The Department of Clinical Sciences and Nutrition has an experienced team of researchers, with an international reputation. Their main research themes are Public Health Nutrition and Physical Activity, Cardiometabolic Health, and Clinical Practice.

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  • Optimal omegas – barriers and novel methods to narrow omega-3 gaps. A narrative review

    Derbyshire, Emma J.; Birch, Catherine S.; Bonwick, Graham A.; English, Ashley; Metcalfe, Phil; Li, Weili; Nutritional Insight Limited, London; AgriFood X Limited, York; HTC Group Limited, Cheshire; Efficiency Technologies Limited, Milton Keynes; University of Chester (Frontiers Media, 2024-02-02)
    Dietary intakes of omega-3 long chain polyunsaturated fatty acids (O3LC-PUFAs) such as eicosapentaenoic and docosahexaenoic acid are central to development and health across the life course. O3LC-PUFAs have been linked to neurological development, maternal and child health and the etiology of certain non-communicable diseases including age-related cognitive decline, cardiovascular disease, and diabetes. However, dietary inadequacies exist in the United Kingdom and on a wider global scale. One predominant dietary source of O3LC-PUFAs is fish and fish oils. However, growing concerns about overfishing, oceanic contaminants such as dioxins and microplastics and the trend towards plant-based diets appear to be acting as cumulative barriers to O3LC-PUFAs from these food sources. Microalgae are an alternative provider of O3LC-PUFA-rich oils. The delivery of these into food systems is gaining interest. The present narrative review aims to discuss the present barriers to obtaining suitable levels of O3LC-PUFAs for health and wellbeing. It then discusses potential ways forward focusing on innovative delivery methods to utilize O3LC-PUFA-rich oils including the use of fortification strategies, bioengineered plants, microencapsulation, and microalgae.
  • Development of Edible Food Wrappers: An Eco-Friendly Approach Towards Sustainability

    Basharat, Zunaira; Ahmed, Darakhshan; Tariq, Muhammad Rizwan; Ali, Shinawar Waseem; Pervaiz, Muhammad Usama (IGI Global, 2023-12-29)
    Edible food wrappers are safe packaging systems that can be consumed with food. Edible packaging developed using natural renewable resources come under the category of bio-based and biodegradable packaging. The main components of edible wrappers include a biopolymer solubilized in a solvent to form film casting solution and certain additives to improve functional characteristics of packaging. Biopolymers are frequently used in food packaging applications due to their flexibility in film formation and biodegradability. The development of green packaging materials utilizing discarded edible materials will be beneficial to confront the challenges associated with traditional packaging systems, attaining sustainability, and fostering recycling in the food industry. Edible food wrappers present a number of benefits over synthetic materials. These packaging systems can replace and possibly strengthen the outside layers of packed items in order to elude moisture loss, flavors, and bioactive components from the foods as well as between them.
  • The efficacy and safety of ketamine for depression in patients with cancer: A systematic review

    Azari, Leila; Hemati, Homa; Tavasolian, Ronia; Shahdab, Sareh; Tomlinson, Stephanie M.; Bobonis Babilonia, Margarita; Huang, Jeffrey; Tometich, Danielle B.; Turner, Kea; Jim, Heather S. L.; et al. (ElsevierAsociación Española de Psicología Conductual, 2023-12-15)
    Management of depression in the oncology population includes supportive psychotherapeutic interventions with or without psychotropic medication, which take time to demonstrate effectiveness. Fast-acting interventions, like ketamine, can provide a rapid antidepressant effect; however, there has been limited research on effects of ketamine among cancer patients. The objective of this review is to provide an overview of research on the efficacy and safety of ketamine on depression in patients with cancer. We reviewed the published literature in MEDLINE® (via PubMed®), EMBASE, and Scopus from 1 January 1982 to 20 October 2022. We screened the retrieved abstracts against inclusion criteria and conducted a full-text review of eligible studies. Following extraction of data from included studies, we used a framework analysis approach to summarize the evidence on using ketamine in patients with cancer. All 5 included studies were randomized clinical trials conducted in inpatient settings in China. In all included studies ketamine was administered intravenously. Three studies used only racemic ketamine, and two studies used both S-ketamine and racemic ketamine. All included studies reported ketamine a tolerable and effective drug to control depression symptoms. Included studies showed administration of sub-anesthesia ketamine significantly improves postoperative depression among patients with cancer. [Abstract copyright: © 2023 The Author(s).]
  • Development of a novel dietary assessment tool for vitamin D and the in vivo and in vitro effects of supplementation on asthma

