• Bilateral L1 and L2 dorsal root ganglion blocks for discogenic low-back pain.

      Richardson, J.; Collinghan, N.; Scally, Andy J.; Gupta, S. (2000)
      Background It is possible that interruption of nociceptive input from intervertebral discs can be modulated through bilateral L1 and L2 dorsal root ganglia (DRG) blockade. In order to test this hypothesis, we prospectively collected data from patients with low-lumbar pain, accurately diagnosed as discogenic using provocation discography. Methods Twelve patients were recruited with a mean (SD) symptom duration of 13.7 (8.2) years. Bilateral DRG blocks of L1 and L2 were performed using methylprednisolone 80 mg, clonidine 75 µg and 0.5% bupivacaine 4 ml in each patient. Results Analysis of Brief Pain Inventories showed no significant change in pain scores. Conclusion We conclude that blocks of this nociceptive pathway in humans using bilateral DRG blocks has no therapeutic value.
    • Binocular summation and other forms of non-dominant eye contribution in individuals with strabismic amblyopia during habitual viewing

      Barrett, Brendan T.; Panesar, Gurvinder K.; Scally, Andy J.; Pacey, Ian E. (2013-10-29)
      Adults with amblyopia ('lazy eye'), long-standing strabismus (ocular misalignment) or both typically do not experience visual symptoms because the signal from weaker eye is given less weight than the signal from its fellow. Here we examine the contribution of the weaker eye of individuals with strabismus and amblyopia with both eyes open and with the deviating eye in its anomalous motor position. The task consisted of a blue-on-yellow detection task along a horizontal line across the central 50 degrees of the visual field. We compare the results obtained in ten individuals with strabismic amblyopia with ten visual normals. At each field location in each participant, we examined how the sensitivity exhibited under binocular conditions compared with sensitivity from four predictions, (i) a model of binocular summation, (ii) the average of the monocular sensitivities, (iii) dominant-eye sensitivity or (iv) non-dominant-eye sensitivity. The proportion of field locations for which the binocular summation model provided the best description of binocular sensitivity was similar in normals (50.6%) and amblyopes (48.2%). Average monocular sensitivity matched binocular sensitivity in 14.1% of amblyopes' field locations compared to 8.8% of normals'. Dominant-eye sensitivity explained sensitivity at 27.1% of field locations in amblyopes but 21.2% in normals. Non-dominant-eye sensitivity explained sensitivity at 10.6% of field locations in amblyopes but 19.4% in normals. Binocular summation provided the best description of the sensitivity profile in 6/10 amblyopes compared to 7/10 of normals. In three amblyopes, dominant-eye sensitivity most closely reflected binocular sensitivity (compared to two normals) and in the remaining amblyope, binocular sensitivity approximated to an average of the monocular sensitivities. Our results suggest a strong positive contribution in habitual viewing from the non-dominant eye in strabismic amblyopes. This is consistent with evidence from other sources that binocular mechanisms are frequently intact in strabismic and amblyopic individuals.
    • Biosciences in nurse education: is the curriculum fit for practice? Lecturers' views and recommendations from across the UK

