Public understanding of and judgements towards physical health-related interventions in forensic service users

To explore the general public’s understanding and judgement of health interventions inside and outside of prisons. To examine the role members of the community have in the successful rehabilitation and reintegration of individuals with convictions

Deep-Sea Mining: Processes and Impacts

Mining the extensive accumulations of minerals on the seafloor of the deep ocean can provide important resources but also has the potential to lead to widespread environmental impacts. Some of these impacts are unknown but there are expected to be differences between the mining of the three main resource types: polymetallic nodules, seafloor massive sulphides and cobalt-rich crusts. Here we detail the mining processes as well as the expected impacts of mining and discuss their potential effects to deep-ocean ecosystems. We also highlight the missing evidence needed to underpin effective environmental management and regulation of the nascent deep-sea mining industry.The attached document is the author’s final accepted/submitted version of the journal article. You are advised to consult the publisher’s version if you wish to cite from it

“I just get on with it.”: A qualitative phenomenological study looking at the personal experience of chronic benign pain

"Objectives: Chronic benign pain is a complex, distressing and prevalent problem in society. It is observed that pain impedes everyday activities (Andrew et al., 2013) and that it is a unique sensory and emotional experience (Bushnell, Čeko, and Low, 2013). Therefore, the objective of this study was to look at individuals’ experiences of pain to help understand its complicated nature and their perception of the self. Design: A qualitative phenomenology approach was used, with a small, profound sample of chronic pain sufferers. Methods: Semi-structured interviews were conducted and diary entries collected from two women and one man, which were then transcribed for interpretative phenomenological analysis. Results: Three major themes were found under the headings; the adversarial nature of pain, pain and the family role, and the physical entrapment of pain. Conclusions: Participants found the journey of chronic pain distressing and mostly negative by accounts of what they had experienced. The participants found that social interaction could be both positive and negative. Support systems were positive in one regard, however it also showed individual what they lacked physically. Physically, pain trapped the participants, with pain depersonalised from the self.

Investigating the association between socio-economic position and stillbirth in Brazil and the UK

Stillbirths are under-researched in comparison to other child health outcomes. They rarely appear in national health targets or commitments, despite being an immense global burden with 2.6 million cases annually. Using routine national datasets, this thesis compares the social disparities in stillbirth rates within and between the UK and Brazil as a high-income and middle-income country, respectively. The role of socio-economic position (SEP) in the likelihood of stillbirth, and how it is mediated through behavioural, health and pregnancy-related factors, is clarified comprehensively reviewed and a new conceptual model constructed. A comprehensive review of perinatal health policies in the UK and Brazil showcases Brazil’s evolution as a major emerging economy from a public health perspective, in relation to the UK. Analysis of the UK required two separate datasets; aggregated birth counts from ONS for England and Wales, and Scotland’s Maternity and Neonatal Linked Database (MNLD). In England and Wales, higher stillbirth rates were associated with areas containing higher proportions of ethnic minority babies, after accounting for maternal age and other confounders. Whilst the data for England and Wales was limited to an aggregate analysis, the comprehensive Scottish data allowed a mediation analysis which was applied to the MNLD to investigate more fully the causal pathways between SEP and stillbirth. While socio-demographic factors such as maternal age, ethnicity, and marital status were found to have no direct effect on stillbirth risk, their mediating influence on gestational age and birth weight played a vital role in the cause of stillbirth. Brazil’s National Household Sample Survey (PNAD) was analysed to determine the primary socioeconomic risk factors associated with stillbirth. The main challenge presented by the data was that the birth outcomes were presented as counts - the numbers of live births and stillbirths had by each woman. By converting the observed live birth and stillbirth counts for each woman into lists of possible birth sequences, and deriving the appropriate likelihood function, this thesis was able to perform regression on a new binary outcome for live birth verses stillbirth. Women with lower levels of education and inadequate household goods and services had a higher risk of stillbirth. Analysis of stillbirth rates based on women’s lifetime birth histories revealed some counter-intuitive relationships between geographic and social factors and stillbirth, which were distorted by high parity among disadvantaged women. Data and methodologies were too different to compare the magnitudes of variable effects between countries. Whilst our new methodological approaches have allowed more sophisticated analyses than have been previously possible, ultimately, this thesis has highlighted the strengths and limitations that different data sources allow in describing stillbirths globally. Without more comprehensive monitoring and better defined outcomes, countries will struggle to see the full picture. As we have shown aggregate level data are inadequate for public health monitoring in England and Wales, and restrictions on data availability prohibit informative individual-level analyses. Looking to the future the Scottish data has shown that the gold standard of data linkage is both viable and recommended for 21st century public health management

Dataset for "Pharmacy professionals' experiences and perceptions of providing NHS patient medicines helpline services: A qualitative study"

