University of Kent Open Access Journals
Not a member yet
879 research outputs found
Sort by
Does Ethnicity affect the Rate of Suicide: A Statistical Comparison Analysis using Real Time Suicide Surveillance Data.
Full text linkBackground: Nationally, there is limited data available regarding the link between ethnicity and suicide. This is because ethnicity is not recorded consistently on official death certificates and therefore the potential variations between the rate of ethnicities, and any correlations, are not known or understood. This subject is understudied. This study was both a comparison study, and a feasibility study, using police data from one county in England to bring to light what the effect may be and highlight any evidence surrounding the topic.
Methods: Data from the county’s’ Real Time Suicide Surveillance system (a partnership between the county police and county council) was analysed to examine the proportion of suspected suicides from each ethnic minority. This was compared to the ethnic profile of the county using local census data. The sample was 608 individuals from the county who had died by suicide between 2018-2022, and which included 37 individuals from an ethnic minority. Comparative analysis included demographic details such as age and gender, and wider factors such as whether the individual was known to secondary mental health (MH) services or had been impacted by domestic abuse.
Results: Individuals from ethnic minorities accounted for 10.2% of the suspected suicides in the sample (where ethnicity was recorded), this compares to data from the county census which shows that 16.8% of county citizens are from ethnic minorities. When comparing individuals from ethnic minority communities who died by suicide, with the wider cohort of all suicide deaths in the county, there were several similarities as well as some interesting differences. The mean age of suicide for both the general population of the county and those of ethnic minorities are remarkably similar at 46.64 years and 46.43 years, respectively. In both groups there were more male suicides than female, however women made up 35% of deaths within the ethnic minority cohort compared to 25% within the overall population of suicides. Individuals within ethnic minorities were more likely to be known by MH services than the non-minority population (41% compared to 27%).
Conclusions: This project has been a successful comparative feasibility study; it has demonstrated that it is possible to compare the proportion and characteristics of people from ethnic minorities who died by suicide with non-ethnic minority deaths. However, the small sample size and the fact that there were 245 entries where the ethnicity was not recorded in the data means that the results are inconclusive and cannot be considered reliable. Although no clear deductions or recommendations can be issued, other valuable insights regarding factors such as a higher proportion of female deaths, and an increased likelihood to be known to mental health services, have been identified which should be considered for examination in future research projects
REVIEW ESSAY: William “Spirit” Knifeman: The postindian warrior of survivance in Reservation Dogs
Full text linkSterlin Harjo and Taika Waititi’s hit television show Reservation Dogs (2021-2023) has revolutionised Indigenous representation in the mainstream. This review discusses the role of the character William “Spirit” Knifeman (Dallas Goldtooth) as the embodiment of what Gerald Vizenor describes as a postindian warrior. Knifeman allows the screenwriters of Reservation Dogs to employ a blend of trickster storytelling, humour, and subversion to create a sense of survivance within the show. These narratives of survivance help shatter the mass-mediated figure of the imagined indian and are shown to provide a sense of healing to both individuals and their wider communities
Non-pharmacological interventions to tackle delirium in elderly hospitalised patients? A scoping review.
Full text linkBackground: Delirium is an acute neuropsychiatric syndrome that is characterised by fluctuations in attention, awareness and cognition. Delirium has a high prevalence within hospitals and is associated with increased morbidity and mortality. This incurs substantial healthcare associated costs and often prolongs the duration of hospital admissions, placing strain on the patient and their family and impacting upon the availability of hospital resources, a widespread issue across numerous hospital trusts.
Methods: A scoping review was conducted of literature exploring the current knowledge base of non- pharmacological interventions for the prevention of delirium and their efficacy using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Sources were subject to thematic analysis.
Results: Four hundred and thirty-nine articles were identified through a database search on APA PsycINFO, Embase, Medline and PubMed. A total of fifteen papers were included in the final synthesis. Thematic analysis identified five major themes, including intervention type, efficacy, staff adherence and education, cost efficacy and requirements for prospective research.
