Now showing items 1-20 of 7505

    • Impostors or interlopers? Intersectionality and belonging in mid-career academia

      Mondokova, Andrea; Suresh, Subashini; Renukappa, Suresh; Tsouroufli, Maria; Karodia, Nazira (British Academy of Management, 2024-12-31)
      This developmental paper explores the sense of belonging amongst a frequently overlooked group in higher education, the mid-career academics. The ‘leaky pipeline’ in Science, Technology, Engineering, and Mathematics (STEM) academia is a widely accepted phenomenon affecting women and minorities and whilst much of the efforts to date focus on the bottom-up approach by increased recruitment of future STEM academics, this project seeks to focus on the often-forgotten middle part of the pipeline. In an effort to transform academia for the better and to remove any societal, organisational and personal barriers continuously experienced by students and staff, it is essential that all groups receive an equal amount of attention. Therefore, this research seeks to fill the gap in understanding of lived experiences of mid-career STEM academics. This qualitative study sets out to understand how the intersectional self-identification of participants impacts their experiences of (non)belonging in UK higher education. Following the initial stages, the project intends to explore the raised issues in more depth, as well as to expand its reach to include participants from across more UK universities. This will be done to evaluate their experiences of the identified themes and to gauge their proposed solutions. In the long term, the research seeks to develop a blueprint for sustainable solutions towards improving the work environment of academic colleagues employed at post-92 institutions.
    • Experiences of healthcare workers working in COVID-19 isolation wards in Lesotho: a qualitative study

      Mahlelehlele, Bokang Amelia; Lebona, Maselobe; Murandu, Moses (Science Publishing Group, 2023-02-24)
      Background: Health and wellbeing of Healthcare workers impacts the health of the nation. COVID-19 pandemic has brought to light a number of challenges faced by Healthcare workers all over the world, affecting their psychosocial, financial, spiritual and physical well-being. There has been an alarming number of healthcare workers being affected by COVID-19 across the globe, some even succumbed to death as a result of COVID-19. Some identified reasons for this tragedy have been lack of appropriate Personal Protective Equipment (PPE), insufficient knowledge about the disease, shortage of healthcare workers and the compromised welfare of the Healthcare workers. Few studies within Lesotho focused on the perceptions of healthcare workers on COVID-19 and there was none conducted on the experiences of healthcare workers working in the COVID-19 isolation wards therefore, the aim of this study is describe the experiences of Healthcare workers working in COVID-19 isolation wards in Lesotho. Material and Methods: A descriptive phenomenological research design was utilized and data was collected using unstructured interviews which were audio-recorded. The interviews were conducted amongst the nine Healthcare workers who were working in the COVID-19 isolation ward and they composed on one office assistant, two medical doctors and six registered nurses. Analysis: Colaizzi’s seven-step method of qualitative data analysis was followed in this study. Results: Findings revealed increased workload, significant amount of negative emotions in the early stages of the pandemic, positive emotions at the later stage as well as stigma and discrimination. Conclusions: The COVID-19 pandemic placed a huge burden on the health care system. Health care workers, being in the front line, were significantly affected; they had to endure continued psychological distress because of the unique type of care required.
    • Barriers to lifestyle modification compliance among type 2 diabetic patients in Lesotho

      Malefu, Ts’osane; Mahlelehlele, Bokang Amelia; Murandu, Moses (SciVision Publishers, 2023-02-02)
      Diabetes mellitus (DM) has been considered a serious long-term condition which is one of the top 10 causes of death among adults and it has got a major impact on lives and well-being of individuals, families and societies. The most common type of DM in Africa is Type2 (T2DM). Diabetes being a major problem worldwide, healthy eating coupled with regular physical activity help in achieving a good glycemic control as well as delaying and reducing the onset of commonest diabetes complications. The current study aimed at exploring the barrier to lifestyle modification compliance among type 2 diabetic clients at Paki health center Lesotho. In this study, a quantitative descriptive design was applied in exploring the barriers of compliance to lifestyle modifications (diabetes self- management) among adults with type 2 diabetes. Data was collected using semi-structured questionnaires, which were administered to 40 study participants who were purposively selected for inclusion into study. The study revealed that among other factors, financial constraints 21participants (52.5%) is associated with non- compliance to healthy eating habits. Other reasons from non-compliance to healthy eating were identified as absence of written instructions, sickness, lack of stamina to exercise, laziness and lack of access to physical activity facilities with percentages 85%, 65%, 50% and 40% respectively. Thus, study findings reveal needs for continuous health education on health benefits of healthy eating habits and physical activity.
    • Effects of resistance exercise and whey protein supplementation on skeletal muscle strength, mass, physical function, and hormonal and inflammatory biomarkers in healthy active older men: a randomised, double-blind, placebo-controlled trial

