Public Health Institute Journal (LJMU)
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A quantitative study exploring wellbeing amongst UK based male supporters of Manchester based premier league clubs
No full textPoor mental health and wellbeing is a global issue which is receiving considerable focus due to its widespread nature and the impact of the current pandemic. At present, there is a lack of research which assesses the impact that spectating football can have on wellbeing levels. This study assesses the impact spectating football has on wellbeing levels in men. In England, around one in eight men have a common mental health problem such as depression, anxiety, panic disorder or Obsessive Compulsive Disorder (OCD). An online questionnaire was distributed to Manchester City Football Club and Manchester United Football Club Facebook football fan pages and football forums gathering data from the target population which was any UK based man aged 18+ and a supporter of either Manchester City or Manchester United Football Clubs. The study gained 81 completed responses with all participants aged 18 and above. The results from this study have revealed that spectating football both in football stadia and from home can have both a positive and negative impact on wellbeing levels. Many fans aged 18-34 stated that they often become angry, aggressive, or depressed after a team loss and strongly identify with the team they support. Conversely those aged 35 and over were not as affected after a team loss and do not identify with their teams as strongly as younger fans. The same age group also identify more with their players/team and opposing players/team. The findings have highlighted that the younger fans wellbeing levels are affected more by the performances and results of their teams than older fans. The researcher has identified a number of recommendations which can be made. These include implementing more wellbeing health interventions which specifically target younger age groups, utilising online social media and football fan forums in order to promote help seeking behaviours in young men. This will support in reducing stigmas attached to poor mental health and wellbeing which could be strengthened by utilising professional footballers of the clubs to promote help seeking in order to encourage the fans to engage. 
Welcome
No full textWelcome to the second issue of the Public Health Institute Journal (PHIJ). In this edition we present the abstracts of dissertation projects undertaken by our MSc Public Health, International Public Health, Public Health Addictions and Public Health Nutrition students. They are to be commended for producing high calibre, innovative and thought provoking work - all done during the COVID-19 pandemic. National restrictions, to stem the spread of the coronavirus, necessitated changes to how research was conducted. It also sparked interest in new topics and for some, mastery of online methods of data collection. Not surprisingly many students investigated the impact of COVID-19, covering mental health and well-being in the student population, physical activity levels among BAME students, eating behaviour and take away food consumption and the use of a weight management app during lockdown. Vaccination uptake amongst university students was also examined, as were social distancing and testing decisions, and adverse COVID outcomes for BAME groups. Whilst COVID-19 based research projects predominated, more traditional public health issues were not neglected and there is some excellent research around risky health behaviours, including substance misuse projects on SPICE amongst the homeless, skin infections and injuries among men who inject image-and performance enhancing drugs, the impact of national changes in public health policy on local drug treatment service delivery, and a review of the UK’s 12 Step Groups for those seeking recovery from substance dependency. Childhood obesity, stigma and veganism, menstrual hygiene in the British army, parental experiences of free school meals, electronic cigarette use in pregnancy and the attitudes of gay men to physical activity are just a few of the other timely public health topics that were tackled this year.
The impact of Euro 2020 on domestic violence was examined through the print media and a gender-based violence and bystander intervention programme was evaluated. Prevention was the focus of several reviews, including infection prevention in the ambulance sector and preventing adolescent pregnancy in low and middle income countries. Social media continues to generate interest; there were projects on the influence of Instagram on perceived body image and weight management and the online sports betting behaviours of UK men. Sub-Saharan Africa (SSA) was the context for a cluster of reviews that looked at maternal mortality, CVD risk prevention in HIV patients, climate change and childhood diarrhoea. Tuberculosis in different countries was systematically reviewed, as was the consumption of processed meats and chronic diseases in Middle Eastern and North African countries. These abstracts provide a rich tapestry of the many contemporary public health issues affecting the world today that our MSc students consider important and relevant. Further they demonstrate our students’ ability to apply in practice key public health concepts - prevention, protection and promotion - and a passion for and commitment to improving the public’s health.
