Public Health Institute Journal (LJMU)
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Tales of compassion and grief: A qualitative study of peer worker experiences in Vancouver, Canada, during the toxic drug supply crisis: Public Health Addictions Dissertation Prize Winner
No full textBackground: The public health emergency linked to illicit drug deaths was declared in 2016 in British Columbia (BC), Canada. Since that date, more than 10 000 people have lost their lives from overdoses in BC, and public health authorities increased the surveillance and interventions to prevent those deaths. In that context, a community response emerged, and people with lived experience (PWLE) of substance use stepped up to become significant actors in the overdose response strategy. From first responders in the overdose prevention sites to advisors and content specialists for public health bodies, they are at the frontline of a crisis causing thousands of deaths in the last six years. This qualitative study explores the impacts of the toxic drug supply crisis on frontline peer workers in Vancouver, Canada, by analysing their experiences, challenges, and coping mechanisms.
Methods: Data was collected via in-depth, semi-structured online interviews, between April and July 2022, with seven Vancouver frontline peers (3 females, 3 males and 1 two-spirited) working or having recently worked at any level of the overdose response since 2016. Using the inductive theme analysis method described by Braun and Clark (2013), four main themes related to the research question ‘How is the opioid crisis impacting harm reduction peer workers in Vancouver’ were identified.
Results: The overdose crisis created numerous job opportunities for PWLE of substance use in Vancouver, facilitating development of their role in the public health response to the toxic drug supply crisis in Vancouver. Peers got involved in overdose response early on and in an emergency context, emergency linked to the high increase of the number of deaths since 2016. Their work conditions, and the nature of the job, created tremendous challenges, and the risk for burnout was prevalent for most of the peers included in the study, six related mainly to grief and bereavement. Stigma linked to substance use impacted their professional and personal life, and systemic and organisational support is needed to recognise their role and improve their wellbeing. Finally, compassion was identified as the leading motivation for doing the work. PWLE working on the frontline expressed their determination to help their community and people impacted by substance use stigma. They are essential advocates for systemic and policy changes and should be included in policy making.
Conclusion: PWLE are vital actors in the public health response to the toxic drug supply crisis that impacts British Columbia. Their expertise and motivation to do the job are invaluable. They need to be supported by evidence-based interventions as they face trauma linked to grief and precarious work conditions, putting them at high risk of burnout. Participative research should be conducted in these environments to develop innovative solutions to support them and allow them to participate in improving work conditions and substance use related policies
What is the relationship between the mortality rate among hospitalised diabetic patients and COVID-19? A systematic review of quantitative studies
No full textBackground: The global COVID-19 pandemic has significantly contributed to the mortality rate all over the world. Data demonstrates that the people who succumbed to death were often people diagnosed with chronic diseases, particularly diabetes and other underlying risk conditions. Although there are comprehensive studies on COVID-19, there are limited studies examining the relationship between the two COVID-19 and diabetes. Thus, this paper aimed to explore the relationship between the mortality rate among the two diseases, namely COVID-19 and diabetic Mellitus.
Methods: An evidence-based systematic approach has been adopted by analysing quantitatively the five studies based on different countries. These studies were cohort and cross-sectional studies based on observing diabetic and non-diabetic patients in various hospitals and health centres during the pandemic phase. The study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Critical Appraisal Skills Programme (CASP), and Joann Briggs Institute (JBI) instruments for appraising the validity of the selected studies and synthesised via narrative synthesis.
Results: The findings demonstrated a strong relationship between COVID-19 and diabetic patients’ death rate. Moreover, this paper also explained why COVID-19 infection had a fatal impact on diabetic patients, particularly elderly and young participants. It was found that obese diabetic patients, and participants with higher levels of HbA1c, LDH and C-reactive protein, were more affected than other Covid-19 infected patients. Also, this review revealed that HbA1c is equally connected to the mortality rate in diabetic and undiagnosed diabetic people.
Conclusions: The results enhance the concern on the control mechanism of blood glucose levels, LDH and CRP to policymakers and health communities. Also, suggest more research on this area with a larger sample size and control group of diabetic people with HbA1c as an essential element so that the risk of infection is minimised, and the mortality rate is diminished. Additionally, tackling poverty and obesity problems in communities is key to preventing diabetes mellitus
LJMU students’ knowledge, views, attitudes, and understanding of the cultural influence on menopause
No full textBackground: Menopause is a natural transition in women’s lives. Due to drastic hormonal changes, most women go through complicated symptoms, which causes lower quality of life. Accurate knowledge and broader attitudes of the young student regarding menopause is necessary as it is a significant part of women’s reproductive system. Most importantly, accurate knowledge from a younger age will change everybody’s attitudes toward menopause and make them well equipped to manage this menopausal transition effectively and support menopausal women as well. The present study aimed to explore LJMU students’ knowledge, views, attitudes, and understanding of the cultural influence on menopause.