      Griffen, Corbin; Duncan, Michael; Hattersley, John; Weickert, Martin O.; Dallaway, Alexander; Renshaw, Derek; Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom. Electronic address: (Elsevier, 2021-12-20)
      Purpose: To determine the individual and combined effects of 12 weeks of resistance exercise (RE) and whey protein supplementation on skeletal muscle strength (primary outcome), mass and physical function, and hormonal and inflammatory biomarkers in older adults. Methods: Thirty-six healthy older men [(mean±SE) age: 67±1 y; BMI: 25.5±0.4 kg/m2] were randomised to either control (CON; n=9), whey protein (PRO; n=9), RE+control (EX+CON; n=9), or RE+whey protein (EX+PRO; n=9) in a double-blinded fashion. Whole-body RE (2 sets of 8 repetitions and 1 set to volitional failure at 80% 1RM) was performed twice weekly. Supplements (PRO, 25 g whey protein isolate; CON, 23.75 g maltodextrin) were consumed twice daily. Results: EX+CON and EX+PRO increased leg extension (+19±3 kg and +20±3 kg, respectively) and leg press 1RM (+27±3 kg and +39±2 kg, respectively) greater than the CON and PRO groups (P<0.001, Cohen's d=1.50–1.90). RE (EX+CON and EX+PRO groups pooled) also increased fat-free mass (FFM) (+0.9±0.3 kg) and 6-min walk test distance (+21±5 m) and decreased fat mass (−0.4±0.4 kg), and interleukin-6 (−1.0±0.4 pg/mL) and tumor necrosis factor-alpha concentration (−0.7±0.3 pg/mL) greater than non-exercise (CON and PRO groups pooled; P<0.05, Cohen's f=0.37–0.45). Whey protein supplementation (PRO and EX+PRO groups pooled) increased 4-m gait speed greater than control (CON and EX+CON groups pooled) (+0.08±0.03 m/s; P=0.007, f=0.51). Conclusion: RE increased muscle strength, FFM and physical function, and decreased markers of systemic inflammation in healthy active older men. Whey protein supplementation alone increased gait speed. No synergistic effects were observed. This study was registered at as NCT03299972.
    • Changes in lumbar muscle diffusion tensor indices with age

      Weedal, Andrew D.; Dallaway, Alexander; Hattersley, John; Diokno, Michael; Hutchinson, Charles E.; Wilson, Adrian J.; Wayte, Sarah C.; Radiology Physics, Department of Clinical Physics and Bioengineering, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom. (Oxford University Press, 2024-01-13)
      Objective To investigate differences in diffusion tensor imaging (DTI) parameters and proton density fat fraction (PDFF) in the spinal muscles of younger and older adult males. Methods Twelve younger (19-30 years) and 12 older (61-81years) healthy, physically active male participants underwent T1W, T2W, Dixon and DTI of the lumbar spine. The eigenvalues (λ1, λ2, and λ3), fractional anisotropy (FA), and mean diffusivity (MD) from the DTI together with the PDFF were determined in the multifidus, medial and lateral erector spinae (ESmed, ESlat), and quadratus lumborum (QL) muscles. A two-way ANOVA was used to investigate differences with age and muscle and t-tests for differences in individual muscles with age. Results The ANOVA gave significant differences with age for all DTI parameters and the PDFF (P < .01) and with muscle (P < .01) for all DTI parameters except for λ1 and for the PDFF. The mean of the eigenvalues and MD were lower and the FA higher in the older age group with differences reaching statistical significance for all DTI measures for ESlat and QL (P < .01) but only in ESmed for λ3 and MD (P < .05). Conclusions Differences in DTI parameters of muscle with age result from changes in both in the intra- and extra-cellular space and cannot be uniquely explained in terms of fibre length and diameter. Advances in knowledge Previous studies looking at age have used small groups with uneven age spacing. Our study uses two well defined and separated age groups.
    • Learning lessons from five student paramedics within their exposure to suicide: a critical narrative study

