Public Health Institute Journal (LJMU)
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Systematic review of Adverse Childhood Experiences (ACEs) and their association with later life substance use in prisoner populations in high-income countries
No full textBackground: Studies are ever more recognising the relationships Adverse Childhood Experiences (ACEs) and adult health risk behaviours, physical and mental health, and social determinants of health. ACEs and their association to Alcohol Use Disorder (AUD) and Substance Misuse Disorder (SUD) in later life has been recognised internationally as a key public health concern. While children and adults with experiences of ACEs are more prone than the general population to interact with the criminal justice system, as victims, witnesses and/or perpetrators of crime. This considered, within the UK, more than a third of individuals serving a custodial are imprisoned for drug-related crimes, and around 15% of prisoners are testing positive to random drug tests (Black, 2020). A review of reoffending found that one-quarter of individuals released returned to prison within 3 years for violations that included testing positive for drug use (Chandler et al., 2009). A theoretically significant related factor is ACEs. Often trauma paves the way for SUD (Khantzian, 1985) and SUD has also been related to rates of re-offending. However, relatively few studies have explored the prevalence of ACEs in prisoners with AUD and SUD. Existing studies of this topic have primarily been conducted with non-incarcerated populations. Given that ACEs have been associated to violent offending and SUD to general offending, understanding the effects of ACEs within forensic settings is exceptionally important this understanding may make way for more inclusive assessment of prisoner need and treatment planning. This study intended to obtain insight of the prevalence and associations of ACEs in this population.
Methods: A systematic review was conducted to search for studies covering the topic of ACEs in prisoners with AUD and SUD. A search strategy was developed, and several databases were searched using specific search terms and inclusion criteria. The review was guided by the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines.
Results: A total of 437 studies were identified through the search strategy and 12 where included into the study. While only 5 of the studies assessed AUD, all of these studies found a positive relationship between ACEs and AUD. Meanwhile, all studies assessed SUD and 9 of the studies found a positive correlation between ACEs and SUD in prisoners.
Conclusion: ACEs serve as an immense predictor of later life health and social conditions of daily life. Prisoners are a vulnerable population for both experiencing and developing AUD and SUD. There is a gap in literature about this issue and more primary research is needed to inform public health about the actual burden of ACEs in prisoner populations and the most effective ways to treat AUD and SUD within these groups.
 
A quantitative study exploring the knowledge, attitudes and experiences of drink spiking: Public Health Dissertation Prize Winner
No full textBackground: Drink spiking is the administration of alcohol or drugs into another person’s drink without their knowledge and/or consent. Although drink spiking is not a new phenomenon, recent years have seen an increase in both incidence and number of reported crimes. Despite the potential for serious harm as a result of drink spiking, there are currently no accurate estimates of drink spiking prevalence within the UK, and therefore, the true scope and extent of the public health problem remains widely unknown. This prevents policymakers from developing policies and practice related to the reduction of drink spiking prevalence and subsequent harms. This study aimed to explore the knowledge, attitudes, and experiences of drink spiking among those aged 18 over who reside in the UK.
Methods: This study was approved by the Research Ethics Committee at Liverpool John Moores University. A descriptive cross-sectional study was conducted using an online self-administered questionnaire, distributed to individuals through social media platforms. The survey covered questions based around participant’s demographics, their knowledge of drink spiking, their attitudes towards drink spiking, their awareness of existing interventions and their experiences of drink spiking. Participants were recruited utilising a convenience sampling method. A total of 163 individuals participated in the study. Quantitative analyses were undertaken in SPSS using descriptive statistics.