    Mushtaq, Sohail; Harrison, Tanja; Watkins, Stephanie (University of Chester, 2023-09)
    Vitamin D is a secosteroid hormone with the essential role of maintaining calcium and phosphorus homeostasis to support bone metabolism. Furthermore, vitamin D has also been shown to have important immunomodulatory functions, which have been linked to inflammatory diseases such as asthma. In the UK, 18.8% of the general population are vitamin D deficient during the winter. In 2016, SACN proposed recommendations that adults in the UK consume 400 IU (10 μg) vitamin D day-1. Health and disease are linked to diet and nutrition therefore, assessing food intake is crucial. A food frequency questionnaire (FFQ) captures habitual food intake with a lower participant burden compared to alternative methods. Validation of a FFQ requires comparison of nutrient biomarkers with another method of dietary assessment. The first study in this thesis recruited 50 healthy volunteers to assess the agreement between a four-day food diary and a newly designed vitamin FFQ to measure dietary intake of vitamin D. Participants provided a blood sample for plasma analysis of 25(OH)D concentrations. Results of this study showed a strong correlation between vitamin D intake recorded by the FFQ and the food diary (r = 0.609, p < 0.0001) within 95% limits of agreement. Our analysis suggested that this FFQ is a useful and rapid tool for researchers and health professionals to assess vitamin D dietary intakes in UK adults. Vitamin D deficiency is linked to asthma in adults and associated with reduced lung function. Clinical trials investigating the effect of vitamin D supplementation have mainly focussed on asthmatic children and trials carried out in adults have used bolus dosing. The aim of chapter 3 was to conduct a 12-week randomised placebo-controlled trial investigating the effect of daily 5000 IU vitamin D supplementation on lung function and inflammation in 32 adults with mild to moderate asthma. The intervention resulted in a significant increase in the mean (± SD) ratio of FEV1: FVC from baseline (week 0) to post-intervention (week 12) in the vitamin D group (+ 0.05 ± 0.06) compared to the placebo group (+ 0.006 ± 0.04, p = 0.04). This dosing strategy at a level above current UK recommendations may be a useful adjunct to existing asthma control strategies. The Calu-3 cell line has been used as a model of asthma and the aim of chapter 4 was to investigate the effect of calcitriol and 25(OH)D treatment of Calu-3 cell cultures on cell proliferation and secretion of inflammatory biomarkers. Incubation of cultures for 24 and 72 hours respectively, with 50nM (p = 0.002; p < 0.0001), 100nM (p = 0.004; p = 0.007) and 200nM (p = 0.002; p < 0.0001) 25(OH)D resulted in significantly decreased proliferation compared to an untreated control. No effect was observed with calcitriol treatment. To our knowledge, this is the first in vitro study using the Calu-3 cell line to show differing effects of vitamin D metabolites. The findings from this thesis are clinically relevant in the UK in a population that is at increased risk of vitamin D deficiency during the winter months. The new tool designed and validated will facilitate easier measurement of vitamin D dietary intakes and the clinical trial and in vitro work have provided novel insights to patient outcomes and underlying mechanisms of the benefit of vitamin D supplementation to asthma patients.
  • Cucumeropsis mannii seed oil protects against bisphenol A-induced hepatotoxicity by mitigating inflammation and oxidative stress in rats

