• 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)
    • 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.
    • 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.
    • 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)
    • 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+.
    • The Long-Arm Approach to Placement Supervision and Assessment

      Knight, Kate H; Whaley, Viki; Bailey-McHale, Rebecca; Simpson, Angela; Hay, Jonathon; University of Chester (British Journal of Nursing, 2022-02-26)
      In response, to the regulatory changes that require health and/or social care registrants to supervise and assess students on practice placements (NMC, 2018), the University of Chester’s (UoC) Faculty of Health and Social Care (H&SC) has developed an innovative long-arm practice supervision model, which supports the development of these types of practice placements as HUBs and also funds the registrants to deliver it, ensuring optimum support for students and the practice area.
    • Risk factors for intimate partner homicide in England and Wales

      Chopra, Jennifer; Sambrook, Laura; McLoughlin, Shane; Randles, Rebecca; Palace, Marek; Blinkhorn, Victoria; Liverpool John Moores University; University of Birmingham; University of Chester (Wiley, 2022-02-17)
      Intimate partner homicides are often situated within the context of domestic abuse, and although less prevalent than domestic abuse, there have been several multi-agency approaches to understanding the risk for these fatal crimes. Domestic Homicide Reviews (DHRs) were introduced in 2011 to provide information to help with assessing such risk. This paper aims to analyse DHRs in England and Wales to investigate/determine risk factors for domestic homicide following intimate partner abuse. All publicly available DHRs published between July 2011 and November 2020 where the victim and perpetrator were or had been intimate partners (N = 263) were retrieved from Community Safety Partnership websites in England and Wales. A quantitative design was used to extract data from DHRs, and descriptive and inferential statistics were generated by SPSS 26. Findings identified risk factors relating to domestic abuse, including stalking, separation, and the victim being in a new relationship. Sociodemographic risk factors included higher levels of deprivation, lower income and higher barriers to housing and services. This highlights the role of both individual and sociodemographic factors in domestic homicides, and particularly the need for greater socioeconomic security for victims of domestic abuse. In conclusion, though much of the data is in line with previous research, our analysis highlights the pivotal role of regional poverty, with comfortable socioeconomic conditions offering protection against intimate partner homicides. This research suggests important directions for future research and makes a valuable contribution to a more in-depth understanding of the relationship between domestic abuse and intimate partner homicide.
    • Five years of national policies: progress towards tackling obesity in England.

      Tedstone, A E; Sabry-Grant, C; Hung, E; Levy, L B (2022-02-14)
    • A scoping review of clinical skill development of preregistration registered nurses in Australia and five other English‐speaking countries

      Currie, Jane; orcid: 0000-0002-8721-089X; Thompson, Cristina; orcid: 0000-0002-4369-0940; Grootemaat, Pam; Andersen, Patrea; Finnegan, Alan; Carter, Michael; Halcomb, Elizabeth; orcid: 0000-0001-8099-986X (Wiley, 2022-02-10)
    • “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.
    • Impact of progressive familial intrahepatic cholestasis on caregivers: caregiver-reported outcomes from the multinational PICTURE study.

      Mighiu, Claudia; orcid: 0000-0002-2938-4939; O'Hara, Sonia; Ferri Grazzi, Enrico; Murray, Karen F; Schattenberg, Jörn M; Ventura, Emily; Karakaidos, Melanie; Taylor, Alison; Brrang, Harpreet; Dhawan, Anil; et al. (2022-02-02)
      <h4>Background</h4>Progressive familial intrahepatic cholestasis (PFIC) is a spectrum of rare genetic diseases characterized by inadequate bile secretion that requires substantial ongoing care, though little research is published in this area. We report health-related quality of life (HRQoL) and work productivity outcomes from the retrospective, cross-sectional PICTURE study investigating the burden of PFIC on caregivers. Information from caregivers of patients with PFIC 1 or 2 in Germany, the United Kingdom and the United States from September 2020 to March 2021 was included.<h4>Results</h4>The PICTURE study sample comprised HRQoL responses from 22 PFIC caregivers. Patients were on average 8.2 years old; most caregivers were 30-49 years old (68%) and mothers (77%). Median CarerQoL-7D score was 67.7/100; mean CarerQoL-VAS score for general happiness was 5.7/10 (SD 2.1). Most caregivers reported fulfilment in their caregiving responsibilities, but problems with mental and physical health, finances, and relationships. When stratified by patient's PFIC type, mean CarerQoL-7D and CarerQoL-VAS scores suggested worse HRQoL outcomes with PFIC2 versus PFIC1 (59.4 vs. 71.2, and 5.3 vs. 6.5, respectively). Additionally, more caregivers reported impact on sleep in the PFIC2 versus PFIC1 subgroup (93% vs. 75%). When stratified by history of PFIC-related surgeries, mean CarerQoL-7D and VAS scores were higher among those whose children had no specified surgeries (67.7 vs. 59.0/100 and 6.2 vs. 5.2/10, respectively). Nearly all caregivers reported an impact of caregiving responsibilities on sleeping (86%) and on personal relationships (82%). No caregivers reported having formal care support. Most caregivers were employed (73%); a third reported mean productivity loss of 12.9 days (SD 19.3) over the last 3 months, and a mean of 2.8 (SD 9.5) missed years of employment during their career. A higher number of workdays were missed by PFIC 2 caregivers compared to PFIC1 over last 3 months (16 days vs. 3 days).<h4>Conclusions</h4>The PICTURE study has demonstrated the prevalent, comprehensive, and meaningful burden that caring for an individual with PFIC has on caregivers. Despite fulfilment from caregiving, the breadth and depth of these responsibilities reduced caregiver reported HRQoL including mental and physical health, productivity, career prospects, sleep, relationships and finances.
    • Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019