Finally, the cover image chosen for this issue showcases one of two beautiful cathedrals in Liverpool. The Liverpool Anglican Cathedral has been home to Liverpool John Moores University graduations for many years and marks a period of celebration and achievement. Whilst graduations have been postponed recently due to COVID-19, we are pleased to see them rescheduled for early 2022 and look forward to celebrating our students\u27 success with them, their friends and family. We congratulate our MSc students on their excellent work and wish them much success as they embark on the next stage of their careers in public health.
Lorna, Conan, Jen and Jan
Exploring takeaway food consumption, lifestyle behaviours and wellbeing amongst the UK population during Covid-19 pandemic
No full textBackground: In December 2019, a new disease (Covid-19) caused by Sars-Cov2 first emerged in the city of Wuhan, China and subsequently spread worldwide within a short period of time. The WHO declared the disease a public health emergency of international concern. The pandemic has had an impact on nutritional and lifestyle behaviours by implementing social distancing and lockdown measures to reduce the transmission. It has also had a detrimental effect on human health and wellbeing. This empirical study aimed to explore the relationship between takeaway food consumption and wellbeing during Covid-19 restrictions among the United Kingdom population aged 18 -65 years, Furthermore, this study compares wellbeing amongst keyworkers and non-keyworkers.
Methods: The study comprised an online survey that included demographic information; anthropometric data; nutritional habits information; and lifestyle behaviours. The survey was conducted between the third UK lockdown (March-June 2021).
Results: 92 participants took part, aged between 18-65 years (71.3% female; 28.7% male). This research confirmed an association between takeaway food consumptions with wellbeing and BMI status. Adverse wellbeing was more prominent among keyworkers. Takeaway food consumption decreased during Covid-19 pandemic. However, fast food (38%) remained the most frequently consumed takeaway food amongst the population during the pandemic.
Conclusions: This is the first study to explore the behaviours and dietary choices amongst keyworkers in the UK, with particular focus on takeaway consumption and wellbeing during Covid-19 restrictions. However, further investigations are required among a larger sample
Investigating the effect of food poverty on LJMU Students: A survey study
No full textFood poverty is a public health issue which is affecting people all over the world. There have been numerous studies looking into the effects of food poverty, the reasons behind it and who are most likely to suffer with it. Despite the ever-growing data on the topic there is limited data on student food poverty and particularly for UK students. The aim of this study was to investigate food poverty in LJMU students, identify any effects this has on their studies and if there is something that LJMU can do to help their students. The research was carried out via an online questionnaire and was filled in by LJMU students from different levels of study (n=74). These results identified that nearly half of the sample had skipped a meal because they could not afford to eat (n=48.6%) and had gone into university hungry (n=43.8%). In addition, only 14.9% of students were eating the full recommended portions of fruit and vegetables a day. These results suggest a certain level of malnutrition in students which is worthy of further investigation. Recommendations include a further university wide quantitative and qualitative study supported by the university and the Student Union. Also, to get the Student Union involved in creating solutions to food poverty identified in this research, for example, by creating a food bank or helping create sessions where students can learn how to buy a healthy shop for a week within budget, and then cook meals with the shop. The final recommendation is to further investigate the links between mental health and student food poverty and diet. 
The unequal health impact of Covid-19 on BAME Groups in the UK
No full textThe COVID-19 pandemic has been condemned as ‘the worst challenge for a century for international health and financial systems’ (Singer, 2020). The impact of Coronavirus disease worldwide has brought mainstream attention to the underlying issue of health inequality. Research has shown that Black, Asian and minority ethnic (BAME) groups in the UK have been impacted the hardest by COVID-19, suffering higher morbidity and mortality rates as well as increased financial hardship. Such disparity, as a result of racial inequality, is heavily interlinked with lower socioeconomic status, which is more common among BAME communities in the UK. Through the lens of COVID-19, socioeconomic and ethnic health disparity has been magnified to a greater audience than ever before. This is a significant opportunity for public health researchers and proponents to highlight the need for prioritizing health equity in all areas of policy and intervention. The aim of this research is to understand the ethnic disparity within COVID-19 health outcomes in the UK from a public health perspective and provide a grounding of data within policy and intervention strategy. 
