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  • Reassessing the health impacts of trade and investment agreements: a systematic review of quantitative studies, 2016-20.

    Barlow, Pepita; Sanap, Rujuta; Garde, Amandine; Winters, L Alan; Mabhala, Mzwandile A; Thow, Anne-Marie (2022-05)
    To ensure a high level of health protection, governments must ensure that health and trade policy objectives are aligned. We conducted a systematic review of the health impacts of trade policies, including trade and investment agreements (TIAs), to provide a timely overview of this field. We systematically reviewed studies evaluating the health impacts of trade policies published between Jan 19, 2016, and July 10, 2020. Included studies were quantitative studies evaluating the impact of TIAs and trade policies on health determinants or outcomes. We evaluated methodological quality and performed a narrative synthesis. 21 of 28 067 articles identified via searches met our criteria. Methodologically strong studies found reduced child mortality, deteriorating worker health, rising supplies of sugar, ultra-processed food, tobacco, and alcohol supplies, and increased drug overdoses following trade reforms, compared with the time periods before trade reform. However, associations varied substantially across contexts and socioeconomic characteristics. Our findings show that trade policies, including TIAs, have diverse effects on health and health determinants. These effects vary substantially across contexts and socioeconomic groups. Governments seeking to adopt healthy trade policies should consider these updated findings to ensure that opportunities for health improvement are leveraged and widely shared, while harms are avoided, especially among vulnerable groups. [Abstract copyright: Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.]
  • Towards adoption of mobile data collection for effective adaptation and climate risk management in Africa

    Adekola, Olalekan; orcid: 0000-0001-9747-0583; Lamond, Jessica; orcid: 0000-0001-8931-0192; Adelekan, Ibidun; orcid: 0000-0002-3407-8549; Bhattacharya‐Mis, Namrata; orcid: 0000-0003-4967-8325; Ekinya, Mboto; Bassey Eze, Eze; Ujoh, Fanan; orcid: 0000-0003-2554-0815 (Wiley, 2022-05-16)
  • Immersive Virtual Reality for the Cognitive Rehabilitation of Stroke Survivors

    Chatterjee, Kausik; orcid: 0000-0002-3093-1469; Buchanan, Alastair; Cottrell, Katy; orcid: 0000-0002-1418-7676; Hughes, Sara; orcid: 0000-0001-6510-5960; Day, Thomas W.; orcid: 0000-0002-9153-4862; John, Nigel W.; orcid: 0000-0001-5153-182X (Institute of Electrical and Electronics Engineers (IEEE), 2022)
  • Magazines as contradictory spaces for alcohol messaging: a mixed method content and thematic analysis of UK women’s magazine representations of alcohol and its consumption

    Atkinson, A. M.; orcid: 0000-0002-9936-6138; Meadows, B. R.; Ross-Houle, K. M.; Smith, C.; Sumnall, H. R.; orcid: 0000-0002-7841-9245 (Informa UK Limited, 2022-05-16)
  • Educators' experiences and perspectives of child weight discussions with parents in primary school settings.

    Coupe, Nia; orcid: 0000-0003-4974-5794; Peters, Sarah; Ayres, Matilda; Clabon, Katie; Reilly, Alexandra; Chisholm, Anna (2022-04-22)
    <h4>Background</h4>The role of schools in addressing rising childhood obesity levels has been acknowledged, and numerous diet- and physical activity-related interventions exist. Aside from formal interventions, opportunistic parent-educator conversations about child weight can arise, particularly in primary school settings, yet little is known about how useful these are. This study aimed to understand the utility of child weight related conversations with parents through exploring educators' experiences and perspectives.<h4>Methods</h4>This qualitative study consisted of semi-structured interviews conducted with primary school teaching staff in the United Kingdom (N = 23), recruited through purposive and subsequent snowball sampling. Interviews were audio-recorded, transcribed, and analysed using thematic analysis.<h4>Results</h4>Participants identified opportunities and need for child weight discussions in schools. However, conversations were prevented by the indirect and sensitive nature of conversations, and educators' professional identity beliefs. Using pre-existing face-to-face opportunities, good parent-teacher relationships and holistic approaches to child health and wellbeing were reported as important in optimising these conversations.<h4>Conclusions</h4>Whilst educator-parent child weight discussions are necessary, discussions are highly challenging, with contradictory views on responsibility sometimes resulting in avoidance. Educators' roles should be clarified, and communication training tailored to increase teacher confidence and skills. Current social distancing will likely reduce opportunistic encounters, highlighting a need to further improve communication routes.
  • Nursing care for the military veteran and their family.