      Cureton, Debra; Dickens, Clare; Faculty of Education, Health and Wellbeing (University of Wolverhampton, 2024-04)
      Background A suicide loss leaves behind a ripple effect of exposure and sense-making. Postvention research and practice has in part focused on professional/occupational exposure. However, it appears to have largely neglected paramedic science and emerging professional/occupational contexts for students who are studying a Higher Education course in allied health professions. Methodology The study design is methodologically grounded in the narrative method. The stories of five student paramedics who self-identified as experiencing exposure to suicide in their emerging professional/occupational context were collected. Positioned as socially co-constructed, and emerging in a post-structuralist world, this narrative inquiry then becomes a critical narrative study. A collocation of sense-making emerges within the discussions and places the students’ narrations side-by-side with the wider discourse and discursive practices which surround and construct professional/occupational suicide exposure, which are then analysed through a Foucauldian lens. Findings Having engaged in a critical interpretive synthesis of the background literature, this thesis has exposed how professional/occupational suicide exposure research is constructed as a problem. Expanding this body of knowledge, the student paramedics’ experiences and sense-making are presented within this study against an emergent plot line of voyage and return, travelling through themes of anticipation, initial fascination, frustration, nightmare, and return, and offer a form of oral history and co-constructed sense-making. These themes are merged and held against a narrative plot line and depicts a metaphor of multiple journeys. The concluding chapter offers an evocative and poetic representation of this metaphor, which has the capacity to bridge concepts, and to extend imagination into recognising new possibilities that emerge from the lessons our student paramedics offer. Possibilities Other avenues of research as well as paramedic science pedagogic possibilities emerge from this study, such as a decision to focus on allied health professional students studying in a Higher Education and placement learning context when exploring suicide exposure. Narrative as a way of knowing, would see us move away from a research and pedagogic approach that simply imparts knowledge of an accepted culture to the next generation of professionals. More so, a student paramedics education should offer sufficient time, space, and place to critically evaluate, to develop better knowledge of themselves and their contexts so that they can participate in that professional/occupational space to transform it. The augmented theoretical and conceptual model that is constructed within this critical narrative study, could be adopted within any study focus or topic of inquiry.
    • Soundtracking American smart cinema: self-expression, identity and alienation

      Halligan, Benjamin; Pheasant-Kelly, Fran; Martin, Scott; Faculty of Arts, Business and Social Sciences (University of Wolverhampton, 2024-03)
      The thesis argues that American smart cinema, a film development identified initially by Sconce (2002) and expanded by Perkins (2012), demonstrates a variation in its use of the diegetic soundtrack. This has allowed characters within its narratives to use the expressive qualities offered by listening and consuming music, furthering their desires to communicate with other characters and regulate their sense of self-identity. The thesis has therefore assembled a new and effective method of viewing this cycle of films, one that is characterised by its treatment of music, situated diegetically within the narrative. Rather than view the interrelationship between sound and image as a hierarchy in which the image dominates and soundtrack is subordinate to the visual realm of cinema, the thesis first looks to establish traditional soundtrack strategies and chart their development and alterations across the American smart cinema cycle, in contrast to more mainstream and historical modes of soundtrack. The intersection of the thematic concerns of American smart cinema, most overtly in representations of alienation, identity and memory as barriers towards communication, are supported by the use of the diegetic soundtrack, reinforcing uniformity across the cycle and helping to maintain a general consistency of tone, mood and characterisation. To conclude, this thesis contributes to a body of thought on the use of diegetic soundtrack as a key component in cinema, in this case helping to establish themes within the smart film cycle, namely those of fractured relationships, alienation, identity and nostalgia. Critically, I consider these features and examine the signifying functions in the overlaps between representation, narrative and soundtrack within American smart film.
    • Life for the student at a neoliberal university: a case study investigating the influence of neoliberalism on the experiences of higher education students