    Aja, Patrick M.; Chukwu, Chinecherem A.; Paul-Chima, Ugwu O.; Ale, Boniface A.; Agu, Peter C.; Deusdedi, Tusubira; Chukwu, Darlington C.; Ani, Onyedika G.; Ekpono, Ezebuilo U.; Ogwoni, Hilary A.; et al. (Oxford University Press, 2023-10-20)
    OBJECTIVES This study looked at how CMSO affected male Wistar albino rats' liver damage caused by bisphenol A. METHODS The standard HPLC method was used to assess the CMSO's phenolic content. Then, six (n = 8) groups of forty-eight (48) male Wistar rats (150 20 g) each received either CMSO or olive oil before being exposed to BPA for 42 days. Groups: A (one milliliter of olive oil, regardless of weight), B (BPA 100 mg/kg body weight (BW)), C (CMSO 7.5 mg/kg BW), D (CMSO 7.5 mg/kg BW + BPA 100 mg/kg BW), E (CMSO 5.0 mg/kg BW + BPA 100 mg/kg BW), and F (CMSO 2.5 mg/kg BW + BPA 100 mg/kg BW). KEY FINDINGS A surprising abundance of flavonoids, totaling 17.8006 10.95 g/100 g, were found in the HPLC data. Malondialdehyde, liver enzymes, reactive oxygen species, total bilirubin, and direct bilirubin levels were all significantly elevated by BPA (p 0.05). Additionally, nuclear factor-B, interleukin-6, interleukin-1, tumor necrosis factor, and histological alterations were all considerably (p 0.05) caused by BPA. The altered biochemical markers and histology were, however, noticeably recovered by CMSO to a level that was comparable to the control. CONCLUSION Due to the abundance of flavonoid components in the oil, CMSO protects the liver from BPA-induced hepatotoxicity by lowering oxidative stress and inflammatory reactions.
  • Risk factors for diabetes mellitus after acute pancreatitis: a systematic review and meta-analysis

    Zahariev, Olga J.; Bunduc, Stefania; Kovács, Adrienn; Demeter, Dóra; Havelda, Luca; Veres, Dániel Sándor; Hosszúfalusi, Nóra; Erőss, Bálint; Teutsch, Brigitta; Juhász, Márk F.; et al. (Elsevier, 2023-10-12)
  • Dietary Intakes and the Risk of Low Energy Availability in Male and Female Advanced and Elite Rock Climbers

    Monedero, Javier; Duff, Christina; Egan, Brendan; Dublin City University; University of Chester (Lippincott, Williams & Wilkins, 2022-07-08)
    Monedero, J, Duff, C, and Egan, B. Dietary intakes and the risk of low energy availability in male and female advanced and elite rock climbers. J Strength Cond Res 37(3): e8–e15, 2023—There is a culture among rock climbers of striving to maintain low body mass and percentage body fat to enhance performance. Diet practices based on this belief might lead to increased risk of low energy availability (LEA) or eating disorders (EDs). Twenty-five advanced or elite rock climbers (male, n = 14; female, n = 11) had body composition measured, completed 4-day food intake and physical activity diaries while wearing an accelerometer and heart rate monitor, and completed the Eating Attitudes Test (EAT)-26 and the Low Energy Availability in Females Questionnaire (LEAF-Q; n = 11 female subjects only). EAT-26 scores of 3.5 (1.8, 7.0) [median (IQR)] and 9.3 ± 6.4 (mean ± SD) for male and female subjects, respectively, indicated low risk of ED in this cohort, but 4 female subjects were at high risk of LEA according to LEAF-Q scores. Suboptimal (&lt;45 kcal·kg·FFM−1·d−1) and LEA (&lt;30 kcal·kg·FFM−1·d−1) were evident in 88 and 28%, respectively, of climbers. However, only the female climbers had energy intakes (1775 ± 351 kcal·d−1) significantly lower than their calculated energy requirements (2056 ± 254 kcal·d−1; p = 0.006). In all subjects, carbohydrate intakes were lower (male subjects: 3.8 ± 1.2 g·kg−1·d−1, p = 0.002; female subjects: 3.4 ± 0.7 g·kg−1·d−1, p &lt; 0.001), and fat intakes were higher (male subjects: 1.6 ± 0.5 g·kg−1·d−1, p &lt; 0.001; female subjects: 1.4 ± 0.4 g·kg−1·day−1, p &lt; 0.001) than current sports nutrition recommendations, and inadequate intakes of calcium, magnesium, and vitamin D were observed. Female subjects specifically had lower than recommended intakes of protein and iron. These results show that advanced and elite rock climbers have a high prevalence of LEA and have a risk of having nutritional deficiencies as result of their diet.
  • FTIR and Rheology study of Alginate samples: Effect of Radiation