    Finnegan, Alan; orcid: 0000-0002-2189-4926; Randles, Rebecca; orcid: 0000-0002-7401-5817 (2022-05-09)
  • Modeling cholesterol metabolism and atherosclerosis

    Mc Auley, Mark Tomás; orcid: 0000-0001-9230-6928 (Wiley, 2021-12-20)
  • Suicide rates amongst individuals from ethnic minority backgrounds: A systematic review and meta-analysis.

    Troya, M Isabela; Spittal, Matthew J; Pendrous, Rosina; Crowley, Grace; Gorton, Hayley C; Russell, Kirsten; Byrne, Sadhbh; Musgrove, Rebecca; Hannah-Swain, Stephanie; Kapur, Navneet; et al. (2022-04-28)
    Existing evidence suggests that some individuals from ethnic minority backgrounds are at increased risk of suicide compared to their majority ethnic counterparts, whereas others are at decreased risk. We aimed to estimate the absolute and relative risk of suicide in individuals from ethnic minority backgrounds globally. Databases (Medline, Embase, and PsycInfo) were searched for epidemiological studies between 01/01/2000 and 3/07/2020, which provided data on absolute and relative rates of suicide amongst ethnic minority groups. Studies reporting on clinical or specific populations were excluded. Pairs of reviewers independently screened titles, abstracts, and full texts. We used random effects meta-analysis to estimate overall, sex, location, migrant status, and ancestral origin, stratified pooled estimates for absolute and rate ratios. PROSPERO registration: CRD42020197940. A total of 128 studies were included with 6,026,103 suicide deaths in individuals from an ethnic minority background across 31 countries. Using data from 42 moderate-high quality studies, we estimated a pooled suicide rate of 12·1 per 100,000 (95% CIs 8·4-17·6) in people from ethnic minority backgrounds with a broad range of estimates (1·2-139·7 per 100,000). There was weak statistical evidence from 51 moderate-high quality studies that individuals from ethnic minority groups were more likely to die by suicide (RR 1·3 95% CIs 0·9-1·7) with again a broad range amongst studies (RR 0·2-18·5). In our sub-group analysis we only found evidence of elevated risk for indigenous populations (RR: 2·8 95% CIs 1·9-4·0; pooled rate: 23·2 per 100,000 95% CIs 14·7-36·6). There was very substantial heterogeneity (  > 98%) between studies for all pooled estimates. The homogeneous grouping of individuals from ethnic minority backgrounds is inappropriate. To support suicide prevention in marginalised groups, further exploration of important contextual differences in risk is required. It is possible that some ethnic minority groups (for example those from indigenous backgrounds) have higher rates of suicide than majority populations. No specific funding was provided to conduct this research. DK is funded by Wellcome Trust and Elizabeth Blackwell Institute Bristol. Matthew Spittal is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. Rebecca Musgrove is funded by the NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC-2016-003). [Abstract copyright: © 2022 The Authors.]
  • ‘It’s more than confusing our b’s and d’s’: a commentary on the lack of understanding of the needs of social work students who have dyslexia

    Hewson, Michael; Gant, Valerie (Bristol University Press, 2020-08-01)
    Drawing on principles of auto-ethnography, this commentary offers for discussion reflections on a personal reaction to some of the struggles experienced when navigating the English social work placement landscape for a student who has a diagnosis (or label) of dyslexia/dyspraxia. Commenting on some of the challenges faced in order to try and survive the placement experience necessary to complete the programme, this account makes recommendations and suggestions for educators in university and in practice.
  • Universal Credit, lone mothers and poverty: some context and challenges for social work with children and families

    Carey, Malcolm; Bell, Sophie (Bristol University Press, 2020-08-01)
    Universal Credit is a streamlined benefits delivery system initially introduced in the UK in 2008. Conditionality-based welfare policies are increasingly international in scale, and are now widely adopted by neoliberal governments on the basis that paid employment offers the most efficacious route out of poverty for citizen-subjects. Numerous studies suggest otherwise and highlight their negative impact upon the social rights, lived experiences and attempts to alleviate poverty for claimants. This article analyses the effect of the reformed benefit system and wider workfare policies upon lone mothers, including as a consequence of engagement with an ever-more stigmatising benefit system, and associated risks posed by sanctions or precarious low-paid employment. It highlights some of the consequences for social work with children and families of Universal Credit, including ongoing tensions and challenges created for the profession by the punitive policies of the workfare-oriented centaur state.
  • <i>‘I call it the hero complex’ –</i> Critical considerations of power and privilege and seeking to be an agent of change in qualitative researchers’ experiences

    Oakley, Lisa; orcid: 0000-0001-8909-7889; Fenge, Lee-Ann; orcid: 0000-0003-0896-7323; Taylor, Bethan (Informa UK Limited, 2020-01-30)
  • Beyond the medical encounter: can the free association narrative interview method extend psychosocial understandings of non-epileptic attack disorder?