      Lalli, Gurpinder; Elliot, Mark; School of Education, Faculty of Education, Health and Wellbeing (University of Wolverhampton, 2023-09)
      This study aims to develop an understanding of how students experience university life during neoliberal times. Literature which explains the influence of neoliberalism on higher education (HE) is reviewed. In addition, the social theory of Ritzer (2015) is employed to help understand developments in the HE sector. Whilst there is an abundant body of existing literature examining the impact of neoliberalism on HE, the experiences of students remain relatively unexplored. The research is philosophically underpinned by a constructionist ontology and an interpretivist epistemology. A case study research design is employed with semi-structured interviews and thematic analysis used to collect and analyse the data respectively. Throughout the project, the researcher attempts to occupy a reflexive position which emphasises the need for critical self-evaluation. Despite some participants rejecting the assertion that they were consumers of HE, the study finds that students are increasingly adopting a consumerist and instrumental orientation towards their studies and conceive of university as a means through which to enhance their career prospects. The research also finds that students are becoming increasingly performative and view their relationships with academic staff as transactional rather than pedagogical. This is to say that the experiences of students are increasingly neoliberal in character.
    • Targets and mechanism of actions of novel hybrid peptides with insulin-releasing or glucose-lowering effects

      Ojo, Opeolu O.; Falobi, Ayodele Abiodun; Research Institute in Healthcare Science, Faculty of Science and Engineering (University of Wolverhampton, 2024-03)
    • Investigation of the anticancer activity and mechanisms of zinc diethyldithiocarbamate in multiple myeloma

      Wang, Weiguang; Basu, Supratik; Rajendran, Gowtham; Research Institute in Healthcare Science, Faculty of Science and Engineering (University of Wolverhampton, 2023-11)
      Background: Multiple myeloma (MM) is a haematological malignancy of the plasma cells that primarily arises in the bone marrow. Although the advent of multiple treatment options such as immunomodulatory drugs (IMiDs), proteasome inhibitors (PI), CAR-T therapy and antibody-based therapies have improved the prognosis of MM, all patients eventually relapse due to the presence and development of drug resistance. Therefore, the development of new drugs to meet this challenge is of clinical urgency. Due to the time (15 years) and costs (£1.5 billion/drug) for new drug development, repurposing old drugs for new indications is an emerging alternative strategy that is more viable in terms of costs and time. Disulfiram (DS), an anti-alcoholism drug used in the clinic for over 70 years, demonstrates excellent specific anticancer activity with no/low toxicity to normal tissues. DS chelates with transition metals such as copper and zinc to form metal-metabolite complexes (zinc/copper diethyldithiocarbamate), which are the active anticancer compounds. Diethyldithiocarbamate (DDC), a metabolite of DS, has previously been trialled in clinics to treat HIV patients due to its immunomodulatory properties. Zinc diethyldithiocarbamate (ZnDDC) is a promising compound to translate for MM treatment as a multi-target drug due to the established immunomodulatory properties of its structural moieties Zn and DDC. Although the anticancer potential of DS and its metabolites has been known for more than three decades, its translation has been limited by its very short half-life in the bloodstream (< 4 min) and its metabolite DDC is methylated in the liver that results in the loss of anticancer activity. This study focuses on investigating the anticancer and immunomodulatory potential of ZnDDC in MM and developing a novel PEGylated liposome nanoformulation of ZnDDC (PEGLipo-ZnDDC) to overcome the translational limitations of ZnDDC. Results: In this study, ZnDDC showed potent cytotoxicity in MM cell lines and patient-derived MM cells (IC50s: 5-10μM). ZnDDC synergistically enhances the cytotoxicity of IMiDs (lenalidomide, Pomalidomide) and PI (bortezomib) and reverses resistance of MM cells to these drugs. ZnDDC is able to induce apoptosis in MM cells, demonstrated by cleavage of PARP-1. Although ZnDDC has no effect on the mRNA expression of cereblon (CRBN), Ikaros (IKZF1), aiolos (IKZF3) and Interferon regulatory factor-4 (IRF4), a significant downregulation of protein levels was observed after treating the MM cell lines with sub-cytotoxic concentrations of ZnDDC (2-5 μM). After exposure to low concentration of ZnDDC, levels of both IL-2 mRNA and protein were significantly boosted in T lymphocytes. Molecular docking simulation using the AutoDock4 software predicted the potential binding of ZnDDC to the IMiD binding pocket present in CRBN. The study has led to the successful development of a PEGLipo-ZnDDC nano formulation with appreciable drug-loading content and stability. The formulation also retained the potent cytotoxic profile of free ZnDDC. Conclusion: ZnDDC demonstrates excellent cytotoxicity and synergistic effect when used in combination with clinically used IMiDs and BTZ in MM cells. The developed PEGLipo-ZnDDC nano formulation demonstrates desirable drug loading, size, and stability and retains the cytotoxicity.
    • Kazakhstan can achieve ambitious HIV targets despite expected donor withdrawal by combining improved ART procurement mechanisms with allocative and implementation efficiencies