    Mollah, M. Z. I.; Faruque, Mohammad R. I.; Bradley, David; Khandaker, Mayeen U.; Al-Assaf, Saphwan; Universiti Kebangsaan Malaysia; Institute of Radiation and Polymer Technology; Sunway University; University of Surrey; Daffodil International University; University of Chester (Elsevier, 2022-09-04)
    Two well characterised alginate samples with high and low M/G ratio were subjected to radiation decontamination dose at 15 kGy. Subsequently, a number of techniques were used to determine the effect of radiation on the gelling properties. These techniques include: (GPC-MALLS) gel permeation chromatography linked to a multi-angle laser light scattering and refractive index detector for the determination of molecular weight and distribution. To observe the mechanics, the deformation with flow of α-β alginates rheological measurements in the dynamic oscillation modes, and distinguish the functional group of the samples along with identifying the M/G ratio for quantitative determination of mannuronic and guluronic acid, the FTIR techniques were performed respectively. The results showed clear reduction in the molecular weight following irradiation which was also accompanied by a loss of the gelling properties as well as clear reduction intensity of FTIR peak at 1080-1400 cm -1 for carboxylic group, OH-bonding obtained at 1030 cm-1 (1026 and 1028 cm-1) while the weak signal and skeletal region is attributed at >2800 and < 700 cm-1 respectively. A sample (n = 1; H120L) is homopolyguluronic enriched (820 cm-1 in fingerprint region) with small amount of mannuronic acid fraction. Sample (n = 2; LFR-5/60) is heteropolyguluronic acid enriched in presence of tiny amount guluronic acid (814 cm-1 peak) i.e. comparatively high G to M in this fraction but %G is lower than n = 1. The rheological parameter storage modulus (G′ ) and loss modulus (G”) were noticed higher with the constant frequency mode, a solid-like nature gels was obtained with increasing the frequency in a certain time of relaxation. The gelling properties of the samples calculated is M/G < 1 which able to make hard and rigid gel. Thus, radiation effects for rheology and FTIR in case of functional group distribution was significant.
  • Exploring the perceived influence of social media use on disordered eating in nutrition and dietetics students

    Law, Rebecca; Jevons, Emily; University of Chester (Wiley, 2023-07-20)
    Background: Social media use (SMU) is increasingly widespread. More recently, SMU has been associated with increases in disordered eating; however, few qualitative studies have explored this issue in nutrition and dietetics students specifically, where susceptibility to disordered eating may be particularly high. The present study therefore aimed to investigate the perceived impact of SMU on disordered eating in nutrition and dietetics students. Methods: One‐to‐one, in‐depth, semi‐structured interviews were conducted with nutrition and dietetics students from universities across the UK. Interviews explored students’ views on the potential influence of SMU on their eating‐related thoughts, feelings and behaviours. Data were thematically analysed to identify key themes. Results: The findings suggested that SMU may provide students with a useful tool for the exploration of new recipes, ingredients and health‐related information, thus enabling them to improve their eating behaviour and diet quality. However, students also showed high levels of objective awareness regarding the problems associated with SMU, including the presence of misinformation, body image dissatisfaction, social pressures and disordered eating. Interestingly, despite enabling them to detect sources of misinformation, students also discussed the negative impact that their course had on their eating habits, suggesting course content may be an additional risk factor for the development of disordered eating for this particular group. Conclusions: Future research should investigate ways to mitigate the negative impact of SMU and course content on disordered eating in nutrition and dietetics students.
  • A comprehensive review on food hydrocolloids as gut modulators in the food matrix and nutrition: The hydrocolloid-gut-health axis

    Ağagündüz, Duygu; Özata-Uyar, Gizem; Kocaadam-Bozkurt, Betül; Özturan-Şirin, Ayçıl; Capasso, Raffaele; Al-Assaf, Saphwan; Özoğul, Fatih; Gazi University; Erzurum Technical University; Aydın Menderes University; University of Naples Federico II; University of Chester; Cukurova University (Elsevier, 2023-07-15)
    Background Food hydrocolloids are versatile natural food ingredients, which can be authentically present in food matrices or can be added as functional food ingredients and/or food additives. All hydrocolloids are common in industrial use with enhancers of viscosity, emulsifiers, coating, gelling agents, stabilizing agents and/or thermodynamic stability providers. While safety issues of hydrocolloids in the food industry have been discussed until now, research has turned to their effects on gut modulation, human health and wellbeing. Scope and approach This review focuses on a comprehensive discussion of certain food hydrocolloids in gut modulation and their potential interaction with health through gut modulation. Key findings and conclusions Novel literature suggests that certain food hydrocolloids could substantially change the range and structure of the microbiota of the gut and the primary bioactive metabolites. Besides, hydrocolloids show important outcomes on gut microbiota because of their physicochemical and structural properties. Moreover, they may have various impacts, and the mechanisms of gut microbiota activity are quite diverse depending on their polymeric structure and source. Despite some discrepancies and divergences in their impacts on the gut microbiota-health axis, their reassuring outcomes on health are mainly associated with their prebiotic or prebiotic-like effects. In this way, it can directly/indirectly affect host health. Therefore, while investigating the possible health and safety effects of the use of hydrocolloids in the form of food additives, it may be useful to investigate the benefits and side effects on the gut.
  • Nano‐delivery systems as a promising therapeutic potential for epilepsy: Current status and future perspectives

