Public Health Institute Journal (LJMU)
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A quantitative Study into festival goer’s awareness, attitudes, and behaviour in relation to the environmental impacts of UK music festivals
No full textWith the ever-growing popularity of music festivals in the UK, it is crucial that festival organisers and attendees work together to help reduce the environmental impacts of these events. At present, there is a gap in the literature exploring festival goers’ attitudes, knowledge, and behaviours towards the environmental impacts of festivals. This quantitative study used an online questionnaire which was distributed on Facebook and via email, to gather information from participants who had attended a UK music festival within the last three years. The data produced from the questionnaire was presented in the form of pie and bar charts and analysed using SPSS to compare participant responses with demographics. Chi-Squared tests were also carried out to determine significant relationships between variables. The results from this study revealed a generally positive attitude towards the environmental impacts of festivals and that festival goers had some knowledge of the subject area. The exception to this was the older age group (41+) who tended to respond negatively or neutrally more often than younger groups. A large number of festival goers displayed positive behaviour at festivals through taking part in initiatives and trying to reduce their impact whilst in attendance. However, the results show that some festival goers have bad habits, with over half of participants agreeing that their behaviour changes (at least sometimes) when at festivals compared to at home. The researcher felt that in determining their attitudes, knowledge and behaviour, some recommendations could be made. These include increased education for festival attendees on how to better reduce their impacts and to inform them on the extent of the issue, the introduction of initiatives to encourage festival goers to try their best and to push the importance of teamwork to encourage attendees to take some responsibility in ensuring festivals become a more sustainable event
Impact of climate change on the incidence of childhood diarrhoea in Sub-Saharan Africa: A Scoping Review
No full textBackground: Climate change is recognised as an important risk factor to public health and indeed child health in the 21st century. Climate change is expected to increase global temperatures and rainfall intensity and frequency and, if preventative action is not taken, may further widen health inequalities, hinder the attainment of the Sustainable Development Goals and reverse the child survival gains made over the last decade. It is projected that there will be an impact on a number of climate sensitive diseases including childhood diarrhoea. It is therefore imperative to gather evidence on the association between climate change and diarrhoea incidence in children. The objective of the study is to map out literature on the climate change impacts on the incidence of childhood diarrhoea in Sub-Saharan Africa.
Methods: A scoping review of literature was conducted where relevant databases were searched. Papers were screened first by title and abstract then full text screening. Studies were selected (n=15) against the set inclusion and exclusion criteria.
Results: Studies reviewed assessed three climatic variables: temperature, rainfall and humidity. The review revealed varying results on the association of climate factors and incidence of childhood diarrhoea. The review found that increases in temperature and increases in precipitation and precipitation intensity caused an increase in diarrhoea incidence. Relative humidity still needs to be explored further as results are inconclusive.
Conclusions: Climate change is impacting negatively on childhood diarrhoea diseases. However, the association between climate variability and diarrhoea cannot be fully considered without accounting for other confounding variables that are risk factors of childhood diarrhoea. Further research is needed to explore the interactions of climate change and childhood diarrhoea incidence giving projections of morbidity over a long period of time
A qualitative study exploring the Influence of Instagram on 18–34-year-olds body image during the COVID-19 lockdown
No full textBackground: The COVID-19 pandemic has had adverse effects on mental health, physical exercise, and dietary habits. During the COVID-19 lockdown, time indoors and time spend on social media increased which caused a societal trepidation of weight gain. On the social media site Instagram, diet culture content (alluding to a fear of weight gain and pressure to lose weight) increased, reflecting and reinforcing this fear of weight gain as well as the notion that it is undesirable to gain weight. This content created online comparison, with users comparing themselves and their bodies to others, prompting changes to eating habits to achieve the ‘ideal body’. The distribution of such messages may have led to an increased focus on body-image, which has a myriad of associated health harms, including body-dissatisfaction, mental illness and eating disorders.
Methods: This qualitative research explores factors leading to Instagram users being influenced by diet culture during the COVID-19 lockdown. Preliminary analysis of Instagram content provided an initial understanding of diet culture messaging on Instagram shared during the lockdown. Diet culture related posts were scraped and coded to identify the most commonly discussed topics. Posts holding a strong diet culture message were also selected for photo elicitation during the interviews. Interviews were conducted with a purposive sample of male and female 18-34 year olds who use Instagram. Data were analysed thematically and provided in-depth insight into participant’s views, knowledge, reflections and experiences.