Conclusions: Overall, multicomponent interventions were evidenced to be effective at preventing delirium. Adherence across protocols was good and staff education was prioritised. While the field of delirium prevention lacks an abundance of high-quality experimental evidence, recent literature has begun to address the gaps in knowledge. However, further research is vital to comprehensively assess the efficacy of these interventions and expand the knowledge base of delirium prevention. Promisingly, the rising number of prospective clinical trials suggests great potential for future research in the field
An exploration of difference in acute energy expenditure and acute mental well-being when using an E-scooter compared to walking in healthy adults. A Research Project
Full text linkBackground: This study investigates the difference in acute energy expenditure (EE) for e-scooter use compared to walking, to estimate the effects e-scooter use may have on physical activity (PA) output and how this may link to wider aspects of physical health; as well as mental well-being.
Methods: Twenty healthy adult participants were recruited to take part in a pilot randomised controlled crossover trial. This quantitative exploratory laboratory study, utilised online gas analysis to measure gas exchange under two conditions (e-scooter use and walking), to demonstrate the effects on EE. A Subjective Exercise Experience Scale (SEES) was implemented to measure mental state post both conditions (e-scooter use and walking), to understand the effects of e-scooter use on mental well-being. The data on gas exchange was analysed using a One-way repeated measures ANOVA, and data from the SEES was analysed using a paired samples t-test. For both methods of analysis, a p value of 0.05 or less was considered significant.
Results: Results showed that mean Oxygen consumption (VO2) and Carbon dioxide production (VCO2) were significantly higher for walking (0.97 ml/kg/min and 0.82 ml/kg/min, respectively) compared to e-scoter use(0.4 ml/kg/min and 0.33 ml/kg/min). Likewise mean Metabolic equivalent of Tasks (METs) was significantly greater for walking (3.89 METs) compared to e-scooter use (1.6 METs). Lastly psychological factors for meanpositive well- being (PWB), psychological distress (PD) and mental fatigue were comparable for e- scooter use and walking, as statistical analysis revealed no significant difference between both conditions.
Conclusions: The study concludes that e-scooter use has significantly lower levels of EE compared to walking, and through sustained and repeated e-scooter use PA output may decrease as a result, consequently increasing the risk of poor physical health; further straining public health funding. In contrast the study concluded e-scooter use does not affect user mental well-being in comparison to walking, and thus would not increase the incidence of poor mental well-being. Nonetheless, further research is required to improve data validity and generalizability
The relationship between Chronic Traumatic Encephalopathy (CTE) and contact sport- a scoping review
Full text linkBackground: Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease characterised by the accumulation of abnormal tau proteins leading to progressive neuronal destruction different to that of Alzheimer’s disease or any other tauopathy (Mckee et al., 2023). CTE is currently a pathological diagnosis following post-mortem brain examination. Such a diagnosis is usually associated with lifetime symptoms relating to cognition, memory behaviour and mood (Montenigro et al., 2014). CTE has been well documented within the contact sports population suggesting some kind of underlying causal link but with noproven reason as to why (Maroon et al., 2005). This report set out to investigate the link between contact sports and the onset of CTE through a scoping review.
Methods: The scoping review was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) framework. This included the following aspects: development of research question, comprehensive search of the literature, data extrapolation, data analysis, data synthesis anddiscussion. Search strings were created to conduct a literature search which yielded a number of studies of which 5 were selected to be analysed in depth. This selection was based on relatability to the question and also inclusion and exclusion criteria. Data extrapolation was done using the Braun and Clarke method (Braun and Clarke, 2006) and the data was synthesised using a critical appraisal skills programme (Critical Appraisal Skills Programme, 2022).
Results: The data showed a causal link between repetitive traumatic brain injury and CTE pathology (McKee et al., 2013) (Nowinski et al., 2022). The data also showed the severity of brain injury was directly proportional to the pathological effects seen post-mortem (Viano et al, 2005) (Montenigro et al., 2015). Further studies found an association between the allele ApoE4 and risk of CTE onset (Casson et al., 2014). It should be said however that the studies included in this review suffered from a number of limitationsincluding small sample sizes, ascertainment bias, subjective definitions of CTE, short time frame and contradicting data.