      Taylor, Vanessa; Ashelford, Sarah L.; Fell, P.; Goacher, P.J. (2015-10)
      This study aims to review the biosciences component of preregistration nursing programmes in higher education institutions across the UK through the experiences and perceptions of lecturers involved in nursing education. Studies suggest that some qualified nurses lack confidence in explaining the bio-scientific rationale for their clinical practice. Biosciences can be difficult to understand and integrate into clinical decision-making and require protected time within preregistration nurse education. In the absence of explicit national guidelines, it is unclear as to the depth and extent biosciences are taught across different institutions and the level achieved at the point of registration. A survey approach was adopted to generate quantitative and qualitative feedback. Data were collected using a semi-structured questionnaire seeking the experiences and views of lecturers involved in teaching biosciences to nursing students across the UK. Data received from 10 institutions were analysed using descriptive statistics and thematic analysis. Lecturers reported that the hours of taught biosciences ranged from 20-113 hours, principally within the first year. This represents between 0.4-2.4% of time within a preregistration nursing programme (4600 hours). Large group lectures predominate, supplemented by smaller group or practical work, and online materials. The biosciences are assessed specifically in half the institutions surveyed and as part of integrated assessments in the rest. In relation to student feedback, all respondents stated that students consistently requested more time and greater priority for biosciences in their programme. This survey suggests that the number of hours spent teaching biosciences is minimal and varies widely between higher education institutions. All respondents expressed concern about the challenges of teaching difficult bio-scientific concepts to large groups in such a limited time and called for greater clarity in national guidelines to ensure that all nurses are adequately educated and assessed in bioscience subjects. Failure to understand the biosciences underpinning care has implications for safe and competent nursing.
    • Birth weight, head circumference, and prenatal exposure to acrylamide from maternal diet: the European prospective mother-child study (NewGeneris)

      Pedersen, M.; von Stedingk, H.; Botsivali, M.; Agramunt, S.; Alexander, J.; Brunborg, G.; Chatzi, L.; Fleming, S.; Fthenou, E.; Granum, B.; et al. (2012)
      BACKGROUND: Acrylamide is a common dietary exposure that crosses the human placenta. It is classified as a probable human carcinogen, and developmental toxicity has been observed in rodents. OBJECTIVES: We examined the associations between prenatal exposure to acrylamide and birth outcomes in a prospective European mother-child study. METHODS: Hemoglobin (Hb) adducts of acrylamide and its metabolite glycidamide were measured in cord blood (reflecting cumulated exposure in the last months of pregnancy) from 1,101 singleton pregnant women recruited in Denmark, England, Greece, Norway, and Spain during 2006-2010. Maternal diet was estimated through food-frequency questionnaires. RESULTS: Both acrylamide and glycidamide Hb adducts were associated with a statistically significant reduction in birth weight and head circumference. The estimated difference in birth weight for infants in the highest versus lowest quartile of acrylamide Hb adduct levels after adjusting for gestational age and country was -132 g (95% CI: -207, -56); the corresponding difference for head circumference was -0.33 cm (95% CI: -0.61, -0.06). Findings were similar in infants of nonsmokers, were consistent across countries, and remained after adjustment for factors associated with reduced birth weight. Maternal consumption of foods rich in acrylamide, such as fried potatoes, was associated with cord blood acrylamide adduct levels and with reduced birth weight. CONCLUSIONS: Dietary exposure to acrylamide was associated with reduced birth weight and head circumference. Consumption of specific foods during pregnancy was associated with higher acrylamide exposure in utero. If confirmed, these findings suggest that dietary intake of acrylamide should be reduced among pregnant women.
    • Bivariate meta-analysis of sensitivity and specificity of radiographers' plain radiograph reporting in clinical practice.

      Brealey, S.; Hewitt, C.; Scally, Andy J.; Hahn, S.; Godfrey, C.; Thomas, N. (2009)
      Studies of diagnostic accuracy often report paired tests for sensitivity and specificity that can be pooled separately to produce summary estimates in a meta-analysis. This was done recently for a systematic review of radiographers' reporting accuracy of plain radiographs. The problem with pooling sensitivities and specificities separately is that it does not acknowledge any possible (negative) correlation between these two measures. A possible cause of this negative correlation is that different thresholds are used in studies to define abnormal and normal radiographs because of implicit variations in thresholds that occur when radiographers' report plain radiographs. A method that allows for the correlation that can exist between pairs of sensitivity and specificity within a study using a random effects approach is the bivariate model. When estimates of accuracy as a fixed-effects model were pooled separately, radiographers' reported plain radiographs in clinical practice at 93% (95% confidence interval (CI) 92-93%) sensitivity and 98% (95% CI 98-98%) specificity. The bivariate model produced the same summary estimates of sensitivity and specificity but with wider confidence intervals (93% (95% CI 91-95%) and 98% (95% CI 96-98%), respectively) that take into account the heterogeneity beyond chance between studies. This method also allowed us to calculate a 95% confidence ellipse around the mean values of sensitivity and specificity and a 95% prediction ellipse for individual values of sensitivity and specificity. The bivariate model is an improvement on pooling sensitivity and specificity separately when there is a threshold effect, and it is the preferred method of choice.
    • Black and Ethnic Minority Sex Offenders