Spice (Synthetic Cannabis) use among the homeless in England: A Scoping Review
No full textBackground: There is a significant area of concern in the use of spice among the homeless despite the enactment of the Psychoactive Substance Act (2016). The increase in the number of people experiencing homelessness in England suggests that this drug problem will continue. It is vital that we understand spice use among the homeless in order that appropriate support can be provided. The aim of this scoping review is to explore the use of Spice (synthetic cannabinoids) among the homeless people in England.
Methods: A systematic review of the literature published in England from 2015 to 2019 was carried out in August 2021 from the databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE), PSYCHINFO, Web of Science and Scopus, in order to identify eligible studies. Studies were screened by title and abstract, followed by a full text review. Arksey and O’Malley’s five stage methodological framework for scoping reviews was followed. Extracted data was charted, categorised, and summarised narratively.
Results: The scoping review process identified 13 studies for review. The data extraction process resulted in the identification of four themes: the characteristics of spice users; motivating factors for taking the drug; evidenced effects of taking the drugs among the homelessness; and policy/regulatory challenges of tackling the drug problem.
Conclusions and recommendation: The review highlights that homelessness reflects deep-rooted structural inequalities of society. The condition causes vulnerability which increases susceptibility to drug use. The study recommends addressing the homelessness problem in the first place as a health protection measure that could deter for drug use. Beyond this, health prevention and health education, through tailoring service provision to this vulnerable group is necessary
Exploring the impact of national changes in public health policy on service delivery for people who require drug treatment in Liverpool: A qualitative research study
No full textBackground: Since 2010 there have been major changes in the objectives of UK drug policy, and how drug treatment services in England have been commissioned and funded. Liverpool in North West England has more than twice the national average of both the rate of people receiving drug treatment services (9.6/1000 vs 4.4) and deaths from drug use (11/100,000 vs 4.7). This study investigates how changes in public health policy have impacted on service delivery for people who require drug treatment in Liverpool.
Methods: Six semi structured interviews were undertaken with professionals working within the drug treatment field in Liverpool. Interviews explored the changes to drug service provision, how changes in funding and UK drug policy have impacted upon service provision and current challenges which are seen by professionals working with people who use drugs. The use of qualitative methods enabled the researcher to consider first-hand experience and views of professionals directly involved in service delivery, which is a gap in current research. Data from the interviews was thematically analysed using inductive and deductive approaches into 7 key overarching themes.
Results: The interviews show the main challenges which are being faced by both local commissioners and treatment providers in relation to drug treatment service provision in Liverpool. High treatment thresholds, high caseloads, and complexity in relation to people with multiple comorbidities which is also made more challenging due to the disconnect between drug services and other parts of the system such as mental health service provision. The changing need in relation to young adult’s drug use and service provision to meet this need was highlighted by the participants. For example, provision of advice and intervention for people who use drugs other than opioids and cocaine. Participants highlighted a lack of set training standards and opportunities for professional development within the field with this leading to some participants feeling devalued. A lack of ongoing funding for services were raised as a risk, with participants highlighting the issues with short term funding for projects and pilots which reduce opportunities for innovation and service growth. Participants felt that the implications of these challenges are reduced opportunity for intervention at an early stage resulting in potentially poorer outcomes for the person.
Conclusions: The need for a whole system integrated approach to care for people who use drugs was considered the key to reducing risk and providing improved outcomes
A quantitative study to investigate student attitudes and beliefs towards cannabis use and associated drug policies in the UK
No full textCannabis use in the UK could be considered a cultural normality amongst adolescents and young adults with levels of use rising over the last decade. The majority of research focuses on cannabis use among students in the USA with limited studies conducted in Europe; in particular, focus has tended to centre on substance use/misuse among college students. This study assessed student attitudes and perceptions towards cannabis use and associated drug policies in the UK. In addition, it investigated the prevalence of cannabis use in the student population and identified the number of students that could potentially have cannabis use disorder (CUD), defined using the Cannabis Use Disorder Identification Test - Revised (CUDIT-R). This research set out to investigate student perceptions towards cannabis use. Using a quantitative method this study utilised an online questionnaire that measured the prevalence of cannabis use, attitudes towards cannabis and whether the drug should be legalised for recreational purposes. Sixty-three participants were recruited with the target population for the study being students from the Faculty of Health in Liverpool John Moores University (LJMU) to represent the wider student population. The questionnaire also used the CUDIT-R screening tool to assess cannabis users for possible CUD. Over a quarter (27%) of the sample studied had used cannabis in the last six months, for 47% of those there were indications of possible CUD. Almost half (49%) of participants were in favour of the drug being made legal for recreational use. Of concern is that 69.8% felt that the current drug policies offer little or no protection to the young and the vulnerable. The use of cannabis in the LJMU community is evident, however, the prevalence of the drug is lower than current stereotypes which suggests that all students partake in heavy and frequent drug use. There are concerns regarding the amount of cannabis users that could potentially have CUD and there are no strategies in place at an institutional or Governmental level to reduce the levels of drug use in this section of society. Student attitudes towards cannabis use tend to mirror that of the general population with nearly half of students supporting the legalisation of recreational cannabis. It is also apparent that the current drug policies in the UK do not protect the young and vulnerable from drug-related harms. Further research is required to better understand cannabis usage in student populations and the perceptions around the drug and associated legislation. 
Paramedic Views of and Adherence to Infection Prevention Control Measures within the Ambulance Sector: A Scoping Review
No full textBackground: Effective infection prevention control (IPC) within the ambulance sector is vital for the safety of patient care. However, previous studies have demonstrated poor compliance amongst ambulance staff and high levels of bacterial load on ambulance surfaces and equipment. The purpose of this scoping review was to explore the evidence base on the views and adherence to IPC measures within the ambulance sector, to identify key themes and any gaps in the research.
Methods: A scoping review of the literature published between 2010 -2021 was undertaken in July 2021 of three key databases to identify eligible studies. Further manual reference searches and grey literature searches were also undertaken. Studies were screened by title and abstract, and then by a full text review against specific inclusion criteria. The Arksey and O’Malley five stage methodological framework for scoping reviews was followed. Extracted data was charted, categorised and narratively synthesised.
Results: After screening against inclusion criteria, 13 studies were included in the review. Significant areas of non-compliance were found in relation to hand hygiene and the cleaning and disinfection of ambulances. Key barriers to effective infection prevention control highlighted across the studies were: access to facilities and equipment, emergency and operational pressures, lack of adequate training and procedural guidelines and behavioural and cultural norms.
Conclusions: The review highlights that improvements in infection prevention control are required within the ambulance sector. There are a number of existing barriers to overcome, including practical and operational challenges as well as cultural and behavioural issues. Further research is required to explore the potential of specific interventions to improve IPC standards within the ambulance sector, particularly those incorporating theories of behavioural change.
Keywords: infection prevention control, IPC, ambulance, hand hygiene, cleaning, disinfection, barriers, views, compliance, adherenc
Ethnicity and Adverse COVID-19 Outcomes in the UK: A Scoping Review
No full textBackground: In December 2019, COVID-19 was first recognized. The WHO declared the spread of COVID-19 as a global pandemic on the 11th of March 2020. There has been an increase in the published and unpublished evidence that links ethnic minority groups and adverse COVID-19 outcomes which is similar to previous pandemics. This review aims to systematically explore the existing literature that investigates the connection between adverse COVID-19 outcomes and ethnicity.
Methods: A scoping review was undertaken between January 2021 and August 2021 to investigate the influence ethnicity has on COVID-19 outcomes. A comprehensive search of databases using predefined search terms was conducted, to identify available literature. The relevant studies were identified based on the predetermined inclusion and exclusion criteria. Extracted data from relevant studies included first author, year and study aims. Tables and thematic analysis were performed to map out data available from existing literature.
Results: 1081 articles potentially relevant to the aim and objectives of the review were initially identified. After removing duplicates and screening the abstract and full texts for inclusion and exclusion criteria, nine studies were included in the review. Five key themes were identified; positive PCR results, in-hospital outcomes including hospital admission, case severity and ICU admission, risk of death, mortality rate and age.
Conclusions: Data from grey literature and preprint studies have indicated that individuals who belong to ethnic minority groups have a greater risk of acquiring COVID-19 infection than the white cohort. Additionally, they may suffer from higher ICU admission rates and mortality rates when compared with their white counterparts. Several gaps in the available literature were identified as well as recommendations for mitigating against health inequalities
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