Methods: A descriptive cross-sectional study was conducted using an online questionnaire among LJMU students aged above 18. 46 participants completed the survey. To accomplish the research objectives, the survey covered questions on demographics, knowledge, attitudes on menopause, and understanding of cultural influence. The collected data were analysed by using the statistical software SPSS. This study received ethical approval from LJMU Research Ethics Committee.
Results: The study findings revealed that 37.8% of participants accurately knew the general onset of menopause. At the same time, 51.1% of students knew about menopausal treatment options. Furthermore, most students (79.5%) considered irritability and depressive disorder were the most common symptoms of menopause. The study found that student\u27s average menopausal knowledge mean score in the knowledge section was 6.4 out of 14. Female students showed a 1.9% higher mean knowledge score than male students. In this study, no significant correlation had been found between menopausal knowledge scores and with sex group. No significant association had been identified between menopausal knowledge and age groups as well. However, a considerable association had been found between menopausal condition (chronic/ acute) with age group, which was close to significant value. In the attitude section, the study found that the average attitude score was 28 out of 45. Male student\u27s attitude level was 1.31% higher than female students. No significant association had been determined between menopausal attitudes and the sex group. However, a considerable association had been identified between the menopausal attitude and with age group, which was close to the significant value. The study found a limited understanding of cultural influences on menopause among students.
Conclusion: Overall, this study provided an overview of knowledge, attitudes, and understanding of cultural influences on menopause among the young generation (above 18). The study identified a knowledge gap in menopause among the young generation. A moderate level of attitudes and limited understanding of cultural influence had also been identified here. This study suggests that formal education and broader attitudes towards menopause from a young age will ensure a healthy and quality life for women. 3 Keywords: Menopause, menopausal knowledge, menopausal attitudes, LJMU students, menopausal knowledge in younger generation, cultural influences on menopause
A scoping review focusing on the effect of COVID-19 lockdown and social distancing on the mental health of the UK population
No full textBackground: The recent COVID-19 pandemic caused many international governments to impose restrictions on populations in an attempt to contain the virus. The same occurred in the UK when the Prime Minister announced a national lockdown on the 23rd March 2020 and advised for all to “stay at home”. Following this lockdown measures legally came into force on the 26th March 2020. The uncertainty about the virus and the imposing of this lockdown led to an array of mental health related illnesses amongst the population of the UK. This dissertation paper attempts to collate all the information from previous research and papers to present the impact that the restrictions had on mental health of the UK population.
Methods: The methodology adopted in this dissertation is the scoping review of literature to explore the impact of COVID-19 restrictions on the UK population. This is a research project which has systematically analysed the literature on the topic by identifying key concepts, theories and sources of evidence.
Results: After careful literature review and analysis, it was confirmed that the restrictions imposed upon the UK population did have a direct impact on the mental health of some individuals. Some examples of mental health disorders identified include: depression, loneliness and anxiety. The lockdowns and social restrictions impacted on the UK population as well as the actual effects of the virus and in some cases more so.
Conclusion: In conclusion we can ascertain that any social restrictions on the lives of people in the UK will inevitably affect their mental health. If a sudden change is imposed upon individuals whereby their daily interactions and routines change this will affect their mental wellbeing and we all as individuals rely on our social interactions as a way in which to escape the negative effect of mental health disorders like depression, anxiety, stress and loneliness
A statistical evaluation of attitudes towards COVID-19 vaccines and reasons for vaccine hesitancy among LJMU students
No full textBackground: Vaccine hesitancy is a major challenge in combating the COVID-19 pandemic. University students consist of a significant proportion of the population in almost every city in the UK. Understanding their attitudes toward the Covid-19 vaccine is essential to improve vaccination coverage. This study aimed to explore university students’ attitudes toward the COVID-19 vaccine and to determine factors influencing vaccine acceptance and/or vaccine hesitancy.
