarke (2006)’s framework to analyse the data and we identified 13 themes of these impacts; Having a voice. Increased independence and choice. Improved health and quality of life. Improved access to health and social care services. Improved standards, quality of care, and patient experience. Improved awareness of the needs of people with intellectual disabilities. Reduced health inequalities and risks. Making reasonable adjustments. Improved transitions. Improved family life. Improved healthcare outcomes. Increased community presence and inclusion. Improved mental health and reduced challenging behaviour. Conclusions ID nurses implement a wide range of emerging interventions working in multi-disciplinary teams. They practice in a wide range of settings in the UK and other countries. More work is needed in order to better understand the reasons for the limited involvement of ID nurses with pregnant women with IDs and in end-of-life care. The variation in understanding the interventions undertaken by ID nurses between countries need to be further investigated.
  • Scoping review: contribution of intellectual disability nurses

    Mafuba, Kay; Foster, Marc; Chapman, Hazel M.; Kiernan, Joann; Kupara, Dorothy; Chester, Rebecca; Kudita, Chiedza; City University, London; University of Chester; Edge Hill University; Berkshire Healthcare NHS Foundation Trust
    Aims and objectives The objective of this scoping literature review was to summarise evidence on the contribution of intellectual disability (ID) nurses to improving the health and well-being of children, adults and older people with IDs, now and for the future. Review question The scoping literature reviews seeks to answer the following question; What ID nursing-led interventions are in place to respond to the changing needs of people living with IDs, and what is the impact of these interventions Conclusions The limited number of publications identifying the interventions undertaken by ID nurses in relation to maternity, children, older adults and end of life care need to be addressed by the profession. The lack of evidence to demonstrate the impact and effectiveness of interventions undertaken by ID nurses pose a challenge for intellectual disability nurses and the profession, whose wider contribution is ambiguous in wider health and social care practice. The interventions undertaken by ID nurses need to be understood in the context of the complexity and changing needs of people with IDs, as well as the introduction of the new NMC standards for pre-registration nurse education in the UK. Recommendations Given the complexity of health, poorer health, higher rates of co-morbidity, inequalities in health, poor access to health services and higher rates of premature mortality experienced by people with IDs, we recommend that urgent research is undertaken to further clarify ID nurse interventions, more specifically in relation to maternity, children, older adult, and end of life care.
  • Acceptability, usability and weight loss outcomes in a randomized cross-over study of commercially available portion size tools in an overweight South Asian community

    Ellahi, Basma; Aitken, Amanda; Dikmen, Derya; Erdogan, Bilge Seyhan; Makda, Munibah; Razaq, Rifat; University of Chester; Hacettepe University (MDPI, 2022-06-23)
    South Asian women living in the UK are particularly at high risk of obesity-related complications, such as type 2 diabetes and cardio-vascular disease. Exposure to large portion sizes is a risk factor for obesity. Specifically, designed tableware helps individuals to manage weight through controlling food portion sizes. Thirty-one (n=31) overweight or obese South Asian adult women participated in a randomised cross-over trial aimed to assess efficacy, acceptance and weight change for two guided/calibrated commercially available portion control tools (Utensil set and Crockery Set) used in free-living conditions. Data on acceptance, perceived changes in portion size, frequency, and meal type was collected using paper questionnaires and 3-day diet dairies. Scores describing acceptance, ease of use and perceived effectiveness were derived from five-point Likert scales from which binary indicators (high/low) were analysed for significance using multivariate variance analysis for repeated measurements. A reduction in BMI was observed at each point of measurement (p=0.007). For overall tool use, the crockery set scored higher in all areas of acceptance, ease of use, perceived efficacy for all comparisons. Self-selected portion sizes increased for salads and decreased for cooking oil and breakfast cereals with both tools. Further research to scale up and evaluate similar weight management interventions for this group are warranted.
  • Sodium and potassium intakes assessed by 24-h urine among Moroccan University students in Casablanca, Morocco: Cross-sectional study