      Shattock, Andrew J.; Benedikt, Clemens; Bokazhanova, Aliya; Duric, Predrag; Petrenko, Irina; Ganina, Lolita; Kelly, Sherrie L.; Stuart, Robyn M.; Kerr, Cliff C.; Vinichenko, Tatiana; et al. (Public Library of Science, 2017-02-16)
      Background Despite a non-decreasing HIV epidemic, international donors are soon expected to withdraw funding from Kazakhstan. Here we analyze how allocative, implementation, and technical efficiencies could strengthen the national HIV response under assumptions of future budget levels. Methodology We used the Optima model to project future scenarios of the HIV epidemic in Kazakhstan that varied in future antiretroviral treatment unit costs and management expenditure-two areas identified for potential cost-reductions. We determined optimal allocations across HIV programs to satisfy either national targets or ambitious targets. For each scenario, we considered two cases of future HIV financing: the 2014 national budget maintained into the future and the 2014 budget without current international investment. Findings Kazakhstan can achieve its national HIV targets with the current budget by (1) optimally reallocating resources across programs and (2) either securing a 35% [30%-39%] reduction in antiretroviral treatment drug costs or reducing management costs by 44% [36%-58%] of 2014 levels. Alternatively, a combination of antiretroviral treatment and management cost- reductions could be sufficient. Furthermore, Kazakhstan can achieve ambitious targets of halving new infections and AIDS-related deaths by 2020 compared to 2014 levels by attaining a 67% reduction in antiretroviral treatment costs, a 19% [14%-27%] reduction in management costs, and allocating resources optimally. Significance With Kazakhstan facing impending donor withdrawal, it is important for the HIV response to achieve more with available resources. This analysis can help to guide HIV response planners in directing available funding to achieve the greatest yield from investments. The key changes recommended were considered realistic by Kazakhstan country representatives.
    • Evaluation of demand and supply predictors of uptake of intermittent preventive treatment for malaria in pregnancy in Malawi

      Odjidja, Emmanuel Nene; Duric, Predrag; Institute of Global Health and Development, Queen Margaret University, Edinburgh, United Kingdom. (MalariaWorld, 2017-12-08)
      This study assessed both the demand and supply factors contributing to higher dropout of IPT after the first dose. Optimal number of doses was pegged at a minimum of three in accordance with WHO recommendation. Data were analysed from the Malawi multiple indicator cluster survey (2015) and the service provision assessment (2014) of 6637 women (aged 15 – 49 yrs), 763 facilities and 2105 health workers. The sample was made up of pregnant women, health facilities and workers involved in routine antenatal services across all regions of Malawi. A composit e indicator was constructed to report integration of IPTp with ANC services and administration of IPTp - SP as DOT. Multivariate and logistic regression were conducted to determine associations. Regression analysis found that: 1. Age of women (women 35 – 49 yrs, AOR 1.98; 95% CI 1.42 – 2.13, number of children as well as the number of ANC visits were associated with optimal uptake of IPTp. 2. Administering IPT as DOT was higher in facilities in rural areas (AOR 1.86; 95% CI 1.54 – 1.92) than in urban areas. 3. Administration of IPTp as DOT was relatively lower in across all facilities with highest being facilities managed by CHAM (72.8%, AOR 1.40; 95% CI 1.22 – 1.54). Health system bottlenecks were found to present the main cause of low coverage with optimal doses of IPTp. Incorporating these results into strategic policy IPTp formulation could help improve coverage to desired levels. This study could serve as plausible evidence for government and donors when planning malaria in pregnancy interventions, especially in remote parts of Malawi.
    • A scoping review investigating the perspectives of people with mild to moderate intellectual disabilities on experiences of cyberbullying victimisation and its subtypes