Methods: A cross-sectional online survey was conducted (from 8th June 2022 to 9th August 2022) with 31 adult students (aged 18+ years) at Liverpool John Moores University (LJMU), UK. The Oxford COVID-19 vaccine hesitancy scale was used to measure hesitancy to the COVID-19 vaccine. Chi-square, Spearman correlation, Mann Whitney, and Kruskal Wallis tests were used to examine the influence of sociodemographic factors on uncertainty and unwillingness to get vaccinated against COVID-19 including concerns about ineffectiveness, concerns about adverse effects, and concerns about commercial profiting, etc. on negative vaccine attitudes.
Results: Approximately 6.7% of participants showed hesitancy toward vaccination. The mean score of vaccine hesitancy was 9.4 (out of 25) which suggested an overall positive attitude toward the vaccine. There was a significant association between students\u27 age and their uptake of the COVID-19 vaccine. Students between the ages of 30-35 were more likely to be vaccinated. Half (50.0%) of participants reported that side effects from COVID-19 were their greatest concern. The study found a significant relationship between some factors and vaccine hesitancy such as concerns about COVID-19 vaccine ineffectiveness, rapid research and development of the Covid-19 vaccine, preference for natural remedies, and mistrust of ‘big pharma’ profit motive.
Conclusion: The study found an overall positive attitude towards the COVID-19 vaccine among the students at LJMU. Negative attitudes were mostly due to low levels of knowledge and trust in the vaccine. Health education programs need to be implemented to improve hesitant attitudes and build trust in the COVID-19 vaccine
An interview study exploring the impact of social media on Liverpool university students’ feelings and attitudes towards body image
No full textPosting one’s body on social media has become a ubiquitous activity, and previous research suggests the abundance of ideal bodies on social media can lower self-esteem and body satisfaction levels, as well as increase body comparison among those viewing them. Despite the high levels of body dissatisfaction in the United Kingdom (UK), there are very few interventions to help combat this problem. The aim of this qualitative study was to investigate the impact of social media on Liverpool university students’ thoughts and feelings towards body image. Semi-structured interviews with eight students at university in Liverpool were conducted and analysed thematically. Key findings from the study were how and why people compared their bodies to others, what the ideal body looked like for participants, which platform this occurs on mostly and the impact comparisons to ideal bodies on social media has on the participants’ mental health.Both male and female participants felt exposed to ideal bodies online, particularly on Instagram. This was supported through the scroll-back method which evidenced images of ‘attractive’ male and female bodies that participants are exposed to daily. Ideal body types varied with gender and sexuality. Participants felt their exposure to the ideal body caused high levels of social comparison and pressure to self-enhance their own bodies using editing applications, or sometimes even physically, by dieting and exercising. Comparing their bodies caused them to feel distressed, and experience poor mental health. Some students made attempts to reduce their exposure by lowering their social media use and thus had a more positive mental outlook. These results allowed the researcher to come up with recommendations to tackle this public health issue, including educational interventions in schools and universities to help young people foster a positive body image early on in life, improvements with social media algorithms, and building on the current research surrounding gay male’s body standards online and fear of missing out (FOMO) in the context of body image
A quantitative analysis of the air quality of Birkenhead Park
No full textThe primary aim of the study was to explore the levels of Particulate Matter 2.5 within the area of Birkenhead Park and the impacts to health. To enact this, a methodology was developed to carry out an air survey of the park. This involved surveying three separate routes: external, outer and internal, with a Dylos air monitor and the Strava mobile app simultaneously, in order to create an annotated map to determine levels of PM 2.5 within the park. The results of the air survey presented unexpected findings, which revealed that the Internal route of the park had the highest mean concentration of PM 2.5 at 6.92μm3. The external and outer routes measured at 6.27μm3 and 6.37μm3 respectively. PM 2.5 concentrations measured in this study did not differentiate greatly from previous measurements of the area, from a nearby AURN monitor. The study methods were shown to be a novel concept in comparison to other studies investigating air quality, which often collect data from a singular point over a long period. The intricate aspect of the air survey routes in this study allows results to clearly highlight any areas of lower air quality within the air survey area, which would allow more informed actions to remedy areas of concern. Recommendations based upon this study revolve around enhancing the mitigation of PM 2.5. Examples of such recommendations include: improving the durability of road surfaces around urban green spaces to lessen the amount of particle resuspension, introducing a border of coniferous trees to provide a natural barrier from PM 2.5 and improving the durability of certain vehicle parts such as brakes and tyres which can produce PM 2.5 through typical use
A survey study analysing a young adult’s (18-24) knowledge and viewpoints on how social media impacts mental health
No full textA variety of studies have presented mixed opinions on social media’s impact on mental health. Depressive symptoms, poor body image, lowered self-esteem and anxiety have been linked to social media and excessive use, which are of public health concern. On the other hand, social media has been linked with aiding depressive symptoms by increasing connectivity, social security, loneliness and confidence. The aim of this research was to explore the knowledge and understanding of young adults (18- 24 years old), to explore awareness on the positive versus negative health impacts of social media and mental health. This study used a quantitative approach using JISC Online Surveys and gathered 50 respondents in the United Kingdom (UK) to analyse awareness and state of mental health. Research has shown that the population has awareness on the associations between social media and poor mental health. The population felt that social media increases connectivity with others but felt social media was addictive and can lower self-confidence. Most of the population answered questions regarding their state of mental health, suggesting that state of mental health was positive, with few reporting negative feelings. The population understood the importance of managing time spent on social media for mental health, however, some reported ‘withdrawal’ symptoms when not using social media platforms, which is linked to social media addiction
Improbability or impossibility? A qualitative study exploring the stakeholder’s perception of barriers homeless populations face within cancer screening.