    Elarbaoui, Maria; Jafri, Ali; Elkardi, Younes; Makhlouki, Houria; Ellahi, Basma; Derouiche, Abdelfettah; Hassan II University of Casablanca; Mohammed VI University of Health Sciences; University of Chester (Elsevier, 2022-06-14)
    In Morocco, the high consumption of dietary sodium increases the risk of non-communicable diseases (NCDs) and predisposes to cardiovascular diseases (CVDs) and hypertension. This study aims to assess the dietary sodium and potassium intake in a random sample of Moroccan adult students as a benchmark informing a national strategy for reducing salt intake. This cross-sectional study was conducted with 103 adults aged 18 to 25 years recruited in Casablanca. The 24-hour urinary excretion was used to measure the sodium and potassium. Urine volume and creatinine excretion level were used to validate the completeness of the collected samples. The average urinary sodium excretion was 3.1 ± 0.1 g/day, 13.5% consumed less than 5g/day, while 69% consumed more than 5 g/day of which 17.5% consumed more than twice the recommendations. For the average urinary potassium excretion was 1.83 ± 0.06 g/day, and more than 98% of the students consumed less than the adequate intake. The Na/K ratio is significantly higher than the recommended amounts. The results of this pilot study show that the population studied has a high sodium intake and low potassium intake which does not meet World Health Organization (WHO) recommendations, which requires implementing an action plan to reduce salt intake.
  • Sodium and potassium intakes assessed by 24-h urine among Moroccan University students in Casablanca, Morocco: Cross-sectional study

    Elarbaoui, Maria; Jafri, Ali; Elkardi, Younes; Makhlouki, Houria; Ellahi, Basma; Derouiche, Abdelfettah
    In Morocco, the high consumption of dietary sodium increases the risk of non-communicable diseases (NCDs) and predisposes to cardiovascular diseases (CVDs) and hypertension. This study aims to assess the dietary sodium and potassium intake in a random sample of Moroccan adult students as a benchmark informing a national strategy for reducing salt intake. This cross-sectional study was conducted with 103 adults aged 18 to 25 years recruited in Casablanca. The 24-hour urinary excretion was used to measure the sodium and potassium. Urine volume and creatinine excretion level were used to validate the completeness of the collected samples. The average urinary sodium excretion was 3.1±0.1g/day, 13.5% consumed less than 5g/day, while 69% consumed more than 5g/day of which 17.5% consumed more than twice the recommendations. For the average urinary potassium excretion was 1.83±0.06g/day, and more than 98% of the students consumed less than the adequate intake. The Na/K ratio is significantly higher than the recommended amounts. The results of this pilot study show that the population studied has a high sodium intake and low potassium intake which does not meet World Health Organization (WHO) recommendations, which requires implementing an action plan to reduce salt intake.
  • Home‐based care nurses’ lived experiences and perceived competency needs: A phenomenological study

    Rusli, Khairul Dzakirin Bin; orcid: 0000-0002-8096-0006; Fen, Ong Shu; Speed, Shaun; Seah, Betsy; McKenna, Lisa; orcid: 0000-0002-0437-6449; Ying, Lau; orcid: 0000-0002-8289-3441; Ying, Liaw Sok; orcid: 0000-0002-8326-4049 (Wiley, 2022-05-22)
  • Editorial: COVID-19-Social Science Research During a Pandemic

    Ward, Paul R.; Bissell, Paul; Meyer, Samantha B.; Gesesew, Hailay A.; Januraga, Pande Putu; Chang, Dukjin; Lombi, Linda; Torrens University; University of Chester; University of Waterloo; Mekelle University; Udayana University Denpasar; Seoul National University; Catholic University of the Sacred Heart (Frontiers Media, 2022-05-09)
  • Reassessing the health impacts of trade and investment agreements: a systematic review of quantitative studies, 2016–20

