Public Health Institute Journal (LJMU)
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Protecting mental health and well-being after parental loss: a review of the literature on how children and adolescents cope with cancer bereavement: Public Health Dissertation Prize Winner
No full textThe death of a parent to cancer during childhood or adolescence can be a life- altering event that can deeply affect a child or adolescent’s mental health, well-being and development. This dissertation explores how bereaved children (0 to 12 years) or adolescents (13 to 18 years) who experience parental loss process grief, the coping strategies they use, and the long-term impact on their mental health. A scoping search was conducted using the Liverpool John Moores University’s Discover Library, PsycINFO, Web of Science, and CINAHL Ultimate. Search terms followed the population, exposure and outcome (PEO) framework, combining keywords such as “childhood bereavement” and “mental health” with Boolean operators. Of 215 initial records, 26 studies met inclusion criteria after duplicate removal, title and abstract screening, and full-text review. Most studies included focused exclusively on cancer-related parental loss, with data extracted and thematically analysed using a study characteristic table. The findings of this dissertation show that children and adolescents experience grief differently depending on their age. Younger children struggle with death’s permanence, while adolescents experience intense sadness and confusion while navigating independence. Anticipatory grief can provide emotional preparation but also exposes children to traumatic decline. Although family, school and community support help to cope, services in the United Kingdom (UK) remain insufficient, where only 13.8% of hospices offer specific bereavement care. Key recommendations are enhanced pre-bereaved support, cancer-specific bereavement programs, and professional grief training for healthcare professionals
Investigation of carbon monoxide (CO) knowledge and awareness in students studying at university
No full textCarbon monoxide (CO) remains one of the most common forms of poisoning and a massive public health issue, despite being highly preventable. There is a lack of research on students’ knowledge and awareness of CO exposure and poisoning even though they are considered to be one of the most vulnerable groups. This may be because university tends to be the first time a person moves away from home, where they may not need to be as aware of this topic. This study aims to discover what exactly students know about CO exposure and poisoning, where there is a knowledge gap and what variables affects this knowledge, or lack of. An online questionnaire was distributed to students studying at LJMU university via their LJMU email address. The results from this study suggest that although students may have a basic understanding of what CO is, they lack a deeper understanding of how to prevent CO exposure and poisoning, pick up on warning signs and many were aware of just how harmful the effects can have on an individuals’ health and quality of life. This study’s findings were limited as it was a small-scale research study – more participants would have made the results more accurate and allow for generalisability of the student population
A survey study exploring mental health stigma and service utilisation amongst young adults in the UK: Commendation for Significant Achievement
No full textMental health stigma remains a significant barrier preventing young people from accessing the support and services they need. Although public awareness and understanding of mental health have improved in recent years, stigma continues to be a critical issue, particularly among individuals aged 18 to 30. This study aimed to explore the experiences and attitudes of young people toward mental health stigma and examine how these perceptions influence their willingness to seek professional support. A quantitative research design was employed, using an online questionnaire to collect data. The survey was distributed via social media platforms and targeted individuals aged 18 to 30 living in the United Kingdom. Participants were recruited through self-selection and snowball sampling, resulting in 100 valid responses. Data were analysed using Microsoft Excel, with attention to key demographic variables, especially gender. Descriptive statistics were used to interpret the results, and findings are presented using bar graphs to highlight key trends. The results suggest that both perceived public stigma and internalised self-stigma continue to hinder service utilisation among young people. Many participants expressed concerns about being judged, misunderstood, or perceived as weak for seeking mental health support. These concerns were particularly evident among male respondents, who were more likely to associate help-seeking with shame and embarrassment. Despite these challenges, most participants acknowledged the importance of mental health services and expressed support for increased education, awareness, and more open dialogue around mental wellbeing
A survey study exploring the effect of having cats as a companion animal on the mental wellbeing of women in the United Kingdom
No full textBackground: For a long time, cats have lived closely with humans, providing joy, support, and protection. This bond likely affects the mental health and overall wellness of their owners. Despite mixed evidence on the mental health benefits of pet ownership, data specifically on cat ownership is limited. This study tries to explore how owning a cat influences women\u27s mood and emotional well- being, and how companion cats impact mental health.