Results: Data analysis revealed that although the majority of participants had a good understanding of drink spiking and the legal framework which surrounds it, 42.0% of participants (n=68) lacked knowledge of what constitutes drink spiking. The study found that approximately one in 10 participants (11.2%; n=18) believe that drink spiking is a normal part of a night out and is to be expected and 8.7% (n=14) believe drink spiking only occurs to women. The majority of participants were aware of existing interventions aiming to protect individuals against drink spiking, however 82.5% (n=132) believed additional measures could be taken to protect individuals against the harms of drink spiking when on a night out. The study concluded that participants reported higher experiences of drink spiking with drugs (33.3%; n=54) compared to alcohol (27.8%; n=45). There was no significant relationship discovered between age or gender for experiences of drink spiking with alcohol. However, the study highlighted statistically significant differences in both gender (p<0.001) and age (p=0.009) for experiences of drink spiking with drugs, with almost half of females (45.9%) and 63.3% of participants aged 18-21 being spiked with drugs. This suggests that females and individuals aged 18-21 years are at elevated risk of drink spiking victimisation.
Conclusion: Overall, this study provided an overview of the current knowledge, attitudes, and experiences of drink spiking within the UK. It has highlighted the need for further research in all aspects of drink spiking to enable effective responses to the rising prevalence. To help respond to and reduce drink spiking incidence in the UK, there is a need for increased education and awareness of drink spiking, increased training of bar and venue staff and the development of interventions which focus primarily upon diminishing perpetration
An exploration of individual level predictors of cannabis policy preferences in the UK
No full textBackground: Internationally, laws and regulations controlling the sale and use of cannabis are changing. A range of outcomes would impact upon population health should the UK government decide to change current cannabis policy. Public and political discussion often oversimplifies legalisation of cannabis into a binary choice between prohibition and a free market, yet there are a range of possible options. Public support has a crucial role in a policy’s success, but the underlying factors determining support for cannabis policy have yet to be explored. This study aims to explore and identify factors influencing cannabis policy support at an individual level.
Methods: UK adults were recruited through convenience sampling, n=373 completed an online questionnaire examining cannabis policy support in relation to participant characteristics, demographics, cannabis use behaviours, acceptability of health policies that restrict choice and perception of government responsibility over cannabis related harms. Principle component analysis (PCA) was used to reduce policy statements into three underlying dimensions (purchasing, price and permitted activities; marketing and availability; information, treatment and harm reduction). Multiple linear regression analysis was undertaken to explore factors predicting support for these three dimensions using SPSS.
Results: Being female, younger, having a degree and holding a belief that the government should do more to tackle harms caused by cannabis were associated with higher levels of support for all policy dimensions. Policies restricting choice, price and availability were largely supported by individuals who support restrictive health policies generally. Participants scoring highly on a Cannabis Abuse Screening Test predicted lack of support for any proposed policy change. A range of demographic variables were associated with support for polices aimed at harm reduction.
Conclusion: While policy decisions may be informed by evidence of their effectiveness and cost of implementation, public acceptability plays a greater role. Understanding patterns of support for cannabis policy and the range of preferences held within the population can be used to inform future drug policy in a way that is both acceptable to the public and minimises potential harm. This study is novel and the first to explore factors determining support for cannabis policy in the UK
A survey study investigating attitudes and perceptions of consumers towards food pollution affecting food purchasing practices or other lifestyle choices
No full textFood polluted by chemical contaminants is a serious public and environmental health concern. Consumer attitudes to food pollution and how this affects food purchasing practices or other lifestyle choices is dependent upon their knowledge of what food pollution is, and their concern about the risks that food pollution poses to health. The aim of the research was to explore attitudes and perceptions of consumers towards food pollution, specifically chemical contamination of food affecting food purchasing practices or other lifestyle choices. The researcher did not address other food safety hazards such as microbial contamination of foods. The method used was an anonymous questionnaire which comprised 32 questions and followed a logical, structured approach to measure perceptions, attitudes, and behaviours, centred around the areas of demographics, knowledge, attitudes, and practice. The population surveyed was ‘consumers’ and the inclusion criteria for participation in the study was that they must be aged 18 or over. The research study used