      Cowburn, I. Malcolm; Lavis, Victoria J.; Walker, Tammi (HMSO, 2008-07)
      In the past ten years or so there has been a growing concern that the treatment needs of Black and Minority Ethnic (BME) sex offenders in prison are not being appropriately met. Underpinning this concern is the continued under representation of BME sex offenders on the Sex Offender Treatment Programme (SOTP). Although some research has been undertaken into how BME prisoners experience the SOTP and in to its ostensible effectiveness with BME sex offenders, little is known about why the take-up of the SOTP is poor with this group. In this paper we first consider some specific demographic issues that need to be understood in order to reflect more widely on the BME sex offender in prison. We then summarise what is currently known about effective practice with this group, thereafter we consider, in turn, current provision for BME sex offenders in England and Wales and suggestions for developing practice with this group of men. However, before we turn to these issues, it is important to consider briefly issues of terminology. Terminologies in relation to ethnicities and race are fraught with conceptual difficulties. Aspinall has highlighted the limitations of `pan-ethnic¿ groups, such as `BME¿; such groupings are `statistical collectivities¿ and `the groups thus defined will be nothing more than meaningless statistical collectivities that do not represent any of the constituent groups within the term.¿ . However, at the outset of this paper we use the collective term BME - this term is currently used by a number of Government Departments in the UK, including the Prison Service. Later we suggest that a more sophisticated understanding of ethnic cultures may be necessary to develop practice with BME sex offenders.
    • Black and Minority Ethnic Leaders in the Health Sector

      Ashraf, Fahmida (2013)
      As several studies indicate, the National Health Service (NHS) in the United Kingdom is one of the largest employers for Black and minority ethnic (BME) people. Despite many positive action (PA) initiatives to support disadvantaged groups, only a handful of people have managed to progress to senior management. This article considers published literature in relation to BME leadership in NHS and the specific types of PA activities that have been set up to address some issues around inequality. In addition to PA activities, the article also considers the U.K. equality framework. Positive action is allowed under the U.K. legislation for organizations to recruit people from underrepresented communities on merit. It allows organizations to create different initiatives for people to gain appropriate qualifications, skills, and experience to compete for promotions or for better job opportunities.
    • The blood-to-plasma ratio and predicted GABAA-binding affinity of designer benzodiazepines

      Manchester, Kieran R.; Waters, L.; Haider, S.; Maskell, P.D. (2022-03)
      Purpose: The number of benzodiazepines appearing as new psychoactive substances (NPS) is continually increasing. Information about the pharmacological parameters of these compounds is required to fully understand their potential effects and harms. One parameter that has yet to be described is the blood-to-plasma ratio. Knowledge of the pharmacodynamics of designer benzodiazepines is also important, and the use of quantitative structure–activity relationship (QSAR) modelling provides a fast and inexpensive method of predicting binding affinity to the GABAA receptor. Methods: In this work, the blood-to-plasma ratios for six designer benzodiazepines (deschloroetizolam, diclazepam, etizolam, meclonazepam, phenazepam, and pyrazolam) were determined. A previously developed QSAR model was used to predict the binding affinity of nine designer benzodiazepines that have recently appeared. Results: Blood-to-plasma values ranged from 0.57 for phenazepam to 1.18 to pyrazolam. Four designer benzodiazepines appearing since 2017 (fluclotizolam, difludiazepam, flualprazolam, and clobromazolam) had predicted binding affinities to the GABAA receptor that were greater than previously predicted binding affinities for other designer benzodiazepines. Conclusions: This work highlights the diverse nature of the designer benzodiazepines and adds to our understanding of their pharmacology. The greater predicted binding affinities are a potential indication of the increasing potency of designer benzodiazepines appearing on the illicit drugs market.
    • BME sex offenders in prison: the problem of participation in offending behaviour groupwork programmes: a tripartite model of understanding