No full textBackground: Homeless populations are highly susceptible to cancer yet despite such high-risk cancer profiles, cancer screening uptake amongst them remains poor. Although such low rates are alarming as they may lead to a lack of timely cancer diagnosis and treatment, few studies have sought to understand what may be contributing to a lack of engagement of homeless populations with cancer screening. Despite playing a highly crucial role in the lives of those facing homelessness, stakeholders who provide such individuals with the necessary support have never been included in studies on homelessness and cancer screening. This study addresses this, exploring stakeholders understanding of the lived reality of such groups, and any barriers they may face with cancer screening.
Methods: This study adopted a qualitative research design, which made use of semi-structured interviews with eight participants. For this study, thematic analysis was chosen, and four themes were derived from the interview transcriptions after adopting the six-step coding framework by Braun and Clarke.
Results: Consistent with social-ecological models of health-seeking behaviour amongst homeless populations, this study has found that homeless populations face consistent barriers to cancer screening at the individual, peer, community, institutional and cultural levels. Such barriers were found to transcend beyond a lack of physical resources as they also include latent healthcare seeking patterns, as well as a lack of funds being invested into hospitals and homeless support services, which all come to affect the populations’ ability or willingness to screen for cancer.
Conclusion: This study has concluded that cancer screening barriers often exist or are derived from the wider health and social inequalities homeless populations face, hence, there is a pressing need to address such inequalities in conjunction with addressing the minimisation of cancer screening barriers. This study has also concluded that national screening campaigns have consistently failed to address the difficulties and challenges current screening strategies may pose to homeless populations, and that targeted cancer screening interventions that seek to include those facing homelessness in their design and plans of action are required
Psychological aspects of infertility in men, women and couples: A scoping review
No full textBackground: Infertility is a condition which can affect all aspects of the life of those experiencing it. Aside from the physical impacts of infertility, the emotional and mental well-being of the individual can also be affected. There are several manifestations of the psychological impact of infertility such as depressive and anxiety symptoms. Individuals experiencing infertility therefore need to be considered not just for physical treatment of the medical condition but also evaluation of their psychological wellbeing and therapy if needed. This study will review the available literature and gather knowledge on the psychological aspects of infertility. It will investigating the available evidence on psychological implications of infertility. Exploring the several types of psychological characteristics and how they are reflected in men, women, and couples.
Methods: A scoping review was done to answer the research question and gain knowledge on the available literature on this topic. Seeing that this is a broad topic, involving many psychological characteristics, men, women, and not limited to a particular country, a scoping review was the preferred method of research. In addition, recommendations on further research and health strategies on this topic were important. Therefore, scoping review provided a foundation for such suggestions to be made.
Results: This review included twelve studies, of which eight conducted studies on psychological effect of infertility on individuals, while four studies were conducted in relation to coping strategies employed by individuals experiencing psychological stress from infertility. Differentiated themes of psychological effects were depression, anxiety, self-esteem, stress, and distress. An additional theme for coping strategies was made. There were 2 studies conducted on men, while the remaining studies involving women participants and couples.
Conclusion: In view of the impact infertility has on the individual and their spouses, treatment of the condition should not be limited in its approach. It should be multidisciplinary involving mental health because it is of immense value and thus should be made available for times of need
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