      Clements, Fiona; Orchard, Lisa; Chadwick, Darren (SAGE, 2024-05-08)
      This scoping review examines cyberbullying victimisation in people with mild to moderate intellectual disabilities, focusing on specific types of cyberbullying behaviours, such as flaming, harassment, and stalking. A five-stage review of empirical research was conducted using 15 electronic databases, covering publications from October 1969 to January 2024. Twelve studies were selected, reporting cyberbullying victimisation rates ranging from 5% to 64%. Harassment was the most common behaviour experienced. However, flaming, cyber-stalking, griefing, and shaming have not been thoroughly investigated. The impact and coping strategies, including support mechanisms, also lack research. Further investigation is needed to understand the various types of cyberbullying experienced by people with intellectual disabilities and to develop coping and resilience strategies. Recommendations for future research and practice are provided.
    • General practitioners' views towards diagnosing and treating depression in five southeastern European countries

      Duric, Predrag; Harhaji, Sanja; O'May, Fiona; Boderscova, Larisa; Chihai, Jana; Como, Ariel; Hranov, Georgi L.; Mihai, Adriana; Sotiri, Eugjen; Institute for Global Health and Development, Queen Margaret University Edinburgh, Musselburgh, UK. (Wiley, 2018-10-02)
      Aim: To assess and compare general practitioners' (GPs’) views of diagnosing and treating depression in five southeastern European countries. Methods: A cross-sectional study was conducted in Albania, Bulgaria, Moldova, Romania, and Serbia. The sample included 467 GPs who completed a hard-copy self-administered questionnaire, consisting of self-assessment questions related to diagnosing and treating depression. Results: The most common barriers to managing depression in general practice reported by GPs were: patients’ unwillingness to discuss depressive symptoms (92.3%); appointment time too short to take an adequate history (91.9%), barriers for prescribing appropriate treatment (90.6%); and patients' reluctance to be referred to a psychiatrist (89.1%). Most GPs (78.4%) agreed that recognizing depression was their responsibility, 71.7% were confident in diagnosing depression, but less than one-third (29.6%) considered that they should treat it. Conclusions: Improvements to the organization of mental healthcare in all five countries should consider better training for GPs in depression diagnosis and treatment; the availability of mental healthcare specialists at primary care level, with ensured equal and easy access for all patients; and the removal of potential legal barriers for diagnosis and treatment of depression.
    • "Treatment is of primary importance, and social assistance is secondary": a qualitative study on the organisation of tuberculosis (TB) care and patients' experience of starting and staying on TB treatment in Riga, Latvia

      Kielmann, Karina; Vidal, Nicole; Riekstina, Vija; Krutikov, Maria; van der Werf, Marieke J.; Biraua, Evita; Duric, Predrag; Moore, David A.J.; Engel, Nora; Institute for Global Health and Development, Queen Margaret University, Edinburgh, United Kingdom. (Public Library of Science, 2018-10-17)
      Background. Vulnerable individuals with tuberculosis (TB) struggle to access and stay on treatment. While patient-related and social barriers to TB treatment adherence are well documented, less is known about how the organisation and delivery of TB care influences adherence behaviour. Aim To examine the influence of TB service organisation and culture on patients' experience of starting and staying on treatment in Riga, Latvia. Methods An intervention package to support adherence to TB treatment amongst vulnerable patients in Riga, Latvia was piloted between August 2016 and March 2017. Qualitative observations (5), interviews with staff (20) and with TB patients (10) were conducted mid-way and at the end of the intervention to understand perceptions, processes, and experiences of TB care. Results The organisation of TB services is strongly influenced by a divide between medical and social aspects of TB care. Communication and care practices are geared towards addressing individual risk factors for non-adherence rather than the structural vulnerabilities that patients experience in accessing care. Support for vulnerable patients is limited because of standardised programmatic approaches, resource constraints and restricted job descriptions for non-medical staff. Conclusion Providing support for vulnerable patients is challenged in this setting by the strict division between medical and social aspects of TB care, and the organisational focus on patientrelated rather than systems-related barriers to access and adherence. Potential systems interventions include the introduction of multi-disciplinary approaches and teams in TB care, strengthening patient literacy at the point of treatment initiation, as well as stronger linkages with social care organisations.
    • Developing future skills for the engineering sector: evidence from the UK

