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Healthy Communities Publications

Barriers to healthcare access: findings from a co-produced Long Covid case-finding study

Clutterbuck   D, Ramasawmy M, Pantelic M, Hayer J, Begum F, Faghy   M et al

Long Covid is often stigmatised, particularly in people who are disadvantaged within society. This may prevent them from seeking help and could lead to widening health inequalities. This coproduced study with a Community Advisory Board (CAB) of people with Long Covid aimed to understand healthcare and wider barriers and stigma experienced by people with probable Long Covid.

 An active case finding approach was employed to find adults with probable, but not yet clinically diagnosed, Long Covid in two localities in London (Camden and Merton) and Derbyshire, England. Interviews explored the barriers to care and the stigma faced by participants and were analysed thematically. This study forms part of the STIMULATE-ICP Collaboration.

April 2024

Healthy Communities

Domestic Abuse in the Context of Life-Limiting Illness: A Systematic Scoping Review

Michelle Myall, Sophia Taylor, Sally Wheelwright, Susi Lund

Domestic abuse is a global public health issue which impacts the health and wellbeing of victim-survivors and their families. 

While prevalence of domestic abuse is consistent amongst individuals and groups, some experience additional inequalities, vulnerabilities, and risk factors. This includes people living with life-limiting illnesses such as incurable cancer, neurological conditions and progressive heart, pulmonary, and renal conditions, who are at increased risk of domestic abuse because they are vulnerable, frail, isolated, and dependent on others. People with a life-limiting illness are more likely to spend long periods in the home, in close proximity to the perpetrator who may also be their caregiver, and experience multiple barriers to accessing and seeking support and may be less willing or able to escape the abusive situation. Lockdown and social isolation measures implemented to combat COVID-19 exacerbated the risk for those with a life-limiting illness experiencing domestic abuse. Existing patterns of abuse increased in terms of frequency and type.

To date, little is known about domestic abuse in the context of life-limiting illness, including the experiences and support needs of those affected; awareness, knowledge, and understanding of domestic abuse and life-limiting illness amongst health and care professionals and third sector organisations or their views and experiences of enquiring about, responding to, and supporting adults living with a life-limiting illness impacted by domestic abuse. This review has been undertaken as part of a wider study (DALLI) to coproduce a toolkit to enable hospice and palliative care practitioners to identify and respond to domestic abuse. The review is needed to inform understanding about the coexistence of domestic abuse and life-limiting illness, address gaps in academics and practitioners’ knowledge, and identify areas for further research.

April 2023

Healthy Communities

Silymarin (Milk Thistle) Treatment of Adults With Gambling Disorder: A Double-Blind, Placebo-Controlled Trial

Grant JE, Driessens C, Chamberlain SR

Data on the pharmacological treatment of gambling disorder are limited. Silymarin (derived from milk thistle) has antioxidant properties. The goal of the current study was to determine the efficacy and tolerability of silymarin in adults with gambling disorder.


March 2024

Healthy Communities

Cognitive function and skeletal size and mineral density at age 6-7 years: Findings from the Southampton women's survey

Moon RJ,   D'Angelo S, Crozier SR, Fernandes M, Fall C, Gale CR et al

Poor cognitive function and osteoporosis commonly co-exist in later life. In women, this is often attributed to post-menopausal estrogen loss. However, a common early life origin for these conditions and the associations between cognitive function and bone mineral density (BMD) in childhood have not previously been explored. We examined these relationships at age 6–7 years in the Southampton Women's Survey (SWS) mother-offspring cohort.

March 2024

Healthy Communities

Blood pressure measurement and adverse pregnancy outcomes: A cohort study testing blood pressure variability and alternatives to 140/90 mmHg

Wilson   MG, Bone JN, Slade LJ, Mistry HD, Singer J, Crozier SR

To examine the association with adverse pregnancy outcomes of: (1) American College of Cardiology/American Heart Association blood pressure (BP) thresholds, and (2) visit-to-visit BP variability (BPV), adjusted for BP level.

December 2023

Healthy Communities

Causal effects of later-eating rhythm on adiposity in children through the comparison of two cohorts in the UK and China: a cross-cohort study

Zou M,   Northstone K, Leary S.

Later-eating rhythm (LER) refers to a later timing, greater energy intake, and higher meal frequency in the evening. The role of childhood LER in obesity development is emerging, but most evidence is cross-sectional. Cross-context comparison allows the improvement of causal inference in observational studies by comparing cohorts with different confounding structures. This method is applied to assess the causal effects of LER on adiposity, by exploring the likelihood of residual confounding due to socioeconomic status.