    Movahedpour, Ahmad; Taghvaeefar, Rasul; Asadi‐Pooya, Ali‐Akbar; Karami, Yousof; Tavasolian, Ronia; Khatami, Seyyed H.; Soltani Fard, Elahe; Taghvimi, Sina; Karami, Neda; Rahimi Jaberi, Khojaste; et al. (Wiley Open Access, 2023-07-14)
    Epilepsy is a common chronic neurological disorder caused by aberrant neuronal electrical activity. Antiseizure medications (ASMs) are the first line of treatment for people with epilepsy (PWE). However, their effectiveness may be limited by their inability to cross the blood–brain barrier (BBB), among many other potential underpinnings for drug resistance in epilepsy. Therefore, there is a need to overcome this issue and, hopefully, improve the effectiveness of ASMs. Recently, synthetic nanoparticle‐based drug delivery systems have received attention for improving the effectiveness of ASMs due to their ability to cross the BBB. Furthermore, exosomes have emerged as a promising generation of drug delivery systems because of their potential benefits over synthetic nanoparticles. In this narrative review, we focus on various synthetic nanoparticles that have been studied to deliver ASMs. Furthermore, the benefits and limitations of each nano‐delivery system have been discussed. Finally, we discuss exosomes as potentially promising delivery tools for treating epilepsy.
  • 3D hydrogel/ bioactive glass scaffolds in bone tissue engineering: Status and future opportunities

    Aldhaher, Abdullah; Shahabipour, Fahimeh; Shaito, Abdullah; Al-Assaf, Saphwan; Elnour, Ahmed; Sallam, El Bashier; Teimourtash, Shahin; Elfadil, Abdelgadir A.; Sharif University of Technology; Mashhad University of Medical Science; Shahid Beheshti University of Medical Sciences; Qatar University; University of Chester; University of Malaysia Pahang-UMP; Freelance Global and Public Health Expert (FGPHE), Sudan; McMaster University; Al-Neelain University (Elsevier, 2023-07-05)
    Repairing significant bone defects remains a critical challenge, raising the clinical demand to design novel bone biomaterials that incorporate osteogenic and angiogenic properties to support the regeneration of vascularized bone. Bioactive glass scaffolds can stimulate angiogenesis and osteogenesis. In addition, natural or synthetic polymers exhibit structural similarity with extracellular matrix (ECM) components and have superior biocompatibility and biodegradability. Thus, there is a need to prepare composite scaffolds of hydrogels for vascularized bone, which incorporates bioactive glass to improve the mechanical properties and bioactivity of natural polymers. In addition, those composites' 3-dimensional (3D) form offers regenerative benefits such as direct doping of the scaffold with ions. This review presents a comprehensive discussion of composite scaffolds incorporated with BaG, focusing on their effects on osteo-inductivity and angiogenic properties. Moreover, the adaptation of the ion-doped hydrogel composite scaffold into a 3D scaffold for the generation of vascularized bone tissue is exposed. Finally, we highlight the future challenges of manufacturing such biomaterials.
  • The Effect of Carbohydrate Restriction on Lipids, Lipoproteins, and Nuclear Magnetic Resonance-Based Metabolites: CALIBER, a Randomised Parallel Trial