    Barlow, Pepita; Sanap, Rujuta; Garde, Amandine; Winters, L. Alan; Mabhala, Mwandile A.; Thow, Anne-Marie; London School of Economics and Political Science; Univeristy of Liverpool; University of Sussex Business School; University of Chester; University of Sydney
    To ensure a high level of health protection, governments must ensure that health and trade policy objectives are aligned. We conducted a systematic review of the health impacts of trade policies, including trade and investment agreements (TIAs), to provide a timely overview of this field. We systematically reviewed studies evaluating the health impacts of trade policies published between Jan 19, 2016, and July 10, 2020. Included studies were quantitative studies evaluating the impact of TIAs and trade policies on health determinants or outcomes. We evaluated methodological quality and performed a narrative synthesis. 21 of 28 067 articles identified via searches met our criteria. Methodologically strong studies found reduced child mortality, deteriorating worker health, rising supplies of sugar, ultra-processed food, tobacco, and alcohol supplies, and increased drug overdoses following trade reforms, compared with the time periods before trade reform. However, associations varied substantially across contexts and socioeconomic characteristics. Our findings show that trade policies, including TIAs, have diverse effects on health and health determinants. These effects vary substantially across contexts and socioeconomic groups. Governments seeking to adopt healthy trade policies should consider these updated findings to ensure that opportunities for health improvement are leveraged and widely shared, while harms are avoided, especially among vulnerable groups.
  • Coronavirus Disease (COVID-19): The Mental Health, Resilience, and Communication Resources for the Short- and Long-term Challenges Faced by Healthcare Workers

    Mitchell, Andrew E. P.; Keyworth, Chris; Salas, Eduardo; Galli, Federica; Vegni, Elena; University of Chester; University of Leeds; Rice University; Sapienza University; University of Milan
    The coronavirus disease pandemic has been an exceptional time for healthcare workers who have had to adapt to new ways of communicating with each other and delivering care to their patients. Maintaining healthcare workers’ well-being and mental health during increased COVID-19 workload pressure and change in practices is needed. It is essential to have a resilient workforce that can respond to the challenges presented by the pandemic. Healthcare workers at the frontline may be more susceptible to psychological stressors such as the availability of resources to protect themselves and their patients whilst balancing this with maintaining the health and well-being of family and friends. This research topic addresses the problems and issues researchers, policymakers, and educators face when formulating the best evidence and recommendations to support healthcare workers. There is a need to collate the best available practice and share knowledge from diverse contexts so healthcare workers can deliver the best care whilst they stay physically and mentally healthy.
  • Ageing, Sexual Orientation and Mental Health: Lesbian, Gay, Bisexual, Transgender and Intersex Older People

    Broadway-Horner, Matthew; University of Chester (Jessica Kingsley Publishers, 2017-02-21)
    Introduction Discrimination against lesbian, gay, bisexual, transgendered and intersex (LGBTi)i people can often mean they are denied the basic human right to live the life they are born to lead (Kimmel et al. 2006). Traditionally, LGBTi people have often had to live in secret, hidden from the dominant heterosexual society, and many older people are still worried about disclosing their sexual identity (Kimmel et al. 2006). In this chapter I will explore some of the many issues facing older LGBTi people. The chapter starts with a brief overview of the history of the LGBTi communities and how they have been treated as ‘invisible citizens’ through mechanisms of the law and the medicalisation of the ‘homosexual’ (Jennings 2007). Then I examine some of the fears and concerns held by members of LGBTi communities when accessing services, and this is discussed in relation to issues of sexuality, mental health and ageing. It is my hope that in reading this chapter you will gain a deeper understanding of the issues raised and then think of areas of application for your own development as a non-discriminatory practitioner, as well as identifying needs for further service development
  • The Application of CBT for Adults with Learning Disabilities