Methods: An exploratory quantitative survey was conducted using an anonymous online questionnaire distributed through social media. Data collection occurred over four weeks, with a total of 60 participants completing the survey. The collected data were subsequently analysed using SPSS.
Results: The study revealed that 80% of respondents had a high emotional attachment to their cats, and 98% interacted frequently with them. The mean Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) score among female cat owners was 47.8. Among respondents, 54% had only one cat, while the lowest mean WEMWBS scores were found in those with more than five cats. Participants who had owned a cat for over 10 years had the highest mental well-being scores, in contrast to those who had owned a cat for less than one year. Regarding age, the highest mean score of 55.5 was observed in the 75-84 age group, and the lowest mean score of 40.7 in the 18-24 age group. White respondents had higher mean WEMWBS scores compared to other ethnic backgrounds, with no Black participants. A statistically significant association was found between emotional closeness and mental well-being in female cat owners (p=0.001).
Conclusion: This study provided significant insights into the relationship between the number and duration of cat ownership and the mental well-being of female owners, a topic not clearly addressed in previous research. Future studies should explore the specific factors influencing varying levels of well-being among cat owners and to better understand the complex relationship between human-animal bonds and mental health. 
The efficacy of cissus quadrangularis in the management of osteoporosis in India
No full textBackground: Osteoporosis, is a medical condition which leads to reduced bone density, affects millions in India and significantly increases fracture risk. Conventional treatments, such as bisphosphonates and hormone replacement therapy, are associated with high costs and side effects. In contrast, Cissus quadrangularis (CQ), an Ayurvedic herb, has shown promise in supporting bone health through its anti-inflammatory and osteogenic properties, presenting a potential natural alternative for osteoporosis management, particularly in low-resource settings.
Methods: This scoping review assesses the effectiveness of CQ in managing osteoporosis by synthesizing evidence from clinical trials, ethnobotanical studies, and systematic reviews published between 2014 and 2024. A comprehensive search was conducted across databases including PubMed, Scopus, Web of Science and grey literature. The impact of CQ on bone mineral density (BMD), bone turnover markers, fracture risk, pain relief, and quality of life was analysed to determine its potential role in both clinical and public health contexts.
Results: By the 16 selected studies for review, the findings indicate that CQ can contribute to slowing bone loss by influencing bone turnover markers, particularly reducing serum osteocalcin levels. While its effect on BMD showed mixed results, CQ demonstrated clear benefits when combined with other natural treatments, in its different forms and slow down the osteoporotic condition. The anti-inflammatory effects of CQ were noted to reduce pain and enhance mobility in osteoporosis patients. Additionally, ethnobotanical evidence supports its traditional use in bone healing, especially in resource-constrained regions. Despite promising results, further research is necessary to assess the long-term effects of CQ on fracture prevention and its broader public health impact.
Conclusion: CQ shows potential as a complementary therapy for osteoporosis, especially in low-resource settings where access to conventional treatments may be limited. Its ability to address both bone health and inflammation underscores its value in public health strategies targeting osteoporosis prevention and management. However, more rigorous research is needed to establish standardized dosages, confirm long-term efficacy, and validate its role in fracture prevention, particularly in public health frameworks that emphasize accessible and cost-effective interventions. 
The views and experiences of service providers working to integrate mental health and addiction services for individuals with co-occurring serious mental health and substance use disorder in the United Kingdom: A qualitative systematic review : Public Health Addictions Dissertation Prize Winner
No full textBackground: Although the prevalence of co-occurring disorders, which includes both substance-use disorder and serious mental health, is widespread, the disposition and combinations of these disorders can vary greatly. In addition to a long recovery process, people who experience co-occurring disorders have a higher risk of developing other health concerns and may experience early deaths. Integrating mental health care with treatment for alcohol and other drugs has long been recommended to improve outcomes for people with co-occurring disorders, but despite this mental health and addiction services continue to operate in separate silos in many high-income countries. This review examined the views and experiences of service providers in high income countries on integrating co-occurring services and the factors that influence health outcomes.