convenience sampling as the data collection method. The questionnaire was distributed to open social media platforms: Twitter and LinkedIn, using various hashtags to access participants. This non-probability sampling allowed participants to self-select, based on availability and willingness to take part, and allowed for wide and inclusive coverage to obtaincomprehensive data. Data collected from the questionnaire included demographics of the participants, their knowledge and attitudes towards food pollution and their practices in terms of food purchasing and other lifestyle choices. This data was analysed, and the findings revealed: most consumers, but not all, are knowledgeable about the different chemical contaminants that may be present in food; the sources of food pollution; the types of food that could be at risk of being polluted (identifying fish, seafood, and vegetables to be most at risk of containing contaminants); the different pathways that could introduce pollution into food, both during primary and secondary food production; and the populations most at risk from consuming polluted food, for example, pregnant women, babies and the elderly; the attitudes of consumers regarding food pollution is one of concern. In particular, consumers are ‘very concerned’ or ‘concerned’ about consuming food contaminated with pollutants such as microplastics, agrochemicals, and heavy metals; and are ‘very concerned’ or ‘concerned’ about the transmission and concentration of such pollutants through the food chain; and that, despite this knowledge of food pollution and these attitudes towards it, the practices of consumers when it comes to food purchasing and other lifestyle choices was varied. Previous studies have considered consumer attitudes towards food pollution, and these prior studies called for further research and investigation into consumer knowledge and food purchasing practices. This research adopted a quantitative approach using a survey design, to collect and analyse anonymous data to add to the research base in this area of food pollution. As a consequence of the findings, a number of recommendations have been proposed to inform future initiatives to prevent food pollution; inform initiatives toinfluence consumer purchasing practices and other lifestyle choices to prevent food pollution and/or limit the consumption of food contaminated by pollution
An exploration of the environmental impact of single-use menstrual management products
No full textInnovative options for menstrual management have the potential to greatly reduce solid waste and aid in a healthier and cleaner environment. As a significantly used group of products, menstrual management products make up a mass amount of waste produced. However, there are a variety of management options that have the potential to reduce waste impacts if they replace conventional methods. Religion and cultural beliefs have an impact on how people perceive menstruation and restrict menstruators. Stigmas around menstruation in society that were formed as long ago as 77AD present menstruation negatively using verbs such as dirty, unclean, and shameful. Inadequate education and taboos around menstruation have enabled menstrual silence. Single-use menstrual management products such as disposable sanitary pads and tampons are the most impactful on the environment. Sanitary pads were the most impactful product, with the damage to the environment taking place from the first step of production to the end of life. The bleaching process that occurs to make the absorbency layer appear white, releases toxins such as carcinogens into the environment. The environment is then further at risk from physical pollution if single-use sanitary pads are placed into landfill or carcinogens being released while products are thermally treated
Exploring higher education student sex work and current interventions: A scoping review
No full textBackground: Student involvement in the sex industry is growing in popularity, yet universities are lacking in policies and support to protect those involved. This review aims to systematically explore the existing literature that looks at student sex workers, the key topics that surround them and the responses of higher education institutions
Methods: A scoping review was carried out between January 2022 and August 2022 to explore what is known about student sex work and the higher education policies to support those involved in the industry. A comprehensive search of four key databases using predefined search terms was carried out to identify available literature. All relevant studies were identified using the predetermined inclusion and exclusion criteria. Data extracted from these studies included author, year and study aims. A combination of tables and thematic analysis were used to map out the data extracted from the available literature.
Results: Twenty-eight studies were identified as being potentially relevant to this review, after removal of duplicates and screening of abstracts and full texts against the inclusion and exclusion criteria, as well as grey literature and citation searching, 22 studies were included in the review. Ten key themes were identified: types of student sex work, motivators for engaging in student sex work, student sex workers’ experiences in industry, student earnings in the sex industry, risks of student sex work, risky behaviours associated with student sex work, effects of student sex work on mental health, attitudes and awareness towards the student sex industry, career development, and institutional policies on student sex work.