      Daniel, Emmanuel; Oshodi, Olalekan Shamsideen; Marte Gomez, Jose; Marte Gomez; School of Architecture and Built Environment, University of Wolverhampton, Wolverhampton, UK (ICE Publishing Ltd., 2024-05-08)
      Shortage of workforce stifles innovation and increases project costs. Information gleaned from literature shows that the ageing workforce and inability to attract young people are reasons for labour shortages in the engineering sector. To address this shortage, several countries have created various programs, such as degree apprenticeship, to ease the process of recruiting, training and retaining young people. The current study seeks to: (i) uncover factors influencing the decision to sign-up for degree apprenticeship programs and (ii) unearth the factors affecting the outcome of degree apprenticeship programmes in engineering. Interviews were conducted to address the research objectives of the study. The findings indicated that awareness, covid-19 pandemic, funding, incentives [financial and non-financial] and diversity are key factors influencing the decision to sign-up for degree apprenticeship. Also, demand for engineering jobs, balance between theory and practical training, collaboration of stakeholders, leadership support, versatility of apprentice experience are the factors affecting the outcome of degree apprentices. Based on the findings, it is evident that raising awareness among stakeholders, such as career counsellors, and collaboration are vital for improving the supply of qualified young people in the engineering sector.
    • Depression, anxiety and quality of life in patients with chronic hepatitis C virus infection in Vojvodina

      Kačavenda-Babović, Dragana; Duric, Predrag; Babović, Radomir; Fabri, Milotka; Ružić, Maja; Ignjatović, Vojislava Bugarski; 1Center for Disease Control and Prevention, Institute of Public Health, Sombor, Serbia; Histopathology Department, Norfolk and Norwich University Hospital, United Kingdom; 2Queen Margaret University Edinburgh, United Kingdom; Faculty of Medicine, University of Novi Sad, Institute of Public Health of Vojvodina, Novi Sad, Serbia; 3Department of Ophthalmology, James Paget University Hospitals, Gorleston-on-Sea, United Kingdom; 4Faculty of Pharmacy of Novi Sad, University Business Academy in Novi Sad, Serbia; 5Department of Infectious Diseases, University Clinical Centre of Vojvodina; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 6Department of Neurology, University Clinical Centre of Vojvodina; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia. (Sestre Milosrdnice University Hospital and Institute of Clinical Medical Research, 2021-12-01)
      The objective of this study was to investigate the prevalence of depression and anxiety among patients with chronic hepatitis C and how depression and anxiety correlate with re-spective health-related quality of life (HRQoL) domains, sociodemographic factors, and clinico-epi-demiological characteristics. This prospective study involved 150 patients with chronic hepatitis C awaiting interferon treatment for hepatitis C and 150 healthy subjects. All individuals enrolled in the study completed the Short Form 36 (SF-36) questionnaire and Hospital Anxiety Depression Scale. The symptoms showed greater severity/score among patients with chronic hepatitis C for both depression (t=3.37; p<0.01) and anxiety (t=2.35; p<0.05). Regression analysis was used for estimating the relationship between depression and the set of predictors (domains of the SF-36 questionnaire). Three HRQoL domains (Physical Functioning, Vitality, and Mental Health) were found to have the stron-gest predictive contribution to the occurrence of depression. A series of Kruskal-Wallis and Mann-Whitney tests showed a significant difference in depression level between marital status categories (χ2(2)=7.86, p<0.05). Divorced participants had significantly higher scores compared to married participants (Z=-2.40, p<0.05) and single participants (Z=-2.75, p<0.01). Unemployment was associated with a higher degree of depression and anxiety. There was no association identified between duration of the disease, route of hepatitis C virus transmission, existence of cirrhosis, and depression or anxiety. The findings of this study can assist in developing a standard protocol for the management of chronic hepatitis C that will include psychological assessment and support.
    • Delivery of integrated infectious disease control services under the new antenatal care guidelines: a service availability and readiness assessment of health facilities in Tanzania