    Peacock, Marian; Dickson, Jon M.; Bissell, Paul; Grunewald, Richard; Reuber, Markus (Bristol University Press, 2022-05-05)
    This exploratory interdisciplinary study was devised to explore how using the free association narrative interview (FANI) method might extend understanding of non-epileptic attack disorder (NEAD) within a psychosocial framework. NEAD is the medical definition of what can be described as embodied events that resemble epilepsy, but which are not associated with the abnormal electrical discharges in the brain found in epilepsy. They are the most frequent ‘functional’ disorder or medically unexplained symptom (MUS) seen by neurologists. While NEAD is associated with trauma, distress and negative life events, a significant minority of patients report no trauma history. The FANI method, we argue, produced narratives which shed light on events that patients have not acknowledged as traumatic, but which might be considered as such, and we explore what aspects of the method may facilitate this process. Previous work has highlighted that a diagnosis of NEAD is often experienced as deeply troubling and contentious to both give and to receive. We thus reflect on the need for patients to feel a sense of legitimacy and how the challenges of living with a NEAD diagnosis are negotiated. Drawing on the work of Benjamin (2004) on ‘thirdness’, we suggest that the FANI method can allow the research interview to become a space that facilitates novel ways of engaging around NEAD. We conclude that the method may be a powerful tool for studying NEAD, and that further studies should be undertaken using this approach since it may have broader utility in understanding the landscape of functional neurological disorders.
  • Causation, historiographic approaches and the investigation of serious adverse incidents in mental health settings.

    Bhandari, Sahil; Thomassen, Øyvind; Nathan, Rajan; orcid: 0000-0003-2780-6170 (2022-05-03)
    To improve the safety of healthcare systems, it is necessary to understand harm-related events that occur in these systems. In mental health services, particular attention is paid to harm arising from the actions of patients against themselves or others. The primary intention of examining these adverse events is to inform changes to care provision so as to reduce the likelihood of the recurrence of such events. The predominant approach to investigating adverse incidents has relied on the cause-and-effect conceptualisation of past events. Whilst the merits of approaches which are reliant on cause-and-effect narratives have been questioned, alternatives models to explain adverse incidents in health settings have not been theoretically or empirically tested. This novel article (i) examines the notion of causation (and the related notion of omission) in the context of explaining adverse events in mental health settings, and (ii) draws on a long-established discipline devoted to the study of how the past is interpreted (namely historiography) to theoretically investigate the innovative application of two historiographical approaches (i.e. counterfactual analysis and historical materialism) to understanding adverse events in mental health settings.
  • Towards adoption of mobile data collection for effective adaptation and climate risk management in Africa

    Adekola, Olalekan; orcid: 0000-0001-9747-0583; email:; Lamond, Jessica; orcid: 0000-0001-8931-0192; Adelekan, Ibidun; orcid: 0000-0002-3407-8549; Bhattacharya‐Mis, Namrata; orcid: 0000-0003-4967-8325; Ekinya, Mboto; Bassey Eze, Eze; Ujoh, Fanan; orcid: 0000-0003-2554-0815 (2022-05-16)
    Abstract: The collection and use of data on climate change and its impacts are crucial for effective climate adaptation and climate risk management. The revolution in internet access, technology and costs has led to a shift from using traditional paper‐based data collection to the use of Mobile Data Collection using Personal Digital Assistants (PDA) such as smartphones and tablets. In this paper, we report our experiences using both approaches for a household and business survey during a climate adaptation study in two Nigerian cities—Makurdi and Calabar. The focus of this paper is to evaluate and compare the effectiveness of using traditional paper‐based data collection and PDAs as data collection tools for climate change study in African societies. In Calabar, data were collected using paper questionnaires, while in Makurdi the questionnaires were developed on Open Data Kit (ODK) and administered using PDAs. Results show that data collection using PDA was faster, cheaper, more accurate and resulted in fewer omissions than paper‐based data collection. There was a time saving of four (4) minutes per questionnaire and a 24% cost saving when using PDA. PDA provides additional benefits where platforms can collect images, videos and coordinates. This significantly improved the credibility of the data collection process and provided further data that allowed for the mapping of environmental phenomena by linking survey research with geo‐referenced data in a geographic information systems platform to provide spatial representations of social and environmental system convergence. PDA offers a tool for collecting data that will make necessary socio‐environmental data available in a faster, reliable and cheaper manner; future research can build on this study by discovering other possible but less highlighted benefits of PDA. Although, with great benefits, there are lessons to be learnt and issues to consider when deploying PDA in large‐scale household surveys.
  • Factors Influencing COVID-19 Vaccine Uptake among Nepali People in the UK: A Qualitative Study