Conclusion: This review finds that student sex workers are primarily motivated to enter the industry for financial gain, and that students experiences in the sex industry differs from person to person. Students in the sex industry are more likely to engage in health harming behaviours as well as being predisposed to risks such as violence, sexually transmitted infections (STIs) and poor mental health. Despite this, there are a lack of university policies and support which are tailored to the needs of individual student sex workers. Several gaps in the literature have been identified as well as a number of recommendations for support
Exploring LJMU students’ intentions for future lockdowns due to COVID-19 (What they say and what they would do)
No full textBackground: The COVID-19 pandemic impacted on the way we lived with specific laws and regulations which needed be observed. Given the ongoing risks of the coronavirus, there is still potential for future lockdowns, however little is known about attitudes and intentions towards this. This study explored Liverpool John Moores University (LJMU) students’ attitudes towards previous lockdown and restrictions, their attitudes towards future lockdown and restrictions and finally to assess student compliance with lockdown rules and regulations.
Methods: A quantitative descriptive cross-sectional study was conducted with students from the Faculty of Health, LJMU. A 25 item self-administered online survey was created which ask participants for 1) demographic data, items and 2) attitudes towards previous COVID-19 pandemic and potential future pandemics. Ethical approval was obtained from the LJMU Research Ethics Committee. The survey was shared with students via email and through posters with a QR code which were displayed in university premises. The collected responses were entered into Microsoft Excel, coded and exported to SPSS 25. Descriptive data statistics were utilised to show frequencies and percentages.
Results: The study sample consisted of 41 participants, of these 65.9% were female and the majority of students were enrolled on the MSc in Public Health (75.6%). The majority of the participants (68.3%) had been infected with COVID-19 at least once. The highest proportion of student felt that the COVID-19 pandemic was ‘a little in the past’ (34.1%) with 29.3% feeling that COVID-19 was still happening. Over a third (36.6%) of participants felt agreed that ending COVID-19 restrictions in the future would carry benefits, with 61.0% of participants stating that any future lockdowns would affect their daily activities. Less than four in ten participants (39.0%) strongly agreed that they complied with all COVID-19 restrictions during the pandemic.
Conclusion: Overall LJMU students saw COVID-19 restrictions as a past event. Whilst attitude differences were noted between males and females participants, it should be noted that this study had a small sample size. Concerning intentions related to the future pandemics, university students stated that they wished to end current COVID-19 pandemic related restrictions. Furthermore, it revealed that future pandemics and associated lockdowns would interrupt their daily activities. If future pandemics or lockdowns were to occur, LJMU should consider their role in providing information sharing strategies, coping mechanisms, and influencing motivations for restriction compliance.  
Childhood amblyopia and, the effect on quality of life: a scoping review
No full textBackground: Amblyopia, often known as lazy eye, is a vision problem brought on by the eye and brain not functioning properly. It causes a seemingly normal eye to have impaired vision. It is the most typical reason for reduced vision in one eye in children and younger people. It is a common condition, and it can affect up to 3-4% of the general population. Early intervention is necessary for infants with amblyopia to prevent permanent visual loss and reduce other potential quality of life issues such as poor educational outcomes.
Methodology: A scoping review was conducted on, relevant articles, searched between 2011 to October 2022 to examine how childhood amblyopia affects the quality of life. The pertinent studies were found based on the stated inclusion and exclusion criteria. I systematically reviewed databases from PMC (US National library of medicine national institutes of health), BMC Health Services Research, Ophthalmology Journal of Biomedical Science and Technology and also from Ophthalmic Epidemiology. The first author, year, and study objectives were the data extracted from pertinent studies. Thematic analysis and tables were used to map out data derived from published works of literature.
Results: The review contained a total of 11 papers. There are 11 quality-of-life issues related to amblyopia found in the studies. Even though Amblyopia normally affects only one eye, it may impair reading speed in normal binocular reading by 20% to 50% and significantly influence educational achievement in children. The effects of amblyopia on HRQoL were specifically connected to how the condition was treated. These include effects on relationships with family members, social interactions, challenges completing everyday tasks, and feelings and behaviour. Some researchers created their own HRQoL measures, whereas others used proxy measures to calculate HRQoL.