      Odjidja, Emmanuel Nene; Gatasi, Ghislaine; Duric, Predrag; Village Health Works, Bururi, Burundi. (BMC, 2019-03-11)
      Background: Tanzania remains among the countries with the highest burden of infectious diseases (notably HIV, Malaria and Tuberculosis) during pregnancy. In response, the country adopted World Health Organization's (WHO) latest antenatal care (ANC) guidelines which recommend comprehensive services including diagnostic screening and treatment for pregnant women during antenatal. However, as Tanzania makes efforts to scale up these services under the existing health system resources, it is crucial to understand its capacity to deliver these services in an integrated fashion. Using the WHO's service availability and readiness assessment(SARA) framework, this study assesses the capacity of the Tanzanian Health System to provide integrated Malaria, Tuberculosis and HIV services. Methods: Composite indicators of the five components of integration were constructed from primary datasets of the Tanzanian Service Provision Assessments (SPA) under the Demographic and Health Survey (DHS) programs. Chi-squared analysis, T test and ANOVA were conducted to determine the associations of each of the defined components and background characteristics of facilities/health workers. A logistic regression model was further used to explore strength of relationships between availability of service readiness components and a pregnant women's receipt of HIV, Malaria and TB services by reporting adjusted odds ratios. Results: Generally, capacity to integrate malaria services was significantly higher (72.3 95% CI 70.3-74.4 p = 0.02) compared to Tuberculosis (48.9 95% CI 48.4-50.7) and HIV (54.8 95% CI 53.1-56.9) services. Diagnostic capacity was generally higher than treatment commodities. Regarding the components of SARA integration, logistic regression found that the adjusted odds ratio of having all five components of integration and receiving integrated care was 1.9 (95% CI 0.8-2.7). Among these components, the strongest determinant (predictor) to pregnant women's receipt of integrated care was having trained staff on site (AOR 2.6 95% CI 0.6-4.5). Conclusion: Toward a successful integration of these services under the new WHO guidelines in Tanzania, efforts should be channelled into strengthening infectious disease care especially HIV and TB. Channelling investments into training of health workers (the strongest determinant to integrated care) is likely to result in positive outcomes for the pregnant woman and unborn child.
    • Addressing challenges in tuberculosis adherence via performance-based payments for integrated case management: Protocol for a cluster randomized controlled trial in Georgia

      Chikovani, Ivdity; Diaconu, Karin; Duric, Predrag; Sulaberidze, Lela; Uchaneishvili, Maia; Mohammed, Nuredin; Zoidze, Akaki; Witter, Sophie; Curatio International Foundation, 3 Kavsadze Str., 0179, Tbilisi, Georgia. (BMC, 2019-08-28)
      Background: Tuberculosis is one of the greatest global health concerns and disease management is challenging particularly in low- and middle-income countries. Despite improvements in addressing this epidemic in Georgia, tuberculosis remains a significant public health concern due to sub-optimal patient management. Low remuneration for specialists, limited private-sector interest in provision of infectious disease care and incomplete integration in primary care are at the core of this problem. Methods: This protocol sets out the methods of a two-arm cluster randomized control trial which aims to generate evidence on the effectiveness of a performance-based financing and integrated care intervention on tuberculosis loss to follow-up and treatment adherence. The trial will be implemented in health facilities (clusters) under-performing in tuberculosis management. Eligible and consenting facilities will be randomly assigned to either intervention or control (standard care). Health providers within intervention sites will form a case management team and be trained in the delivery of integrated tuberculosis care; performance-related payments based on monthly records of patients adhering to treatment and quality of care assessments will be disbursed to health providers in these facilities. The primary outcomes include loss to follow-up among adult pulmonary drug-sensitive and drug-resistant tuberculosis patients. Secondary outcomes are adherence to treatment among drug-sensitive and drug-resistant tuberculosis patients and treatment success among drug-sensitive tuberculosis patients. Data on socio-demographic characteristics, tuberculosis diagnosis and treatment regimen will also be collected. The required sample size to detect a 6% reduction in loss to follow-up among drug-sensitive tuberculosis patients and a 20% reduction in loss to follow-up among drug-resistant tuberculosis patients is 948 and 136 patients, respectively. Discussion: The trial contributes to a limited body of rigorous evidence and literature on the effectiveness of supply-side performance-based financing interventions on tuberculosis patient outcomes. Realist and health economic evaluations will be conducted in parallel with the trial, and associated composite findings will serve as a resource for the Georgian and wider regional Ministries of Health in relation to future tuberculosis and wider health policies. The trial and complementing evaluations are part of Results4TB, a multidisciplinary collaboration engaging researchers and Georgian policy and practice stakeholders in the design and evaluation of a context-sensitive tuberculosis management intervention. Trial registration: ISRCTN, ISRCTN14667607. Registered on 14 January 2019.
    • The manager as coach

      Ellinger, Andrea D.; Jones, Jenni; Hamlin, Robert G.; Beattie, Rona S.; Cox, Elaine; Bachkirova, Tatiana; Clutterbuck, David (SAGE, 2023-11-14)