    Simkhada, Padam; email:; Tamang, Pasang; orcid: 0000-0003-2733-7239; email:; Timilsina, Laxmi; email:; Simkhada, Bibha; email:; Bissell, Paul; email:; van Teijlingen, Edwin; email:; Sah, Sunil Kumar; email:; Wasti, Sharada Prasad; orcid: 0000-0001-8833-7801; email: (MDPI, 2022-05-14)
    Vaccination saves lives and can be an effective strategy for preventing the spread of the COVID-19, but negative attitudes towards vaccines lead to vaccine hesitancy. This study aimed to explore the factors influencing the uptake of the COVID-19 vaccine in the Nepali community in the United Kingdom (UK). This qualitative study included in-depth interviews with 20 people from Nepal living in the UK. Interviews were conducted by a native-Nepali speaker and all interviews were audio-recorded, transcribed, and translated into English before being analysed thematically. Our study found that attitudes towards COVID-19 are generally positive. Nine overlapping themes around barriers to COVID-19 vaccination were identified: (a) rumours and mis/disinformation; (b) prefer home remedies and yoga; (c) religion restriction; (d) concern towards vaccine eligibility; (e) difficulty with online vaccine booking system; (f) doubts of vaccine effectiveness after changing the second dose timeline; (g) lack of confidence in the vaccine; (h) past bad experience with the influenza vaccine; and i) worried about side-effects. Understanding barriers to the uptake of the COVID-19 vaccine can help in the design of better targeted interventions. Public health messages including favourable policy should be tailored to address those barriers and make this vaccination programme more viable and acceptable to the ethnic minority communities in the UK.
  • How downplaying or exaggerating crime severity in a confession affects perceived guilt

    Holt, Glenys A.; Palmer, Matthew A. (Informa UK Limited, 2020-12-14)
  • A novel genetic search scheme based on nature-inspired evolutionary algorithms for binary self-dual codes

    Korban, Adrian; Şahinkaya, Serap; Ustun, Deniz (American Institute of Mathematical Sciences (AIMS), 2022)
    &lt;p style='text-indent:20px;'&gt;In this paper, a genetic algorithm, one of the evolutionary algorithm optimization methods, is used for the first time for the problem of computing extremal binary self-dual codes. We present a comparison of the computational times between the genetic algorithm and a linear search for different size search spaces and show that the genetic algorithm is capable of computing binary self-dual codes significantly faster than the linear search. Moreover, by employing a known matrix construction together with the genetic algorithm, we are able to obtain new binary self-dual codes of lengths 68 and 72 in a significantly short time. In particular, we obtain 11 new binary self-dual codes of length 68 and 17 new binary self-dual codes of length 72.&lt;/p&gt;
  • New type I binary $[72, 36, 12]$ self-dual codes from $M_6(\mathbb{F}_2)G$ - Group matrix rings by a hybrid search technique based on a neighbourhood-virus optimisation algorithm