November 2023

Healthy Communities

Food insecurity and diet quality in households accessing food membership clubs in Wessex: a mixed-methods study

Taylor   E, Ziauddeen N, Alwan NA, Smith D

Food membership clubs that charge a small fee for a set number of items are in place in Wessex to address food insecurity (inadequate reliable access to sufficient affordable, nutritious food). These clubs incorporate longer-term solutions such as budgeting support, benefit maximisation, and cooking skills. The Wessex DIET project was established to measure acceptability and impact of these clubs. Given the paucity of evidence on the prevalence of food insecurity in those accessing such clubs, we aimed to quantify food insecurity and assess diet quality and wellbeing at recruitment.

November 2023

Healthy Communities

Barriers and facilitators experienced in delivering alcohol screening and brief interventions in community pharmacy: a qualitative evidence synthesis 

Smith A,   Buchanan A, Parkes J, Stone H, Tan QY, Ibrahim K

Following increases in deaths due to alcohol during the COVID-19 pandemic, there have been renewed calls to increase resources in alcohol screening and brief intervention (SBI). Research has shown that community pharmacy could be a promising setting for SBI. This review aimed to investigate the barriers and facilitators to SBI delivery in community pharmacy to inform its further development.

November 2023

Healthy Communities

The Palestinian primary ciliary dyskinesia population: first results of the diagnostic and genetic spectrum

Rumman   N, Fassad MR, Driessens C, Goggin P, Abdelrahman N, Adwan A, Albakri M,   Chopra J, Doherty R, Fashho B, Freke GM, Hasaballah A, Jackson CL, Mohamed   MA, Abu Nema R, Patel MP, Pengelly RJ, Qaaqour A, Rubbo B, Thomas NS,   Thompson J, Walker WT, Wheway G, Mitchison HM, Lucas JS.

Diagnostic testing for primary ciliary dyskinesia (PCD) started in 2013 in Palestine. We aimed to describe the diagnostic, genetic and clinical spectrum of the Palestinian PCD population.

doi:   10.1183/23120541.00714-2022.

April 2023

Healthy Communities

 The role of parity in the relationship between endometriosis and pregnancy outcomes: a systematic review and meta-analysis

Sri   Ranjan Y, Ziauddeen N, Stuart B, Alwan NA, Cheong Y

Endometriosis is a chronic and debilitating condition which can affect the entire reproductive life course of women with a potentially detrimental effect on pregnancy. Pregnancy (and increasing parity) can affect endometriosis by modulating disease severity and suppressing symptoms. Multiparous women could be less likely to suffer from endometriosis-related pregnancy complications than primiparous women. We aimed to systematically review the evidence examining the role of parity in the relationship between pregnancy outcomes and endometriosis.

doi:   10.1530/RAF-22-0070

March 2023

Healthy Communities

Ethnic differences in kidney function in childhood: the Born in Bradford Cohort Renal Study

Ziauddeen N, Jeffrey RF, Waiblinger D, Fraser SDS, Alwan NA, Yuen HM, Azad R, Mason D, Wright J, Coward RJM, Roderick PJ

Endstage kidney failure rates are higher in South Asians than in White Europeans. Low birth weight is associated with adult chronic kidney disease and is more common in South Asians. Foetal kidney size was smaller in South Asians in the Born in Bradford (BiB) birth cohort. 

As part of BiB follow up, we aimed to investigate if there were ethnic differences in kidney function and blood pressure in early childhood and whether this was different by foetal kidney size.


August 2023

Healthy Communities

EXPERTS II - How are patient and caregiver participation in health and social care shaped by experienced burden of treatment and social inequalities? Protocol for a qualitative synthesis.

May CR, Chew-Graham CA, Gallacher KI, Gravenhorst KC, Mair FS, Nolte E, Richardson A

Background: The workload health and social care service users and caregivers take on, and their capacity to do this work is important. It may play a key part in shaping the implementation of innovations in health service delivery and organisation; the utilisation and satisfaction with services; and the outcomes of care. Previous research has often focused on experiences of a narrow range of long-term conditions, and on factors that shape adherence to self-care regimes.

Aims: With the aim of deriving policy and practice implications for service redesign, this evidence synthesis will extend our understanding of service user and caregiver workload and capacity by comparing how they are revealed in qualitative studies of lived experience of three kinds of illness trajectories: long-term conditions associated with significant disability (Parkinson's disease, schizophrenia); serious relapsing remitting disease (Inflammatory Bowel Disease, bipolar disorder); and rapidly progressing acute disease (brain cancer, early onset dementia).

doi: 10.7748/cnp.21.5.22.s10

October 2023

Healthy Communities

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