Transcripts of interviews with thirty-four pharmacy professionals about their experiences and perceptions of providing a National Health Service patient medicines helpline service.An interview schedule was developed for the purpose of interviewing participants regarding their experiences and perceptions of their PMHS, and was informed by the RE-AIM evaluation framework. RE-AIM comprises five dimensions that are considered important for evaluating the impact of healthcare interventions: Reach, Effectiveness, Adoption, Implementation, and Maintenance. We ensured that questions pertaining to each of the five RE-AIM dimensions were included in the schedule. During data collection, the interview schedule served as a flexible guide for interviews, enabling participants to discuss aspects of their PMHS that were important to them. All interviews were audio-recorded. After their interview, the following background data were collected from each participant over the telephone: age, gender, ethnicity, job title, number of years employed as a pharmacy professional, and number of years’ experience of operating or providing a PMHS. All audio-recorded interviews were transcribed verbatim into separate Microsoft Word documents. Framework analysis (FA) was used to analyse the transcribed data. Analysis involved the standard FA stages, as outlined by Ritchie and Spencer (the developers of FA): familiarisation with the data, coding, developing an analytical framework, indexing, charting, and interpretation. The only deviation to the FA stages was that Iterative Categorisation (IC) was used in place of charting. The choice to use IC was made in order to increase transparency and rigour.Data were analysed using NVivo version 12

Service users’ experiences of contacting NHS patient medicines helpline services: a qualitative study

Objectives Patient medicines helpline services (PMHS) are available from some National Health Service (NHS) Trusts in the UK to provide medicines information to hospital patients and carers. To date, studies of PMHS have examined the views of service users via satisfaction surveys. This study used qualitative methods to explore service users' experiences of using a PMHS, including perceived benefits and areas for improvement. Design Qualitative, using semi-structured interviews. Setting This study was conducted across seven NHS Trusts in England. Participants Forty users of PMHS were individually interviewed over the telephone. Interviews were audio-recorded, transcribed verbatim and analysed using Braun and Clarke's inductive reflexive thematic analysis. Ethical approval was obtained before study commencement. Results Participants predominantly called a PMHS for themselves (82%; carers: 18%). Two main themes were generated. Theme 1: timeliness - PMHS provide support during the uncertain transition of care period from hospital to home, when patients and carers often feel vulnerable because support is less available. PMHS met service users' needs for timely and easily accessible support, and quick resolution of their issues. PMHS could be improved with staffing beyond typical work week hours, and by having staff available to answer calls instead of using an answerphone. Theme 2: PMHS are best-placed to help - PMHS were perceived as best-placed to answer enquiries that arose from hospital care. Service users felt reassured from speaking to pharmacy professionals, and PMHS were perceived as the optimal service in terms of knowledge and expertise regarding medicines-related questions. However, several participants were initially unaware that their PMHS existed. Conclusions PMHS are perceived to be a valuable means of accessing timely medicines-related support when patients and carers may be feeling particularly vulnerable. However, their availability and promotion could be improved. We recommend that providers of PMHS consider whether this is achievable, in order to better meet the needs of service users.</p

Dataset for "Service users' experiences of NHS patient medicines helpline services: A qualitative study"

The study used semi-structured interviews to explore service users' experiences of using National Health Service (NHS) patient medicines helpline services (PMHS). This dataset comprises data from 40 participants. The study protocol is included in the dataset to provide additional context.The study used semi-structured interviews to explore service users' experiences of using National Health Service (NHS) patient medicines helpline services (PMHS). This dataset comprises data from 40 participants. Recruitment was conducted via seven NHS Trusts from different regions within England, which acted as participant identification sites. Data were collected via telephone. Prior to their interview, the following background information was collected from participants: Name of NHS Trust contacted, date of PMHS contact, whether they had previously used a PMHS. Patients were also asked whether they were an inpatient or outpatient for their recent period of care, and the number of prescribed medicines they were prescribed at the time of the PMHS contact. Carers were also asked their relationship to the patient who the PMHS contact was regarding. Separate interview schedules to explore participants experiences of using a PMHS were developed for patients and carers. The two schedules were broadly similar, although, for ethical reasons, the carer version did not contain questions that would have resulted in them providing personal information about the patient individual that they care for. The aim of the interview with carers was thus to explore whether the PMHS met their needs as a carer seeking information. Following their interview, the following background data were collected from each participant: Age, gender, ethnicity, and current occupational status. All audio-recorded interviews were transcribed verbatim into separate Microsoft Word documents. Braun and Clarke’s inductive reflexive thematic analysis (TA) was used to analyse this data. Analysis involved the following stages, as outlined by Braun and Clarke: familiarisation with the data, generating initial codes, developing themes, reviewing themes, defining and naming themes, and writing the analysis. All individual interview transcripts were uploaded into NVivo version 12. NVivo was used for generating initial codes and developing and reviewing themes. The only deviation to the TA stages was that Iterative Categorisation (IC) was used in place of the defining themes stage, for increased transparency and rigour. For further details, see the study protocol included within the dataset.All individual interview transcripts were uploaded into NVivo version 12