    Korban, Adrian; Sahinkaya, Serap; Ustun, Deniz (American Institute of Mathematical Sciences (AIMS), 2022)
    &lt;p style='text-indent:20px;'&gt;In this paper, a new search technique based on a virus optimisation algorithm is proposed for calculating the neighbours of binary self-dual codes. The aim of this new technique is to calculate neighbours of self-dual codes without reducing the search field in the search process (this technique is known in the literature due to the computational time constraint) but still obtaining results in a reasonable time (significantly faster when compared to the standard linear computational search). We employ this new search algorithm to the well-known neighbour method and its extension, the &lt;inline-formula&gt;&lt;tex-math id="M1"&gt;\begin{document}$ k^{th} $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt;-range neighbours, and search for binary &lt;inline-formula&gt;&lt;tex-math id="M2"&gt;\begin{document}$ [72, 36, 12] $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt; self-dual codes. In particular, we present six generator matrices of the form &lt;inline-formula&gt;&lt;tex-math id="M3"&gt;\begin{document}$ [I_{36} \ | \ \tau_6(v)], $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt; where &lt;inline-formula&gt;&lt;tex-math id="M4"&gt;\begin{document}$ I_{36} $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt; is the &lt;inline-formula&gt;&lt;tex-math id="M5"&gt;\begin{document}$ 36 \times 36 $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt; identity matrix, &lt;inline-formula&gt;&lt;tex-math id="M6"&gt;\begin{document}$ v $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt; is an element in the group matrix ring &lt;inline-formula&gt;&lt;tex-math id="M7"&gt;\begin{document}$ M_6(\mathbb{F}_2)G $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt; and &lt;inline-formula&gt;&lt;tex-math id="M8"&gt;\begin{document}$ G $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt; is a finite group of order 6, to which we employ the proposed algorithm and search for binary &lt;inline-formula&gt;&lt;tex-math id="M9"&gt;\begin{document}$ [72, 36, 12] $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt; self-dual codes directly over the finite field &lt;inline-formula&gt;&lt;tex-math id="M10"&gt;\begin{document}$ \mathbb{F}_2 $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt;. We construct 1471 new Type I binary &lt;inline-formula&gt;&lt;tex-math id="M11"&gt;\begin{document}$ [72, 36, 12] $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt; self-dual codes with the rare parameters &lt;inline-formula&gt;&lt;tex-math id="M12"&gt;\begin{document}$ \gamma = 11, 13, 14, 15, 17, 19, 20, 21, 22, 23, 25, 26, 28, 29, 30, 31, 32 $\end{document}&lt;/tex-math&gt;&lt;/inline-formula&gt; in their weight enumerators.&lt;/p&gt;
  • Examining patient and professional perspectives in the UK for gene therapy in haemophilia

    Woollacott, Ione; Morgan, George; orcid: 0000-0003-2014-3415; Chowdary, Pratima; O'Hara, Jamie; Franks, Bethany; Overbeeke, Eline; orcid: 0000-0003-0073-9350; Dunn, Nicola; Michelsen, Sissel; Huys, Isabelle; Martin, Antony; orcid: 0000-0003-4383-6038; et al. (Wiley, 2022-04-19)
  • How Well Are Hand Hygiene Practices and Promotion Implemented in Sierra Leone? A Cross-Sectional Study in 13 Public Hospitals.

    Lakoh, Sulaiman; orcid: 0000-0002-7639-0004; Maruta, Anna; orcid: 0000-0002-6417-7273; Kallon, Christiana; Deen, Gibrilla F; Russell, James B W; Fofanah, Bobson Derrick; orcid: 0000-0003-3276-8949; Kamara, Ibrahim Franklyn; orcid: 0000-0003-1454-4650; Kanu, Joseph Sam; orcid: 0000-0003-0799-6907; Kamara, Dauda; Molleh, Bailah; et al. (2022-03-23)
    Healthcare-associated infections (HAIs) result in millions of avoidable deaths or prolonged lengths of stay in hospitals and cause huge economic loss to health systems and communities. Primarily, HAIs spread through the hands of healthcare workers, so improving hand hygiene can reduce their spread. We evaluated hand hygiene practices and promotion across 13 public health hospitals (six secondary and seven tertiary hospitals) in the Western Area of Sierra Leone in a cross-sectional study using the WHO hand hygiene self-Assessment framework in May 2021. The mean score for all hospitals was 273 ± 46, indicating an intermediate level of hand hygiene. Nine hospitals achieved an intermediate level and four a basic level. More secondary hospitals 5 (83%) were at the intermediate level, compared to tertiary hospitals 4 (57%). Tertiary hospitals were poorly rated in the reminders in workplace and institutional safety climate domains but excelled in training and education. Lack of budgets to support hand hygiene implementation is a priority gap underlying this poor performance. These gaps hinder hand hygiene practice and promotion, contributing to the continued spread of HAIs. Enhancing the distribution of hand hygiene resources and encouraging an embedded culture of hand hygiene practice in hospitals will reduce HAIs.

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