Results: The study found that diet culture on Instagram is omnipresent and gendered in the ideals that are presented. In terms of the socio-ecological model, several factors influenced body-image and eating behaviours at the individual, interpersonal and community level. Home-workouts and comparisons were the most significant factors discussed, with both prompting body-dissatisfaction. The use of emojis, in particular the pig emoji, were seen as stigmatising. Peer endorsement reinforced diet culture messaging through comparison with friends who liked diet culture related posts. Several factors were seen as protective against diet culture rhetoric including body positivity posts and awareness that Instagram is not always a representation of reality. Other factors were identified as having both positive and negative influences on body-image and eating behaviours such as the use of humour and individual mind-set.
Conclusions: The study found that diet culture on Instagram is omnipresent and negatively impacts body-image and weight-related behaviours, particularly among those with pre-existing mental health issues and body concerns. Recommendations based on the study findings include disseminating accessible information in a variety of mediums (including social media influencers) that counteracts diet culture rhetoric, increases body positivity, and raises critical media literacy among users. Environmental responses are also needed including stricter regulation and trigger warnings for body image related content and advertisements by Instagram. Future studies should address how diet culture influences Instagram users of different ages -in particular those aged under 18 years, who may not have the same level of media literacy as older users
A quantitative study examining the health and safety experiences of fans at football stadiums on match days
No full textIncreased football stadium attendances and advanced stadium structure designs means health and safety risks within stadiums are forever developing and occurring. In order to manage these risks, effective health and safety control measures need to be implemented into stadium policies and assessments. To achieve the most effective measures it is important to understand fans health and safety experiences on match days while present in stadiums. However, there is a lack of research assessing this topic or one similar, leading the researcher to conduct this study which aims to examine football fans attitudes, knowledge and awareness of health and safety in football stadiums on match days. The researcher produced an advertisement which promoted the study’s online questionnaire. The advertisement was posted on LinkedIn, but also several football fans forums such as talkFootball365. The sampling method used was self-selection and the researcher received 111 questionnaires, which were analysed using Excel. Further statistical analysis, Chi-Squared tests and cross tabulation tables were completed using SPSS. The data were presented in both pie and bar charts, as well as in tables. The results indicate football fans generally have a good knowledge of health and safety practices in football grounds, as the majority accurately identified a fire exit sign and recognise what risks results in the most accidents. Nevertheless, a large proportion of respondents have a poor attitude towards health and safety when attending a football game, due to fans valuing team identification and affiliation over stadium safety. Furthermore, a significant number of participants do not always check where the emergency exits are or know where stewards are positioned in a stadium indicating a lack of awareness to their health and safety surroundings. The researcher believes this may be due to the majority of respondents believing their supported clubs want to protect fans, and can handle any health and safety issue, therefore relying on clubs too much. This then generates additional risks; one example is increased injuries and fatalities during an emergency evacuation. This research generated several recommendations. These include; sporting bodies promoting an educational campaign on issues such as the risks present, accident statistics and the consequences of breaching health and safety; enlarging and illuminating emergency exits; increasing the visibility of stewards, not just the number; and finally future qualitative studies should focus on spectator\u27s health and safety experiences in all stadiums and not just football. 
The Impact of COVID-19 on the Mental Wellbeing of Students at Liverpool John Moores University
No full textBackground: With the COVID-19 pandemic necessitating restrictive measures to social gatherings, travelling, and other normal daily outdoor activities to limit the disease spread, the impacts have been huge on the UK public and the experiences of university students. Particularly, the closure of school buildings, bringing about a switch to online virtual teaching and learning, and the consequent disconnection of students from their usual campus social life have been huge disruptions. This study aimed to assess the effects of the COVID-19 pandemic on the mental wellbeing of students at the Liverpool John Moores University (LJMU) and identify the predominant stressors behind the effects.
Methods: A cross-sectional quantitative design was used in the study, utilising a one-time-response online survey that included the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) to collect data from LJMU students on their mental wellbeing and the stressors they may have experienced during the pandemic. Descriptive statistics were used to analyse the respondents’ demographic data, WEMWBS scores and perceived COVID-19-related well-being stressors, while associations between mental wellbeing and identified stressors were analysed using Fisher’s Exact Test.
Results: The results indicated that out of the 57 student-respondents, the majority were females (70.2%) and undergraduates (64.9%) while almost half (47.4%) were aged 30 or above. The mean WEMWBS score was 43.89 (SD ±11.4), the scores ranging from 14 to 68. Meanwhile, 64.9% had high or average WEMWBS scores. Out of the eight COVID-19-related stressors studied, 6 received an admittance rate of over 50%, ranging from 56.1% to 89.5%. However, the analysis on the association between any of the stressors and the student’s mental wellbeing showed no statistical significance (∝ =0.05).