    McCullough, Deaglan; Harrison, Tanja; Enright, Kevin J.; Amirabdollahian, Farzad; Mazidi, Mohsen; Lane, Katie; Stewart, Claire E.; Davies, Ian G.; Leeds Beckett University; Liverpool John Moores University; University of Chester; University of Wolverhampton; University of Oxford; King's College London (MDPI, 2023-06-30)
    Low-carbohydrate high-fat (LCHF) diets can be just as effective as high-carbohydrate, lower-fat (HCLF) diets for improving cardiovascular disease risk markers. Few studies have compared the effects of the UK HCLF dietary guidelines with an LCHF diet on lipids and lipoprotein metabolism using high-throughput NMR spectroscopy. This study aimed to explore the effect of an ad libitum 8-week LCHF diet compared to an HCLF diet on lipids and lipoprotein metabolism and CVD risk factors. For 8 weeks, n = 16 adults were randomly assigned to follow either an LCHF (n = 8, <50 g CHO p/day) or an HCLF diet (n = 8). Fasted blood samples at weeks 0, 4, and 8 were collected and analysed for lipids, lipoprotein subclasses, and energy-related metabolism markers via NMR spectroscopy. The LCHF diet increased (p < 0.05) very small VLDL, IDL, and large HDL cholesterol levels, whereas the HCLF diet increased (p < 0.05) IDL and large LDL cholesterol levels. Following the LCHF diet alone, triglycerides in VLDL and HDL lipoproteins significantly (p < 0.05) decreased, and HDL phospholipids significantly (p < 0.05) increased. Furthermore, the LCHF diet significantly (p < 0.05) increased the large and small HDL particle concentrations compared to the HCLF diet. In conclusion, the LCHF diet may reduce CVD risk factors by reducing triglyceride-rich lipoproteins and improving HDL functionality.
  • Current status and future challenges of genotoxicity OECD test guidelines (TGs) for nanomaterials: a workshop report

    Doak, Shareen; Andreoli, Cristina; Burgum, Michael J.; Chaudhry, Qasim; Bleeker, Eric A. J.; Bossa, Cecilia; Domenech, Josefa; Drobne, Damjana; Fessard, Valérie; Jeliazkova, Nina; et al. (Oxford University Press, 2023-05-26)
    Genotoxicity testing for nanomaterials remains challenging as standard testing approaches require some adaptation, and further development of nano-specific OECD Test Guidelines (TGs) and Guidance Documents (GDs) are needed. However, the field of genotoxicology continues to progress and new approach methodologies (NAMs) are being developed that could provide relevant information on the range of mechanisms of genotoxic action that may be imparted by nanomaterials. There is a recognition of the need for implementation of new and/or adapted OECD TGs, new OECD GDs and utilisation of NAMs within a genotoxicity testing framework for nanomaterials. As such, the requirements to apply new experimental approaches and data for genotoxicity assessment of nanomaterials in a regulatory context is neither clear, nor used in practice. Thus, an international workshop with representatives from regulatory agencies, industry, government, and academic scientists was convened to discuss these issues. The expert discussion highlighted the current deficiencies that exist in standard testing approaches within exposure regimes, insufficient physico-chemical characterisation, lack of demonstration of cell or tissue uptake and internalisation, and limitations in the coverage of genotoxic modes of action. Regarding the latter aspect, a consensus was reached on the importance of using NAMs to support the genotoxicity assessment of nanomaterials. Also highlighted was the need for close engagement between scientists and regulators to 1) provide clarity on the regulatory needs, 2) improve the acceptance and use of NAMs-generated data, and 3) define how NAMs may be used as part of Weight of Evidence approaches for use in regulatory risk assessments.
  • Suicide in probation: Towards the ideation-to-action model

    Fowler, James; Brooker, Charlie; Tocque, Karen; West, Georgia; Norman-Taylor, Alice; Fowler, James; University of London; University of Chester; St Andrew’s Healthcare (SAGE Publications, 2021-10-16)
    Suicide in probation services is far higher than the general population. This paper presents secondary analysis of data previously used to evaluate the outcome of delivering psychological treatment to probationers in London. A sample of probation service users who screened positive for clinically significant symptoms of distress and were subsequently assessed and offered treatment ( n = 274) were allocated retrospectively to one of three groups: those with a history of suicidal ideations but no suicide attempts (ideation group), those with a history of a suicidal act (attempt group) or a control group where suicide was not evident (no history group). Results indicate no significant difference between the ideation and the attempt groups, but significant differences between these and the no history group. The findings are discussed within the context of the suicide ideation-to-action models that have been debated in other offender settings. We conclude that a more nuanced understanding of suicidal acts and suicide attempts is required in probation services including a prospective study that tests the ideation-to-action model.
  • Medication adherence among patients with heart failure in Nigeria: from the patients’ and healthcare professionals’ perspectives

    Fallows, Stephen; Warren, Jem; Oyelami, Abiola I. (University of Chester, 2022-06)
    Introduction Although the efficacious pharmacotherapy advancements in the treatment of Heart Failure (HF) have been widely documented, mortality rates and hospitalisation rates among patients with HF remain high. An important reason for recurrent hospitalisation is patients’ nonadherence to self-care recommendations. Globally, medication nonadherence is a public health concern and a common phenomenon amongst patients with HF. This represents a continuous burden for patients, their relatives and the health-care system. The overall aim of this research is to develop an in-depth understanding of the issue of medication adherence among patients with HF in Nigeria by integrating the perspectives of both the patients and the healthcare providers. Methods Firstly, a review of empirical literature/qualitative meta-synthesis was conducted to explore the facilitators and barriers to adherence in heart failure. Secondly, a qualitative method by the means of in-depth, semi-structured interviews was utilised in exploring the perspectives of the patients, alongside their caregivers and their healthcare professionals regarding the factors they perceive are barriers and facilitators of medication adherence. The lived experience of patients living with HF was also explored. The results of which are discussed in two chapters. By the means of purposive sampling, a total of 65 participants (45 patients alongside their caregivers and 20 healthcare professionals) who met the inclusion criteria participated in this study. The interviews were recorded, transcribed verbatim and analysed by thematic content analysis. Results The rate of medication adherence was suboptimal (33%). The main barriers identified by the patients and their healthcare professionals include financial constraints, influence of religious beliefs, and culture, patients’ attitude and behaviour towards their medications, knowledge deficit, forgetfulness, interaction with the healthcare system among others. Experiencing side effects was a barrier identified by the patients but not the healthcare professionals. The key facilitators of medication adherence identified were forming a routine, support from family and friends, health education and counselling, and insight about the condition, medications prescribed and the repercussion of medication nonadherence. The strategies to improve medication adherence were also identified. Conclusion This study provides clear evidence that the factors influencing medication adherence are multiple and interrelated. As the barriers of medication adherence are multiple, solutions/ interventions to improve adherence should be holistic, multifaceted, and patient-centered in order to be effective.
  • The European survey of probation staff’s knowledge of, and attitudes to, mental illness

    Brooker, Charlie; Tocque, Karen; University of London; University of Chester (SAGE Publications, 2023-03-01)
    There is a high prevalence of mental health disorders on probation staffs' caseloads. Approximately 40% of all clients will have a mental health disorder often compounded by drug or alcohol problems. It is therefore important that a probation officer can recognise mental illness and refer to the appropriate local agency. It is therefore important to know how much probation staff understand about mental illness. The Mental Health Literacy Scale (MHLS) was distributed to probation staff in all countries registered as members of the Confederation of Europe. In this paper, overall average scores for the MHLS for each country are presented. Factors which help to explain the variation in scores are also examined such a caseload size and gender of staff member. The results are discussed within the context of a possible European curriculum for probation training. Probation (CEP) organisation.
  • Cucumeropsis mannii seed oil ameliorates Bisphenol‐A‐induced adipokines dysfunctions and dyslipidemia

    Aja, Patrick M.; Chiadikaobi, Chukwu D.; Agu, Peter C.; Ale, Boniface A.; Ani, Onyedika G.; Ekpono, Ezebuilo U.; Ogwoni, Hilary A.; Awoke, Joshua N.; Ogbu, Patience N.; Aja, Lucy; et al. (Wiley Open Access, 2023-02-18)
    This study demonstrated the therapeutic potentials of Cucumeropsis mannii seed oil (CMSO) capable of alleviating BPA‐induced dyslipidemia and adipokine dysfunction. In this study, we evaluated the effects of CMSO on adipokine dysfunctions and dyslipidemia in bisphenol‐A (BPA)‐induced male Wistar rats. Six‐week‐old 36 albino rats of 100–200 g weight were assigned randomly to six groups, which received varied doses of BPA and/or CMSO. The administration of BPA and CMSO was done at the same time for 42 days by oral intubation. The adipokine levels and lipid profile were measured in adipose tissue and plasma using standard methods. BPA induced significant (p < .05) increases in triglycerides, cholesterol, leptin, LDL‐C, and atherogenic and coronary risk indices in adipose tissue and plasma, as well as a decrease in adiponectin and HDL‐C levels in Group II animals. BPA administration significantly (p < .05) elevated Leptin levels and reduced adiponectin levels. BPA plus CMSO reduced triglycerides, cholesterol, leptin, LDL‐C, and atherogenic and coronary risk indices while increasing adiponectin levels and HDL‐C in adipose tissue and plasma (p < .05). The results showed that BPA exposure increased adipose tissue as well as serum levels of the atherogenic index, triglycerides, cholesterol, coronary risk index, LDL‐C, leptin, and body weight with decreased adiponectin levels and HDL‐C. Treatment with CMSO reduced the toxicities caused by BPA in rats by modulating the body weight, adiponectin/leptin levels, and lipid profiles in serum and adipose tissue. This study has shown that CMSO ameliorates BPA‐induced dyslipidemia and adipokine dysfunctions. We suggest for further clinical trial to establish the clinical applications.
  • Bowel cancer knowledge gaps evident among Irish residents: results of a national questionnaire survey

    Flynn, Laura; Fallows, Stephen; University of Chester (Springer, 2023-01-19)
    Background: The extent of knowledge of bowel cancer, its symptoms and risk factors are unknown in Irish residents. An understanding of bowel cancer awareness may be useful in aiding healthcare professionals, and policy makers develop improved bowel cancer awareness programmes and public health initiatives in Ireland. Aims and methods: A 22-question online questionnaire survey was designed to gather data to assess residents' awareness of bowel cancer, its symptoms, and risk factors and to determine reasons for not participating in BowelScreen Ireland. Results: There were 449 participants (329 women, 119 men and 1 'prefer not to say'). The majority of participants were aged 35-49 years (42.8%), and 82.6% had completed a third level qualification. Irish residents (non-healthcare professionals/scientists (NHCP/S)) recalled on average less than three warning signs/symptoms. Among NHCP/S the most well-recalled protective diet and lifestyle choices were active lifestyle/exercise (62.1%), a fibre rich diet (45.4%) and no/low alcohol consumption (32.1%). Many were unable to recall red and processed meat as risk factors with only 10.7% and 4.9%, respectively, citing these foods. However, prompted awareness was superior with 71.1% agreeing or strongly agreeing that consumption of red and processed meat is a risk factor. 43.4% said they would be 'fairly confident' in recognising a sign/symptom, but more than a third (38.7%) reported they were 'not very confident'. Conclusion: This survey emphasises the need to improve the awareness of bowel cancer as gaps in this specific cancer knowledge were evident among Irish residents. Keywords: Awareness; Colorectal cancer; Help-seeking; Prevention.
  • Exploring the interplay between fat talk, social media use and body image among young women: New opportunities for health education?

    Kennedy, Lynne; Preston, Grace; Kenny, Ursula A.; Zayed University; University of Chester (SAGE Publications, 2023-01-11)
    Background: ‘Fat Talk’, or the act of negatively discussing one’s own or another person’s body, is linked to body image constructs, body dissatisfaction, low self-esteem and disordered eating. The spaces in which young women talk about the body are changing, as social media use escalates. Understanding the interplay between social media use, body image and fat talk, in different contexts, is needed. Method: Focus group interviews were used to explore how young women (aged 15–19) experience fat talk while using social media and the possible effect on body image constructs. Using purposive convenience sampling, young women who regularly used social media and were living in an inner city of England were recruited. Thematic analysis was used for analysis and six themes were identified, both a priori and inductively, to explore the interplay between them. Findings: Over 35 women were successfully recruited into the study, with 18 of these finally participating in focus group interviews. Among participants, social media use was linked to increased self-evaluation of the body, engagement in social comparative behaviour and negative self-talk about the body. Although fat talk was reportedly common and widespread, it was unacceptable in the online space. However, body talk, other than size or shape, was permissible. Conclusion: Fat talk can be divisive; however, if it becomes unacceptable in the online space, negative self-talk may increase. If fat talk is replaced by an all-encompassing ‘body talk’, then this too may exacerbate existing pressures on young people and their mental health and well-being. Understanding the relationship between social media, body dissatisfaction and body talk may provide new opportunities for health education to promote a more constructive prevention discourse of the body, including body talk, in or around the online space.

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