Methods: The research involved a qualitative systematic review. A literature search was conducted using Medline, CINAHL, and grey literature from 2010 to April 2024. The population, interest and context framework were used to develop the search strategy. The inclusion criterion were primary qualitative studies within high income countries. The critical appraisal skills programme (CASP) qualitative checklist was utilised to evaluate the quality of the papers. Thematic synthesis was adopted to analyse the studies (Thomas and Harden, 2008).
Results: The review included 6 studies on diverse professionals’ views on integrating mental health and addiction services. There were 3 analytical themes 1) appropriate training 2) management of care 3) barriers to the integration of mental health and addiction services. Several of the concerns and knowledge gaps regarding the integration of services were shared between service providers.
Conclusion: There are varying levels of knowledge and views regarding the integration of mental health and addiction services. However, service providers faced issues with a lack of training, experience and knowledge. More experience could reduce stigma and address uncertainties for better treatment outcomes and services for people with co-occurring conditions. This review was the first to provide a synthesis of the views and experiences of service providers in high income countries. Recommendations are made for policy, practitioners and service users. Furthermore, important implications for public health can be drawn from this review. 
A hidden crisis: Addressing the sexual exploitation of girls in England
No full textChild Sexual Exploitation (CSE) is a critical and severe form of abuse that significantly affects girls globally. This literature review aims to shed light on the multifaceted factors associated with CSE specifically impacting girls in England. CSE is defined as the manipulation and coercion involved in engaging in sexual activities by a child, often in exchange for material goods, which highlights the exploitative nature of these interactions. Alarmingly, statistics reveal that CSE disproportionately affects girls more than boys, due to gender inequalities, complex family dynamics, and societal perceptions that correspond vulnerability with weakness. The urgency of addressing CSE has intensified following high-profile cases in Rochdale, Telford, and Rotherham, alongside various independent inquiries that have raised awareness and classified CSE as a national threat. In this dissertation, several crucial factors will be explored, including the roles of government and health practitioners, the dynamics of vulnerability and victimisation among girls, and strategies for prevention and recovery from CSE. This study seeks to thoroughly investigate the scope and prevalence of CSE while also analysing the insights, feelings, and experiences of both girls affected by CSE and the practitioners who work with them. The consequences of CSE are profound, leaving girls struggling with conditions such as Post-Traumatic Stress Disorder (PTSD), depression, anxiety, and guilt, which severely delay their recovery journey. Another primary objective of this dissertation is to identify areas for improvement to broaden the understanding and scope of CSE. Furthermore, it aims to evaluate the effectiveness of current interventions, identifying which methods are successful and outlining aspects needing adjustment. This discussion also addresses the broader societal factors that contribute to exploitation, alongside any recommendations for improvement. The research highlights several key challenges encountered when identifying and responding to CSE-related issues. A significant finding emphasises the pressing need for enhanced training for professionals working in this field. This study specifically reinforces the critical importance of training, centred around the dynamics of victim blaming and the detrimental effects this attitude can have on the girls involved. The findings in this research stress the importance of safeguarding vulnerable girls and ensuring that their specific needs and desires are met, allowing them to receive the extensive support they rightfully deserve as they navigate the aftermath of experiencing CSE
A quantitative study exploring the main effects of the coronavirus pandemic on the mental health of young adults
No full textSeveral pieces of literature have expressed concern regarding the fact that mental health issues among young adults have continued to rise since the beginning of the coronavirus pandemic. Mental health issues are influenced by a number of social, psychological, physical, environmental, and biological factors including loneliness and isolation, relationship challenges, lack of physical activity, domestic violence situations, and a family history of mental illness or substance misuse. These factors, more often than not, contribute to mental health conditions such as depression, anxiety, and chronic stress. The aim of this study was to explore the effects of the coronavirus pandemic on the mental health of young adults and the three main objectives studied throughout were to investigate whether young adults worried about their financial situation during the pandemic, to explore whether young adults feared the virus and the idea that they might contract the virus, and to conduct research in order to determine whether there was an increase in mental health issues in young adults due to the various lockdowns. This study was quantitative and the method used was an anonymous, online self-select questionnaire. Seventy-nine respondents were involved in the study