Conclusions: It appears that the commonality of CTE in contact sports athletes is due to the heightened frequency of traumatic brain injury. It also appears that the severity of the condition, both clinically and pathologically, is increased with more repeated trauma and also more severe trauma. Genetic predisposition, particularly the ApoE4 gene, appears to also contribute to onset and severity and providessome explanation for why not all athletes exposed to equal brain trauma develop CTE. There is potential for application to both clinical and public medicine. Clinicians can be more aware of the effects of repetitive brain injury and seek to manage it early, thus reducing devastating psychological consequences as in the case of ex NFL footballer Aaron Hernandez who tragically took his own life (Kilgore, 2017). Public health bodies and sports regulators can also implement and adapt rules to help reduce the frequency of head injuries in contact sports, thus reducing both short time and long-term pathological consequences
Materialism, Sex Work, and the Law: Doing Feminist Legal Theory Differently
Full text linkThis article places texts from Marxist feminist scholar Silvia Federici and feminist legal and post-Marxist scholar Catharine MacKinnon in conversation with each other. In doing so, it responds to Clare Hemmings’s call for feminist scholars to do feminist theory differently by breaking free from staid tropes and narrative devices through which feminism has been historicised. Starting from a commitment to the rejuvenation of materialist feminist theory and my belief that it could play a bigger role in feminist legal scholarship, I juxtapose texts from Federici and MacKinnon, reading for continuities and links rather than discontinuities and breaks. What is revealed is a ‘scaled-up’ materialist methodology and politics that connects the real essence of capitalism and sexual domination to the phenomenal appearances of capitalism and sexuality. Both Federici and MacKinnon understand liberal law as part of domination’s real essence and a phenomenal appearance distorting this reality. They centre women’s consciousness on creating a class/sex for themselves and view law as a possible site for raising consciousness of the real essence of women’s oppression. I end by reflecting on the difference that this reading of Federici and MacKinnon might make in contemporary legal research about sex work
Exploring the metabolic adverse effects induced by Nilotinib in adult patients diagnosed with Chronic Myeloid Leukaemia – A Scoping Review
Full text linkBackground: Chronic myeloid leukaemia (CML), characterised by the BCR-ABL1 gene mutation, is a myeloproliferative condition primarily managed with tyrosine kinase inhibitors (TKIs), such as 2nd generation Nilotinib. However, the wide range of therapies available, alongside the generally favourable outcomes, may lead to the misconception that CML is a straightforward disease to manage. This attitude can expose high-risk patients to delayed treatment responses, insufficient attention to toxicity concerns and poor outcomes. Thus, a scoping review was conducted to address these concerns, particularly the metabolic safety profile of Nilotinib.
Methods: This review utilised the PRISMA Extension for Scoping Review (PRISMA-ScR) checklist as a foundation for research. A systematic literature search was conducted across multiple databases, and these studies were inputted into Rayyan software. Fifteen studies met the inclusion criteria following a comprehensive review process and data were synthesised through thematic analysis. The papers consisted primarily of observational cohort studies, however there was also 1 randomised controlled trial (RCT) and 1 case report.
Results: All the studies observed adverse Nilotinib-induced metabolic changes, and most commented on the long-term cardiovascular implications of these adverse effects. One of the most prevalent adverse effects was hyperglycaemia; according to several studies, up to 11% of patients experienced grade 3/4 hyperglycaemic episodes and elevated fasting glucose levels. Significant rises in HbA1c, however, were rare. Within three to six months of starting medication, lipid abnormalities such as increased LDL, HDL, and total cholesterol were noted, indicating the necessity of proactive lipid monitoring. Although no clear connection to pancreatitis was found, elevated pancreatic enzymes were also reported. Cardiovascular implications, including increased risk of diabetes, dyslipidaemia, and peripheral arterial disease, were evident, with higher cumulative CV events in patients on prolonged Nilotinib therapy, particularly at higher doses.