      Forde, Hannah; Penney, Tarra; White, Martin; Levy, Louis; Greaves, Felix; Adams, Jean (Maad Rayan Publishing Company, 2022-01-29)
      Background: The World Health Organization recommends that countries implement fiscal policies to reduce the health impacts of sugary drinks. Few studies have fully examined the responses of industry to these policies, and whether they support or undermine health benefits of sugary drinks taxes. We aimed to explore the changes that sugary drinks companies may make to their marketing, and underlying decision-making processes, in response to such a tax. Methods: Following introduction of the UK Soft Drinks Industry Levy (SDIL) in 2018, we undertook one-to-one semi-structured interviews with UK stakeholders with experience of the strategic decision-making or marketing of soft drink companies. We purposively recruited interviewees using seed and snowball sampling. We conducted telephone interviews with 6 representatives from each of industry, academia and civil society (total n=18), which were transcribed verbatim and thematically analysed. Four transcripts were double-coded, three were excluded from initial coding to allow comparison; and findings were checked by interviewees. Results: Themes were organised into a theoretical framework that reveals a cyclical, iterative and ongoing process of soft drink company marketing decision-making, which was accelerated by the SDIL. Decisions about marketing affect a product’s position, or niche, in the market and were primarily intended to maintain profits. A product’s position is enacted through various marketing activities including reformulation and price variation, and non-marketing activities like lobbying. A soft drink company’s selection of marketing activities appeared to be influenced by their internal context, such as brand strength, and external context, such as consumer trends and policy. For example, a company with low brand strength and an awareness of trends for reducing sugar consumption may be more likely to reformulate to lower-sugar alternatives. Conclusion: The theoretical framework suggests that marketing responses following the SDIL were coordinated and context-dependent, potentially explaining observed heterogeneity in responses across the industry.
    • Prevalence of common mental health disorders in military veterans: using primary healthcare data

      Finnegan, Alan; Randles, Rebecca; University of Chester (BMJ Publishing Group, 2022-01-18)
      Introduction Serving military personnel and military veterans have been identified as having a high prevalence of mental disorders. Since 1985, UK patients’ primary healthcare (PHC) medical records contain Read Codes (now being replaced by Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) codes) that mark characteristics such as diagnosis, ethnicity and therapeutic interventions. This English study accesses a cohort profile of British Armed Forces veterans to examine the diagnosed common mental disorders by using PHC records. Methods This analysis has been drawn from initiatives with PHC practices in the Northwest of England to increase veteran registration in general practice. Demographic data were collected including gender, age and marital status. Data were also collected on common mental health disorders associated with the Armed Forces. Result 2449 veteran PHC records were analysed. 38% (N=938) of veterans in this cohort had a code on their medical record for common mental health disorders. The highest disorder prevalence was depression (17.8%, N=437), followed by alcohol misuse (17.3%, N=423) and anxiety (15.0%, N=367). Lower disorder prevalence was seen across post-traumatic stress disorder (PTSD) (3.4%, N=83), dementia (1.8%, N=45) and substance misuse (0.8%, N=19). Female veterans had a higher prevalence of mental disorders than their male counterparts, while men a higher prevalence of PTSD; however, the gender difference in the latter was not significant (p>0.05). Conclusion The SNOMED searches do not detail why certain groups had higher recordings of certain disorders. A future study that accesses the PHC written medical notes would prove enlightening to specifically identify what situational factors are having the most impact on the veteran population. The results from a sizeable English veteran population provide information that should be considered in developing veteran-specific clinical provision, educational syllabus and policy.
    • 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.
    • ‘How you keep going’: Voluntary sector practitioners’ story-lines as emotion work

      Quinn, Kaitlyn; Tomczak, Philippa; Buck, Gillian; University of Toronto; University of Nottingham; University of Chester (Wiley, 2022-01-16)
      The voluntary sector acts as the last line of defense for some of the most marginalized people in societies around the world, yet its capacities are significantly reduced by chronic resource shortages and dynamic political obstacles. Existing research has scarcely examined what it is like for voluntary sector practitioners working amidst these conditions. In this paper, we explore how penal voluntary sector practitioners across England and Scotland marshaled their personal and professional resources to “keep going” amidst significant challenges. Our analysis combines symbolic interactionism with the concept of story- lines. We illuminate the narratives that practitioners mobilized to understand and motivate their efforts amidst the significant barriers, chronic limitations, and difficult emotions brought forth by their work. We position practitioners' story- lines as a form of emotion work that mitigated their experiences of anger, frustration, overwhelm, sadness, and disappointment, enabling them to move forward and continue to support criminalized individuals. Our analysis details three story- lines— resignation, strategy, and refuge—and examines their consequences for practitioners and their capacities to intervene in wicked social problems.
    • 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.
    • Invisible and at-risk: older adults during the COVID-19 pandemic.

      Benbow, Susan M; Bhattacharyya, Sarmishtha; Kingston, Paul; Peisah, Carmelle (2021-12-16)
      During the COVID-19 pandemic the risks to older adults of systemic abuse and neglect have become amplified, alongside increasing abuse and neglect in the community. Novel risks have also evolved involving cybercrime and the use of remote technologies in health and social care related to the pandemic. This commentary brings together lessons to be learned from these developments and initial ideas for actions to mitigate future risks.