and the target population was young adults between the ages of eighteen and thirty years old of whom were able to fluently speak the English language. Once this study was conducted, the researcher discovered a number of different findings. The majority of young adults have experienced mental health issues to some extent, and pre-existing mental health conditions have worsened since the coronavirus pandemic and most respondents felt that their mental health had declined post-pandemic. It was also found that individuals who rated their mental health higher tended to feel less lonely in comparison to those who rated their mental health poorly. Young adults also stated that their financial situations were a contributing factor to their mental health worsening and that this had become more apparent since the coronavirus pandemic had occurred. Finally, very few young adults worried about contracting the virus all of the time, and those who did worry often did little to protect themselves or others. There were some gaps across existing research studies, therefore it was recommended that these gaps be filled in so that future researchers have a stronger understanding in relation to this area of research. As well as this, interventions for young adults should be implemented as there are few interventions available to young adults compared to the resources on offer for children and adolescents
Breaking the silence: understanding mental health stigma among young adults in higher education in the UK
No full textThis dissertation reviews the literature on how young adults in UK Higher Education perceive mental health stigma. With an emphasis on how stigma around mental health impacts students’ desire to seek treatment, the review summarise the body of research on the prevalence, causes, and consequences of mental health stigma in academic contexts. The literature identifies important factors that support the continuing existence of stigma among young adults, including peer reviews, cultural attitudes, and institutional support systems. Through an analysis of qualitative and quantitative studies, the review explores how stigma affects social integration, academic achievement, and mental health outcomes. It also focuses on interventions and initiatives aimed at reducing stigma, such as mental health awareness campaigns and peer-led support groups. The findings imply that although there has been progress in increasing awareness, there are still significant limitations to overcome in order to combat the stigma attached to mental health, especially among male students and members of particular cultural groups. The research concludes with suggestions regarding how universities might foster more welcoming cultures, promote open conversations about mental health, and offer focused assistance to underserved student groups
Welcome
No full textWelcome to the ninth issue of the PHI journal. Our guest editorial comes from Graeme Mitchell who is the programme lead on the BSc Environmental Health. This year, Graeme was awarded the outstanding teacher award at the annual JMSU Student Experience Awards, voted for by LJMU students.
The submission of your dissertation often signals the end of your time at LJMU, the culmination of three years hard work and commitment. I’m sure that the last three years have flown by, perhaps you recall someone telling you on your first day, that it will all be over in the blink of an eye? I’m sure you also recall thinking how impossible a dissertation sounded when you first came across it. How could you think of an idea, let alone undertake and write up an original piece of research? How could you write something that was 10,000 words long, when you doubted you even knew 10,000 words? But you did it, and you should be proud that you did.
Whilst I hope that your dissertation was all plain sailing, I suspect that for most of you there were a few bumps in the road along the way. In all fairness, no one promised that your dissertation was going to be a smooth ride but you navigated your way through it to the end. Your dissertation was three years in the making and the fact that your dissertation is included in this journal is a recognition of your success – trust me, I know that sometimes it takes a while to be recognised (I’ll just say JMSU Outstanding Teacher award and leave that there). It may be hard to believe, but as academics success to us is not just measured in terms of the marks achieved. It’s also measured is seeing you as a student develop and grow as a person over the last three years, and it has been a pleasure and a privilege to be able to be part of your journey.
The dissertations contained within this years’ journal cover a wide range of topics, which highlights the diversity of subjects, which formed part of your programmes, and how they have the potential to touch every aspect of our daily lives. I think this shows how important the subjects you have studied are and how you now, genuinely, have the opportunity to go out andmake the world a better place.
It is easy to see your dissertation as an end point, as you transition from a student to a graduate, but in other ways it is also a beginning. As this is a beginning, it is worthwhile to consider for a moment what the future will hold – for some of you your dissertation will form the foundation of your new career, for others you’ll take a different path, but regardless, alwaysremember the skills, dedication and commitment you applied to your dissertation and be proud at what you have achieved.
So, congratulations and good luck for the start of your new journey, wherever that may take you
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