Conclusion: This scoping review identifies that childhood Amblyopia can have significant impact on quality of life. When thinking about managing amblyopia, it\u27s important to consider the documented findings of the HRQoL implications. The difficulties noted in the review are explored regarding how HRQoL is measured (treatment compliance vs. proxy measures) and whether HRQoL is viewed from a child\u27s or a parent\u27s perspective.
 
A quantitative study into public perceptions and experiences of hospital food
No full textBackground: It is important to reduce the length of time people stay in hospital for both the patient and the hospital especially in this unprecedented time. Food plays an important part in the healing process, it’s important to eat well in order to heal well. Some types of hospital malnutrition, especially in vulnerable people, has a negative effect on many clinically significant outcomes which increase health expenditure, such as longer stay in hospital, higher risks of infection, wounds taking longer to heal and increasing mortality rate in hospitals. Hospital food is a complex subject with many facets outside of the food itself such as food safety and food chain management. Poor management can of these elements can lead to additional issues for both the patients and government organisations through incidents such as food borne outbreaks. Trying to achieve the ultimate purpose of public health, research will consider if hospital food helps or hinders this process. The aim is to explore public experiences and perceptions (in the UK and Egypt) of hospital food and its role in the healing process.
Methods: The methodology is a quantitative study, collecting data by an online questionnaire posted on social media platforms like Twitter, LinkedIn, and Facebook.
Results: The study concluded that, most of the participants are satisfied by the food offered and its quality. However 82% of respondents reported bringing food from outside the hospitals. Balanced hospital food menus that contain protein, fat, carbohydrate, minerals were perceived to positively impact on participants’ healing process and patient satisfaction. Moreover, 88% that the food they eat is the most important factor in healing.
Conclusion: The researcher recommends that it is possible to re-establish the hospital as a space for communal eating by strategically integrating and enabling hospitality into hospital meal practices. Furthermore, family and friends should have a significant role in this process
What are the motives for controlled drug use in university students, and are they influenced by student experiences at university?
No full textBackground: The levels of which UK university students use substances without the knowledge to do so safely is concerning. The public health consequences of problematic substance use are extensive including the economic cost, mental health issues and risk behaviours. However, there is a gap in the literature regarding the motivations behind these high levels of substance use and whether aspects of the university experience can influence these reasons. The aim of this study is to examine perceived motivations for controlled drug use in UK university students, and to determine if aspects of student experience influence these motivations in order to fill the gap in existing literature.
Methods: Data was collected via convenience sampling using a questionnaire. Of 88 participants who completed the survey, after screening, 67 students were included in analysis. Correlational analyses were used to determine the relationships between the following variables: university experiences and motivations for substance use, motivations for substance use and substances used, and university experiences and substances used. Relationships were deemed statistically significant when p<0.05.
Results: Of the 67 participants, only 10 reported no use of any substances. The most reported substances included alcohol, tobacco, cannabis and cocaine. All perceived motivations were above the scale midpoint of 2.50, with enhancement and social having the highest scores. Correlational analysis showed that while aspects of student experiences had significant influence on motivations for substance use, overall student experiences did not. Furthermore, enhancement motivations had significant relationships with cannabis, tobacco and cocaine and social motivations were linked to cannabis use. However, alcohol was negatively correlated with social, conformity, self-expansion and performance motivations. Finally, the majority of student experiences had no significant influence on students’ illicit drug use.
Conclusion: There is an increasingly high prevalence of substance use within UK universities, as well as a range of perceived motivations for this substance use. However, student experiences may not be as important an influence as previously imagined; future research should aim to discover what may be influencing students’ substance use and their motivations for taking illicit substances. The high level of substance use reported suggests a need for education in universities regarding alcohol, substance use and general health as well as greater promotion of welfare services offered to students
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