Conclusions: Findings highlight the need for robust cardiovascular risk assessment and careful monitoring of Nilotinib's metabolic effects to reduce long-term risks
The Right to Belong: Citizenship and the Crisis of Internal Displacement Among Iraq’s Assyrians & Chaldeans
Full text linkBy critically examining the relationship between citizenship, legal recognition, and internal displacement, this dissertation focuses on the Assyrian people (inclusive of Chaldeans and Syriacs) in Iraq. Following the rise of ISIS between 2014 and 2017, this paper explores how Assyrians, despite holding Iraqi citizenship, were and continue to be, systematically displaced internally and denied effective protection. Drawing on Hannah Arendt’s concept of “the right to have rights” and Jürgen Habermas’ theory of juridification and communicative power, this article argues that formal legal status of citizenship alone is insufficient to guarantee political inclusion or access to rights, particularly in the context of internal displacement. While the Iraqi Constitution and international frameworks such as the UN Guiding Principles on Internal Displacement recognise minority rights and the protections owed to internally displaced persons (IDPs), these recognitions have not been meaningfully implemented. A significant gap is revealed between Iraq’s legal commitments and the lived experiences of internally displaced Assyrians, particularly regarding property restitution, return support, security, and political participation. Using a critical legal approach, it demonstrates that the Iraqi state’s response to internal displacement has remained largely symbolic, failing to adequately protect and restore the rights of its minority indigenous populations. Conclusively, a more substantive approach to legal recognition, integrating minority voices and addressing structural barriers to reintegration, is necessary to facilitate a safe and dignified return for displaced Assyrians to their ancestral homelands. This dissertation contributes to the broader discourse on displacement, legal citizenship, and the limits of state protection in post-conflict societies
Rectal Cancer Treatment and its Effect on Quality of Life - A Systematic Review
Full text linkBackground: Colorectal cancers (CRC) are the 4th commonest cancer in the UK, with approximately a third affecting the rectum. The management of rectal cancer is dependent on the stage and grade of the disease and may involve a combination of medical and surgical interventions such as radiotherapy, chemotherapy and surgical excision. Immunotherapy in rectal cancer management is relatively novel and could play an important role in combination therapies. This systematic review evaluated the different rectal cancer treatments and their effects on quality of life (QOL).
Methods: For this systematic review, a mixed approach using both quantitative and qualitative research was adopted, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. The databases used to search for the literature included Scopus AI, MEDLINE, EMBASE and PubMed.
Eligibility criteria included articles published in the last 5 years, journals with an impact factor >3 that were peer-reviewed, available in the English language with study participants aged 18 years or older. The identified literature was then checked for duplicates using Zotero before being quality assessed, with risk of bias also quantified.
Results: Out of 657 articles identified using the defined search criteria, a total of 14 papers were included in this review. This consisted of 6 RCTs, 5 cohort studies, 1 questionnaire study, 1 phase II study and 1 cross-sectional study. The differences between the short and long-term consequences of treatment were modality dependent. For example, fatigue and nausea were more common in those who had chemotherapy, and the symptoms of radiation proctitis, such as bleeding, were more common in those who had neoadjuvant radiation therapy. The surgical preference for many patients was sphincter preservation surgery, which had benefits such as being able to return to normal bowel functioning without a stoma. However, some patients had better outcomes with a long-term stoma, including reduced rates of low anterior resection syndrome, such as faecal incontinence. The published literature had little information on the psychological impact of the physical symptoms and their effects on the well-being of patients.
Conclusions: This review highlighted the impact of rectal cancer treatments, demonstrating the breadth of information available on the physical consequences, with fatigue and bowel symptoms being prominent. There was, however, a lack of detail around the psychological impacts of rectal cancer treatments, which needs to be addressed. The addition of real-life case scenarios may be useful for informed decision-making by giving patients a better idea of likely outcomes following treatment. The need for psychological support may be implicated in the future management of rectal cancers
Access Repository Dashboard
Do you manage University of Kent Open Access Journals? Access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard!