Public Health Institute Journal (LJMU)
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Care beyond the city: The lived experiences of caring for a family member with dementia in rural Northern Ireland
No full textDementia is one of the most pressing health and social care challenges facing the United Kingdom, with over 900,000 people currently living with the condition. In Northern Ireland alone, more than 22,000 individuals are affected, a number projected to nearly double by 2040. While much of the research and policy focus has centred on urban care provision, less attention has been given to the distinct experiences of caregivers in rural settings. This dissertation explores the lived experiences of individuals caring for a family member with dementia in a rural area within Northern Ireland, a demographic that faces compounded challenges due togeographic isolation, limited services, and systemic gaps in support, leaving a gap in understanding how these rural-specific barriers affect informal carers. The central research question guiding this study was: What are carers’ experiences of caring for a parent or family member with dementia in rural Northern Ireland? The study aimed to understand the unique difficulties faced by these caregivers, how they perceive and engage with formal and informal support systems, and the coping mechanisms they employ to manage emotional, physical, and logistical pressures. Five research objectives were developed to examine themes around isolation, access to services, support networks, rural-specific challenges, and potential improvements to care provision.
A qualitative research design was adopted using semi-structured online interviews with ten participants. Inclusion criteria required that participants were currently or had previously cared for a parent or family member with dementia for a minimum of six months while residing in a rural area in Northern Ireland. Participants were recruited via purposive and snowball sampling methods, with interviews conducted online via Microsoft Teams (MS Teams) to ensure accessibility across rural locations. The data collected was analysed using Braun and Clarke’s reflexive thematic analysis, which enabled the identification of patterns of meaning across the dataset while acknowledging the active role of the researcher in the interpretive process. The findings reveal that caregivers in rural Northern Ireland experience high levels of emotional strain and burnout, exacerbated by limited access to healthcare, poor transport infrastructure, and the inflexibility of care packages. Many participants described feeling unsupported, both practically and emotionally, and often relied heavily on informal networks or self-taught strategies. However, a small number of participants also spoke positively about strong family support and trusted local healthcare providers.
This study concludes that caregiving in a rural area within Northern Ireland presents distinct and significant challenges that require targeted responses. Key recommendations include the decentralisation of dementia services, improved transport support, more flexible care packages, structured guidance for carers using direct payments, and the introduction of accessible training and emotional support resources for informal carers. These findings aim to inform local policy and service delivery to ensure that rural carers are better supported in their essential roles
Psychological consequences of teenage pregnancy in sub-Saharan Africa: A scoping review
No full textBackground: Adolescent pregnancies are a major public health issue across sub-Saharan Africa and can result in serious psychological effects on the young mothers. This scoping review explores in detail the psychological burdens experienced by pregnant teenage girls and adolescent mothers in this region.
Methods: A scoping review of literature was conducted. Relevant databases were searched using key terms related to the topic, with the aid of the PCC search framework. Thereafter, the screening process was carried out first by excluding duplicates of studies selected from the database, followed by a title and abstract then full text screening. Studies were selected against the set inclusion and exclusion criteria which resulted to 13 relevant studies being included from various sub-Saharan African countries, including Nigeria, South Africa, Kenya, Uganda and Ghana.
Results: The findings revealed a range of psychological impacts, such as depression, anxiety, stress, low self-esteem, and stigmas, consistently reported across the included studies. Additionally, some studies also identified suicide thoughts. Contextual factors, including unplanned pregnancies, lack of social support, poverty, disrupted education, history of mental illness, intimate partner violence (IPV) and gender-based violence, and diseases were identified as contributors to the psychological distress experienced by these young women. The proposed interventions and strategies to mitigate these issues included counselling services and support systems, economic empowerment programs, and community-based support systems.
Conclusion: The review highlighted an urgent need for a comprehensive and culturally sensitive intervention that not only addresses the mental health elements identified but also its root causes, which are majorly socio-economic and culturally embedded. Recommendations include tailoring mental health service provision, strengthening community- based support systems, improving access to comprehensive education and youth-friendly reproductive health services, sustainable economic empowerment, and prioritizing research and capacity-building initiatives. Overall, this scoping review emphasises that improving psychological well-being among pregnant teenagers and adolescent mothers is a necessary requirement for breaking the intergenerational cycles of disadvantage and supporting inclusive societal development initiatives in sub-Saharan African countries. 
The perceptions of adult residents in Delta State, Nigeria on the harms experienced by street children: A survey study
No full textBackground: Street children are a global public health issue and most common in in low- to middle-income countries like Nigeria. The average life expectancy, future economy, and security of a nation are determined by children, some of whom are on the street, so there is a need for more research. The aim of this research was to explore the perception of adult residents in Delta State, Nigeria, on the harm experienced by street children, targeted at informing policymakers on the need to address the issues faced by street children and improve the nation’s wealth.
Methods: This quantitative study used a convenience sampling method to recruit adult residents from 4 cities (Okpanam, Sapele, Ughelli, and Asaba, the capital city) in 19 local government areas in Delta State, located in the south-south region of Nigeria. Recruitment was undertaken via WhatsApp groups (community, religious, financial, and professional groups), and data was collected via an online questionnaire.
Results: 85 people (56% male) responded to the survey, and most (76%) are residents of Asaba from Oshimili South (34%). Street children were perceived negatively (56%), and the major factors that drove them to the street were perceived to be poverty (94%), neglect or lack of family responsibility (86%), orphanhood (69%), and a lack of parental education. Street children aged 5–10 years were mostly seen weekly (76%), and respondents perceived that these children experienced child abuse (92%), drug abuse (91%), ritual killings (82%), road traffic accidents (78%), alcohol abuse (75%), sexually transmitted infection 68% and mental problems (68%), diarrhoea (42%), and 9% of child trafficking, cultism, drug, and crime peddlers. Participants perceived that they often fall ill, and 75% of them have no access to medical care. Residents perceived that the government does not do enough to help street children’s situation, and it was highly recommended that everyone, including government and non-governmental organizations (NGOs), have a role to play, but mostly the government should provide free medical care, accommodation, free education, and health awareness programs to the parents and children. Parental financial empowerment and laws to force the government to curb this plight should be put forward. However, lack of funding and support from policymakers due to corruption, lack of cooperation from children and their parents, and illiteracy are perceived barriers to address the plight of street children.
Conclusion: Financial empowerment for parents and free education for the children would be most helpful in addressing this issu
A qualitative investigation into the perceptions and acceptance of the Sudanese community in Liverpool towards the Covid-19 vaccine
No full textBackground: The Covid-19 pandemic has significantly impacted global health, the economy, and daily life. Vaccination has been identified as an essential technique for regulating the virus\u27s transmission and lowering associated morbidity and fatality rates. However, vaccination adoption varies substantially between societies and is impacted by various factors such as cultural beliefs, trust in healthcare systems, and the availability of reliable information. The Sudanese community in Liverpool, like many other immigrant communities, faces particular obstacles and barriers that may influence how they perceive and embrace the COVID-19 vaccine. By investigating the underlying causes of vaccine hesitancy or acceptance, this study hopes to provide insights that can drive public health strategies and improve the effectiveness of vaccination efforts in this community.
Methods: Semi-structured, in-depth interviews were conducted to examine the perception of eight Sudanese Participants aged 18-58, with the first interview serving as the pilot interview. Participants were purposively sampled. Manual thematic analysis was used to analyse the qualitative data from the interviews.
Results: Eight participants, three men and five women (mean age; 38 years) were interviewed. Half of the participants had received the Covid-19 vaccine. Findings revealed eight themes as enablers and barriers to Covid-19 vaccination. The themes highlighted diverse factors influencing vaccine acceptance or hesitancy. External mandates, such as government and healthcare professionals\u27 roles, were found to play a crucial part in promoting vaccination through education and advocacy. Concerns about the safety and development of vaccines underscore the importance of transparent communication and addressing misinformation to build public trust. Participants showed concerns towards potential long-term vaccine effects.
Conclusion: The study on Liverpool\u27s Sudanese population\u27s acceptance of the Covid-19 vaccine revealed that different demographic groups had varying degrees of vaccine acceptability. Misinformation and cultural beliefs influenced vaccination acceptance, and the report stressed the importance of education in dispelling myths and building trust. It highlighted the vaccine\u27s efficacy and safety, the value of sensitive communication, and the role of healthcare professionals and community leaders in disseminating accurate information. The study also aimed to educate the public about support networks and resources for informed vaccination decisions
An empirical quantitative research study examining the health-related behaviours and knowledge of university students’ (18-30 years) towards e-cigarettes in the UK
No full textBackground: This research investigates what university students in the UK (aged 18-30) think and know about e-cigarettes and how they affect health. The goal of the study was to find out how much students know about e-cigarettes, how they feel about them, and if they perceive e-cigarettes as a way to stop smoking.
Methods: A survey was sent out online to 103 students studying different subjects and at different academic levels.
Results: The results show that 90% of people know about e-cigarettes, but levels of knowledge vary. Among them, 34% know a lot, 24% know some, 27% know a little, and 15% do not know at all. Almost half (46%) think e-cigarettes are just as harmful as regular cigarettes, while 31% think they are not as harmful and 15% think they are worse. Also, 63% think e-cigarettes can help people quit smoking, but 37% disagree. More females (52%) than males (38%) took part in the study, and the most common age group was 21-23 years old (33%). Postgraduate students made up the biggest educational group at 32%.
Conclusion: The research shows that better educational programs are needed to counteract misunderstandings about e-cigarettes and make public health messages clearer. In the future, researchers need to explore the impact of school programs and how students feel about the health impacts of e-cigarettes. 
A scoping review on contraceptive use (condom) and sexually transmitted infections in young people in Southeast Asia
No full textBackground: Sexually Transmitted Infections (STIs) is a public health concern due to the increasing incidence and prevalence around the world. Young People are mostly affected especially in Southeast Asia (SEA) due to involvement in risky sexual behaviours and lack of the use of condoms. The aim of the study is to explore studies which report on knowledge, awareness, attitudes, and risky behaviours related to STIs and condom use among young people in SEA.
Methods: This scoping review analyses the existing literatures to assess the extent of research that specifically investigates the topic of contraceptive use (specifically condoms) and sexually transmitted infections (STIs) in the population of young individuals residing in Southeast Asia (SEA). The PCC search Framework was adopted using key terms related to the topic and targeting articles published from 2010 to 2024, sought from CINAHL, Medline, Web of Science and PsycINFO. Duplicates were eliminated, followed by a sequential evaluation of the titles and abstracts, and finally a thorough examination of the relevant entire texts. Studies were chosen based on the given inclusion and exclusion criteria.
Results: Following the screening procedure, 11 studies were included in the review. Findings from the studies were categorized into four major themes; 1) knowledge and awareness of STIs 2) sociodemographic factors 3) factors associated with risky sexual behaviours, and 4) condom use and safe sex.
Conclusion: The review highlighted various factors associated with STIs and condom use in young people in SEA such as low levels of knowledge and awareness, engaging in unsafe sex, having multiple partners, and low socioeconomic status. This scoping review calls for increased investment in education, dissemination of information and awareness, interventions that emphasize self-efficacy in condom use and condom negotiation to prevent STIs and increase condom use. 
Parental perceptions on the use of technical devices on children aged three to seven years old
No full textThis study explores parental perceptions on the use of technical devices by children aged 3-7 years old. This includes parents’ opinions on how they perceive the use of electronic devices, for example, iPads, tablets, television, computers and game consoles as both positive and negative parts of children’s development. With the growing increase of digital technology use within the younger generations, it is important parents are aware of their own personal attitudes, concerns and rationales regarding the use of screentime. This study examines what influences and shapes these perceptions, for example parental knowledge and how parents perceive the impact of these devices on their children’s holistic developmental needs, as well as the factors influencing their decisions regarding screen time. Utilising a qualitative research design, data was collected via interviews with 6 parents. Interviews were done separately from their partners as some parents have different viewpoints than others. The findings indicate that while parents acknowledge both the educational benefits and potential drawbacks of technical devices, there is concern regarding overuse and its impact on relying on the use of iPad/consoles with some parents believing children have ‘forgotten’ how to play and be imaginative. Additionally parental perceptions were influenced by factors such as age, educational background, and personal experiences with technology. The study highlights the importance of balanced screen time, how parents perceive it to be both a negative and positive use of time, and why they may think it affects their child\u27s use of social skills, creativity and playtim
A qualitative study to explore port health officers’ opinions of the challenges for port health in the next five years: Commendation for Significant Achievement
No full textThe term port health refers to a function of environmental health which comprises of the protection of both public health and animal health and is carried out by the Local Authorities, Port Health Authorities at airports and at seaports. Like the environmental health profession, port health is facing some significant challenges. Despite the importance of the port health function, there are no previous studies which have investigated the challenges for port health and so the aim of this study is to explore opinions of the challenges for port health in the next five years among port health officers in order to enhance our understanding of the importance of the port health function and challenges which could affect the way how this function is delivered. A qualitative research approach was selected. One-to-one semi-structured interviews were adopted as the most suitable data collection method. Using both convenience sampling and snowball sampling, four participants were recruited. The data was thematically analysed manually and five broad themes emerged: the importance of the port health function, challenges for port health, effectiveness of legislation, consequences/effects of challenges and potential solutions. These were discussed in relation to the literature and showed that the challenges for port health are an important issue which needs to be recognized and addressed effectively. If the challenges are not addressed effectively, it could affect how port health is delivered and increase the risk of an outbreak of a new animal or plant pest or pathogen which could affect public, animal and environmental health leading to devastating consequences for industry and economy of the country
Understanding the impact of child sexual abuse (CSA): a comprehensive analysis of psychological, legal, and social implications in the UK
No full textSexual abuse affects millions of children and adolescents globally - 18% of girls and 8% of boys, posing a significant public health issue and human rights violation. It is estimated that 18 million children in the European Region have experienced sexual abuse before they turn 18 years old. It is a solemn concern that demands attention and action from public health officials as well as society at large. In addition to being a grave violation of fundamental human rights, this poses a serious public health risk. The effects of child sexual abuse (CSA) go well beyond the immediate physical harm; they frequently show up as long-lasting mental health issues that can last a person\u27s entire life. It is strongly linked to various short- and long-term negative consequences, according to scholars working in the field. The most serious violation of children\u27s rights and a major mental health issue for societies is CSA causing severe and often fatal consequences on survivors, including mental illness, self-harm, suicidal ideation, and suicide attempts, affecting them throughout their lifetime. Thus, comprehensive measures are needed to ensure survivors receive necessary resources for healing and prevent atrocities while raising awareness and taking collective action can protect society\u27s most vulnerable citizens. Since CSA is a worldwide issue and a very broad topic, it would be endless to investigate on a global scale; therefore, this dissertation will concentrate on CSA in the UK. The aim of this dissertation is to explore the short and long-term effects on children’s mental health, the effects on their brain, common intervention strategies, legal responses to child sexual abuse (challenges and gaps), institutional settings and CSA from a global perspective; understanding the perpetrators: profile and risk factors; the impact of child sexual abuse on family dynamics; the role of social media in child sexual abuse: risks and prevention; the role of media in shaping public perception of CSA; the role of social workers and child protection services in the UK; the role of education in preventing CSA. The overall conclusion is that CSA has been treated with a certain degree of levity and justice has been done very slowly over the years, and a series of measures are needed to address all the gaps and challenges more effectively. Final recommendations are addressed to the government and all institutions working with children and families in the UK
The effectiveness of exercise and diet in type 2 diabetes mellitus prevention in young people in Sub-Saharan Africa
No full textBackground: Type 2 Diabetes Mellitus (T2DM) is an escalating public health issue among youth aged 15–29 in sub-Saharan Africa (SSA), fuelled by urbanization, globalization, and lifestyle changes such as unhealthy diets and physical inactivity. As SSA faces a dual burden of communicable and non-communicable diseases, preventive strategies tailored to the region’s unique socio- economic and cultural contexts are urgently needed. This scoping review evaluates the effectiveness of dietary and physical activity interventions in preventing T2DM among SSA youth, emphasizing the importance of culturally sensitive and sustainable solutions.
Methods: A scoping review methodology was adopted, guided by the Population, Concept, and Context (PCC) framework. The review systematically identified and synthesized evidence from eight studies focused on dietary and physical activity interventions targeting youth in SSA. Data extraction included study design, intervention type, outcomes such as glycaemic control and obesity reduction, and contextual factors influencing intervention success. Thematic analysis was utilized to identify patterns and trends across studies, highlighting both successes and limitations.
Results: The findings demonstrate that lifestyle interventions significantly reduce T2DM risk among SSA youth by improving glycaemic control, reducing obesity, and enhancing physical activity levels. Dietary modifications, such as reducing sugar-sweetened beverage consumption and promoting traditional diets, emerged as effective strategies. Physical activity interventions, particularly community-based programs, overcame barriers like safety concerns and limited facilities. Integrated interventions combining diet and exercise yielded superior outcomes compared to standalone approaches. However, challenges persist, including socio-economic barriers, cultural norms favouring larger body sizes, and inadequate healthcare infrastructure.
Conclusion: This review highlights the urgent need for context-specific and culturally sensitive interventions to prevent T2DM in SSA youth. Addressing barriers such as the high cost of healthy foods, limited recreational spaces, and cultural perceptions is critical. Future research should focus on long-term outcomes, scalability, and regional disparities. Leveraging community-based programs, education campaigns, and mobile health platforms can enhance the effectiveness and sustainability of interventions, reducing the T2DM burden among SSA youth and improving overall public health outcomes.
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