    Serfaty, Marc; Broadway-Horner, Matthew; Hassiotis, Angela; University of Chester; University College London (Cambridge University Press, 2022-01-13)
    The chapter provides an evidence-based overview of predominantly cognitive behavioural interventions for common mental disorders, e.g. anxiety and depression, undertaken in the field of intellectual disabilities (ID). The evidence was generated by reviewing international publications between 1980 - 2020 which identified the use of Cognitive Behavioural Therapy (CBT), including third wave CBT therapies and also informed from our extensive clinical practice in the field of ID. The first section provides an outline of the historical and sociological context of psychological therapies and the possible barriers to CBT in an ID population. The chapter includes a summary of how intellectual disabilities, depression and anxiety disorders are defined. It considers key issues, problems and solutions, associated with applying CBT and its associated approaches in an ID population. Finally, two case vignettes introduce the reader to CBT techniques to illustrate ideas that will help clients using CBT to bring about a reduction in self-defeating behaviours. With the aid of a support worker and electronic sources, there is a much broader range of resources to help client and therapist journey and support the therapeutic alliance.
  • Editorial: Coronavirus Disease (COVID-19): The Mental Health, Resilience, and Communication Resources for the Short- and Long-term Challenges Faced by Healthcare Workers

    Mitchell, Andrew E. P.; Galli, Federica; Keyworth, Chris; Vegni, Elena; Salas, Eduardo; University of Chester; Sapienza University of Rome; University of Leeds; University of Milan; Rice University (Frontiers Media, 2022-04-18)
    During the early phases of the COVID-19 pandemic, the world initially focused on measures to suppress COVID-19 transmission and protect their populations by developing vaccines and drug treatments for the most vulnerable and a host of social actions, including implementing social distancing, working from home, travel restrictions, lockdowns, and face coverings. Nearly 2 years after the initial outbreak, at the time of writing this editorial, and through research conducted as part of this Research Topic, it is clear that the mental health impacts of COVID-19 on healthcare workers (HCW) are significant. There is an urgent need to understand and address these impacts (Greenberg et al., 2020). This is particularly true given the World Health Organisation has outlined a series of mental health and psychosocial considerations aimed explicitly at HCWs (World Health Organisation, 2020). The present Research Topic on Coronavirus Disease (COVID-19) and HCWs has added to the scientific knowledge in several main areas, including barriers and enablers to healthcare delivery, understanding HCWs' mental health and well-being, resilience, coordination and communication within the workforce, and specific interventions to promote mental health and well-being.
  • Veteran help-seeking behaviour for mental health issues: a systematic review

    Randles, Rebecca; Finnegan, Alan; University of Chester (BMJ Military Health, 2021-07-12)
    Introduction Serving military personnel and veterans have been identified to have a high prevalence of mental health disorders. Despite this, only a significantly small number seek mental healthcare. With the UK beginning to invest further support to the armed forces community, identification of barriers and facilitators of help-seeking behaviour is needed. Methods Corresponding literature search was conducted in PsycINFO, PsycArticles, Medline, Web of Science and EBSCO. Articles which discussed barriers and facilitators of seeking help for mental health concerns in the veteran population were included. Those which discussed serving personnel or physical problems were not included within this review. A total of 26 papers were analysed. Results A number of barriers and facilitators of help-seeking for a mental health issue within the veteran population were identified. Barriers included stigma, military culture of stoicism and self-reliance, as well as deployment characteristics of combat exposure and different warzone deployments. Health service difficulties such as access and lack of understanding by civilian staff were also identified. Facilitators to help combat these barriers included a campaign to dispel the stigma, including involvement of veterans and training of military personnel, as well as more accessibility and understanding from healthcare staff. Conclusions While some barriers and facilitators have been identified, much of this research has been conducted within the USA and on male veterans and lacks longitudinal evidence. Further research is needed within the context of other nations and female veterans and to further indicate the facilitators of help-seeking among veterans.
  • Looking into the LGB affirmative therapies over the last fifty years – a mixed method review synthesis