Conclusions: The results of this study suggest a negative impact of the COVID-19 pandemic on the mental wellbeing of LJMU students on the average. The most important wellbeing stressors, meanwhile, have been academic performance, fear of contracting the virus, lack of social contact and support from friends and family, and the changes in teaching and learning format. The researcher recommends, among other issues, further studies to delineate the impacts of the pandemic on specific psychological parameters such as levels of anxiety and depression
Fitspiration and body image: A qualitative study
No full textBackground: Western society’s ‘toned’ body ideal is commonly found on Instagram’s ‘fitspiration’ pages, which aim to inspire healthy lifestyles through diet and exercise. Research suggests that these accounts have the potential to cause body dissatisfaction in women - a serious public health concern. Qualitative studies indicate that both positive and negative experiences of fitspiration are common, suggesting that further in-depth exploration is needed.
Methods: The current qualitative study explored the motivations for accessing the accounts and experiences of fitspiration, alongside its perceived positive and negative effects. Three focus groups (total of 19 women, aged 20-23) were conducted.
Results: Discussions revealed how the unrealistic ideal and extrinsic motivation presented by fitspiration pages is negatively received, with participants placing greater emphasis on the effect of the picture rather than the accompanying caption. Analysis showed how individuals were easily overwhelmed by seeing too much fitspiration; this was commonly attributed to the design of Instagram and the algorithm, and suggested users had to actively avoid dysfunctional content. Participants reflected on periods of vulnerability to the negative effects of fitspiration, including during school-age years and the COVID-19 lockdown, when pressure to get fit intensified. This sample of women were critical viewers of fitspiration; they displayed advanced media literacy skills throughout and considered the influence of the body positive movement on Instagram. The findings can also be explained using the social comparison theory as participants negatively compared themselves to unrealistic ideals and preferred to follow more relatable accounts.
Conclusions: Overall, this study reflected on the societal changes needed to eliminate the pressure on women to use diet and exercise as a beauty product. This study also made feasible recommendations for Instagram, corporate companies, and media literacy programmes to improve and co-ordinate their efforts to alleviate and tackle pressures on their users from the content they are consuming. Changes to the algorithm and the promotion of media literacy through body positive activists are likely to prevent distressing fitspiration experiences
Factors and characteristics associated with soft skin and tissue infections and injuries among men who inject image-and performance enhancing drugs: A secondary data analysis
No full textBackground: The increasing use of image-and performance enhancing drugs (IPEDs) in the UK is a significant public health concern. Those who inject IPEDs are at risk of skin and soft tissue infections (SSTIs) and may experience symptoms such as redness and abscesses at an injecting site. However, most of the research is focused on risk factors associated with experiencing symptoms of SSTIs in those who inject psychoactive substances. The aim of this study was to determine which characteristics and risk factors are associated with experiencing redness and abscesses in those who inject IPEDs, in order to add to existing literature.
Methods: This is a secondary data analysis on data collected for the National IPED Info Survey 2016. Of all participants who completed the survey, 562 men who injected IPEDs were included in this analysis. Risk factors which had been found to be associated with SSTIs in earlier literature were entered into a cross tabulation. Those which were significant (p<0.05) were entered into a bivariate regression analysis to produce the unadjusted odds ratio. These variables were then entered into a multivariate analysis to obtain the adjusted odds ratio.
Results: A total of 308 participants reported ever experiencing redness at an injection site, and 67 reported ever experiencing an abscess at an injection site. Results from the multivariate analysis found that experiencing redness at an injection site was associated with having ever taken a growth hormone, having ever shared a multi-dose vial, re-using own needles/equipment and having ever thought that IPEDs were fake. Similarly, reporting an abscess was found to be associated with having ever taken a growth hormone, shared a multi-dose vial and re-using own needles and syringes.
Conclusions: Symptoms associated with skin and soft tissue infections are common amongst people who inject IPEDs. However, there are still a high number who don’t access any healthcare services due to stigma and associated barriers. In order for health to be improved amongst those who inject IPEDs, interventions need to have increased accessibility and healthcare services need to provide a greater understanding of user’s attitudes and motivations
The relationship between social media & the mental health and wellbeing of adults
No full textA wide variety of studies have shown the relationship between social media use and individuals’ mental health and wellbeing, including the effects social media can have on body image. The majority of this research focuses on the adolescent and student age range, meaning the ‘adult’ age range are being excluded despite mental health affecting individuals at any age. Previous studies also often focus on a specific social media platform (e.g. Facebook), which also has limitations as individuals now tend to be active across multiple social media platforms which could have a cumulative effect on mental health. This study addressed these limitations by investigating adults’ social media use across all platforms. Specifically, the aim of this research study was to investigate the relationship between social media and mental wellbeing amongst adults in Merseyside. The target population was adult social media users (aged over 18 years). An online quantitative approach was taken using anonymous questionnaires. The researcher used a convenience sampling method, and the questionnaire was completed by 95 participants. The data collected was then analysed using Microsoft Excel, along with word clouds which identified common themes for open-ended questions. The results showed that the majority of individuals feel that social media can have a negative effect on their mental wellbeing, body image and self-esteem, with only a small minority claiming it was making them happy and connected to friends and family. It also found that social media was mainly used out of boredom, and was felt to be a distraction when individuals needed to be productive. There is a need for more research on issues covering broader areas including body image and if users felt addicted to social media. 