    Broadway-Horner, Matthew; Kar, Anindya; University of Chester; Advanced Neuropsychiatry Institute, Kolkata (Taylor and Francis, 2022-04-04)
    In the past few decades, affirmative therapies for sexual minorities have burgeoned. These are appropriate therapies but often there is a lack of adequate research. We set out to study the research evidence available. For this mixed-methods review, we identified 15 studies looking into the experiences of lesbian, gay and bisexual people in psychological therapies. These included nine qualitative, five quantitative and one mixed-method study. The minority stress hypothesis may explain some of the major difficulties LGB individuals face. Studies showed computer-based therapies may reduce or even eliminate unhelpful responses on part of the therapist. Challenges related to confidentiality and privacy in this context remain. Therapists may focus on minority stress but other stressors and not just discrimination may contribute to various mental health problems and their clinical presence. And finally, divergent findings found internalized homophobia may best explain discrimination-based minority stress and that therapist self-disclosure of own sexuality produced better results than the therapists who did not self-disclose. These findings are discussed and future directions for research are identified.
  • Interaction between Dietary Fat Intake and Metabolic Genetic Risk Score on 25-Hydroxyvitamin D Concentrations in a Turkish Adult Population

    Isgin-Atici, Kubra; Alathari, Buthaina E.; Turan-Demirci, Busra; Sendur, Suleyman Nahit; Incilay, Lay; Ellahi, Basma; Alikasifoglu, Mehmet; Erbas, Tomris; Buyuktuncer, Zehra; Santhanakrishnan, Vimaleswaran Karani; et al. (MDPI, 2022-01-17)
    Previous studies have pointed out a link between vitamin D status and metabolic traits, however, consistent evidence has not been provided yet. This cross-sectional study has used a nutrigenetic approach to investigate the interaction between metabolic-genetic risk score (GRS) and dietary intake on serum 25-hydroxyvitamin D [25(OH)D] concentrations in 396 unrelated Turkish adults, aged 24-50 years. Serum 25(OH)D concentration was significantly lower in those with a metabolic-GRS ≥ 1 risk allele than those with a metabolic-GRS < 1 risk allele (p = 0.020). A significant interaction between metabolic-GRS and dietary fat intake (energy%) on serum 25(OH)D levels was identified (Pinteraction = 0.040). Participants carrying a metabolic-GRS ≥ 1 risk allele and consuming a high fat diet (≥38% of energy = 122.3 ± 52.51 g/day) had significantly lower serum 25(OH)D concentration (p = 0.006) in comparison to those consuming a low-fat diet (<38% of energy = 82.5 ± 37.36 g/d). In conclusion, our study suggests a novel interaction between metabolic-GRS and dietary fat intake on serum 25(OH)D level, which emphasises that following the current dietary fat intake recommendation (<35% total fat) could be important in reducing the prevalence of vitamin D deficiency in this Turkish population. Nevertheless, further larger studies are needed to verify this interaction, before implementing personalized dietary recommendations for the maintenance of optimal vitamin D status.
  • “Our feelings are valid”- reviewing the lesbian, gay, and bisexual affirmative approaches in a mental health setting.

    Broadway-Horner, Matthew; Kar, Anindya; University of Chester; Advanced Neuropsychiatry Institute, Kolkata (Taylor and Francis, 2022-02-07)
    In recent years, although research into support mechanisms for managing distress experienced by Lesbian Gay and Bisexual (LGB) communities has increased. Stigma-related discrimination related to sexual minority status remains. This is further compounded by stigma against mental illnesses thus creating double jeopardy. This review will outline recent discoveries by exploring existing theories highlighting factors that explain health disparities for cisgender LGB people. It appears that the experience of the LGB population and the use of psychological therapies is varied across the spectrum. Some focus upon symptom reduction as part of the experience, but others talk about not being validated. Some mention minority stress constructs, alongside the psychological mediation framework, which offers a potential theoretical understanding of the experiences of the LGB population who receive psychological therapies.
  • New challenges for an expanding generation of older persons with haemophilia