‘Filling the Gaps’: The nature and extent of the beauty industry in the UK, focusing on unregulated fillers procedures - why has this become an issue for Public and Environmental Health?
No full textDermal/ lip fillers are growing into a major public health issue due to lack of statutory regulations allowing anybody to undertake the procedure without any prior training or understanding of dangers associated with fillers. People undergoing the procedure are often unaware that it is not regulated. This literature-based study aims to investigate and evaluate current regulations on fillers, their effects on health and the nature and extent of the problem. This dissertation will examine whether regulation could improve health and provide recommendations on how this can be implemented. The Charted Institute of Environmental Health (CIEH) have identified concerns and risks associated with dermal fillers. The British Association of Oral and Maxillofacial Surgeons (BAOMS) has added its voice to calls from the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) for regulation of this industry. Most of the cosmetic industry is self-regulated which means no formal training, qualifications or medical training is required, leaving the public susceptible to harm. Anybody can set up their own business doing fillers without any regulations, leaving botched treatments to the NHS to treat (Chartered Institute of Environmental Health, 2019).There is a clear link between dermal fillers and social media, with social media influencing the industry in a positive and a negative way. Social media is increasingly cited as a contributing factor to the rising public interest in cosmetic procedures (Hopkinset al, 2020). As new social media platforms emerge advertisements increase, allowing trends to develop. Social media has caused dermal fillers to become a trend with celebrities influencing the behaviour of people. People want to look like a celebrity or influencer. However, regulations in this sector have not moved on with new adaptions and cultural changes. This dissertation uses a range of sources and evidence to demonstrate that the lack of regulations on dermal fillers is impacting public health, with levels of botched treatments on the rise. Dermal fillers can cause infections, necrosis, and loss of circulation and permanent facial disfigurements, all resulting in hospital treatment/ re-correction surgery with a cost to the NHS and the taxpayer. Recommendations are for the government to take urgent action in tightening the regulations, scrapping self-regulation. This would bring a standard to the cosmetic industry and stop untrained “cowboys” from practising unsafe cosmetic treatments. There is a need for further research within this topic, with public surveys needed to examine the impact of dermal fillers under the current regulations. In addition, there should be a register and data needs to be compiled from the NHS to see how much this is affecting public health. 
A quantitative study to explore the knowledge, attitudes, and behaviours of LJMU students aged 18-24, in relation to alcohol consumption, investigating the difference in prevalence of alcohol use between different student groups
No full textAlcohol is attributable to many diseases and injury-related health conditions and is the fifth leading risk factor of premature death globally; and among people between the ages of 15-49 years, it is the first leading cause. Problematic alcohol use by university students is also an important public health issue due to its wide range of effects on physical and mental health. This study utilized a quantitative questionnaire to explore the social and environmental factors which influence high alcohol prevalence among the student population. The study also sought to determine prevalence levels among students at LJMU in different student cohorts (1st, 2nd, 3rd year students) and ascertain the level of understanding shown by students in relation to alcohol prevalence. Convenience sampling was used to recruit Liverpool John Moores students aged 18-24 years in the city of Liverpool. Participants were recruited through social media groups for LJMU students and emailing Environmental/public Health students. Convenience sampling offers certain advantages by identifying participants quickly on a voluntary basis. The questionnaire asked general questions regarding year of study, age, gender, and questions relating to the participant’s alcohol use based on the AUDIT-C test. Forty-four participants aged 18-24 years took part in the anonymous quantitative questionnaire. The results from the study revealed that 3rd year students drink more than students in their 1st and 2nd year of study. Moreover, the findings indicate the majority had previously engaged in binge drinking and that drinking frequency was similar between participants in Year 1. Year 2 and Year 3. The study showed the topic needs larger studies to produce more robust findings, but the sample is useful in exploring alcohol prevalence amongst small student cohorts. 
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