    O’Hara, Jamie; orcid: 0000-0001-8262-034X; Noone, Declan; orcid: 0000-0003-2183-4277; Kritikou, Persefoni; Myren, Karl-Johan; orcid: 0000-0003-2065-2930; Chaplin, Steve; orcid: 0000-0001-7508-5609; Hart, Daniel P; orcid: 0000-0001-9084-8598 (Walter de Gruyter GmbH, 2022-03-09)
    Abstract Background Increasing survival among people with haemophilia means that more individuals are at risk of developing age-related morbidity. Little is known about morbidity and health-related quality of life (HRQoL) in different age groups within a single large population of people with haemophilia. Aim This study aimed to explore the association between increasing age and comorbidity among people with haemophilia and to compare their HRQoL with that of a sample of the general population in England. Methods The prevalence of comorbidity recorded in medical records and HRQoL assessed by EQ-5D were compared by age group in participants in the Cost of Haemophilia in Europe: A Socioeconomic Survey study (CHESS) in Europe. HRQoL was compared with that of a sample of the general population taken from the 2012 Health Survey for England (HSE). Results Younger adults in CHESS were more likely to have received prophylaxis from an early age. The mean number of affected joints in younger adults was 1.0; participants aged 41–50 (1.25) and 51–60 years (1.41) had the highest mean number of affected joints. The prevalence of comorbidity was 36% in patients aged 18–30, 61% in 31–60-year-olds and 68% in those aged 61+. HRQoL impairment in young adults with haemophilia was comparable with that in the HSE population aged over 60. Conclusions Older people with haemophilia have impaired quality of life compared with younger adults and an increasing prevalence of several age-related disorders affecting mental health and cardiovascular and bone health. Young adults with haemophilia report impaired HRQoL comparable with that in a general population aged 61+.
  • How Well Are Hand Hygiene Practices and Promotion Implemented in Sierra Leone? A Cross-Sectional Study in 13 Public Hospitals

    Lakoh, Sulaiman; Maruta, Anna; Kallon, Christiana; Deen, Gibrilla F.; Russell, James B. W.; Fofanah, Bobson D.; Kamara, Ibrahim F.; Kanu, Joseph S.; Kamara, Dauda; Molleh, Bailah; et al. (MDPI, 2022-03-23)
    Healthcare-associated infections (HAIs) result in millions of avoidable deaths or prolonged lengths of stay in hospitals and cause huge economic loss to health systems and communities. Primarily, HAIs spread through the hands of healthcare workers, so improving hand hygiene can reduce their spread. We evaluated hand hygiene practices and promotion across 13 public health hospitals (six secondary and seven tertiary hospitals) in the Western Area of Sierra Leone in a cross-sectional study using the WHO hand hygiene self-Assessment framework in May 2021. The mean score for all hospitals was 273 ± 46, indicating an intermediate level of hand hygiene. Nine hospitals achieved an intermediate level and four a basic level. More secondary hospitals 5 (83%) were at the intermediate level, compared to tertiary hospitals 4 (57%). Tertiary hospitals were poorly rated in the reminders in workplace and institutional safety climate domains but excelled in training and education. Lack of budgets to support hand hygiene implementation is a priority gap underlying this poor performance. These gaps hinder hand hygiene practice and promotion, contributing to the continued spread of HAIs. Enhancing the distribution of hand hygiene resources and encouraging an embedded culture of hand hygiene practice in hospitals will reduce HAIs.
  • Association of factor expression levels with health-related quality of life and direct medical costs for people with haemophilia B

    Burke, Tom; orcid: 0000-0001-6768-1670; Shaikh, Anum; Ali, Talaha M.; Li, Nanxin; Curtis, Randall; orcid: 0000-0002-6859-6432; Garcia Diego, Daniel-Anibal; Recht, Michael; Sannie, Thomas; Skinner, Mark; orcid: 0000-0002-0934-0680; O’Hara, Jamie; orcid: 0000-0001-8262-034X (Informa UK Limited, 2022-03-15)

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