      Cowburn, I. Malcolm; Lavis, Victoria J.; Walker, Tammi (De Montfort University and Sheffield Hallam University, 2008-04-16)
      This paper addresses the under representation of Black and minority ethnic (BME) sex offenders in the sex offender treatment programme (SOTP) of the prisons of England and Wales. The proportional over representation of BME men in the male sex offender population of the prisons of England and Wales has been noted for at least ten years. Similarly the under representation of BME sex offenders in prison treatment programmes has been a cause for concern during the last decade. This paper presents current demographic data relating to male BME sex offenders in the prisons of England and Wales. The paper draws together a wide range of social and cultural theories to develop a tripartite model for understanding the dynamics underlying the non-participation of BME
    • Born in Bradford's Better Start: an experimental birth cohort study to evaluate the impact of early life interventions

      Dickerson, J.; Bird, P.K.; McEachan, Rosemary; Pickett, K.E.; Waiblinger, D.; Uphoff, E.P.; Mason, Dan; Bryant, M.; Bywater, T.; Bowyer-Crane, C.; et al. (2016-08-04)
      Background: Early interventions are recognised as key to improving life chances for children and reducing inequalities in health and well-being, however there is a paucity of high quality research into the effectiveness of interventions to address childhood health and development outcomes. Planning and implementing standalone RCTs for multiple, individual interventions would be slow, cumbersome and expensive. This paper describes the protocol for an innovative experimental birth cohort: Born in Bradford’s Better Start (BiBBS) that will simultaneously evaluate the impact of multiple early life interventions using efficient study designs. Better Start Bradford (BSB) has been allocated £49 million from the Big Lottery Fund to implement 22 interventions to improve outcomes for children aged 0–3 in three key areas: social and emotional development; communication and language development; and nutrition and obesity. The interventions will be implemented in three deprived and ethnically diverse inner city areas of Bradford. Method: The BiBBS study aims to recruit 5000 babies, their mothers and their mothers’ partners over 5 years from January 2016-December 2020. Demographic and socioeconomic information, physical and mental health, lifestyle factors and biological samples will be collected during pregnancy. Parents and children will be linked to their routine health and local authority (including education) data throughout the children’s lives. Their participation in BSB interventions will also be tracked. BiBBS will test interventions using the Trials within Cohorts (TwiCs) approach and other quasi-experimental designs where TwiCs are neither feasible nor ethical, to evaluate these early life interventions. The effects of single interventions, and the cumulative effects of stacked (multiple) interventions on health and social outcomes during the critical early years will be measured. Discussion: The focus of the BiBBS cohort is on intervention impact rather than observation. As far as we are aware BiBBS is the world’s first such experimental birth cohort study. While some risk factors for adverse health and social outcomes are increasingly well described, the solutions to tackling them remain elusive. The novel design of BiBBS can contribute much needed evidence to inform policy makers and practitioners about effective approaches to improve health and well-being for future generations.
    • Born in Bradford, a cohort study of babies born in Bradford, and their parents: protocol for the recruitment phase

      Raynor, Pauline; Born in Bradford Collaborative Group (2008)
      BACKGROUND: Bradford, one of the most deprived cities in the United Kingdom, has a wide range of public health problems associated with socioeconomic deprivation, including an infant mortality rate almost double that for England and Wales. Infant mortality is highest for babies of Pakistani origin, who comprise almost half the babies born in Bradford. The Born in Bradford cohort study aims to examine environmental, psychological and genetic factors that impact on health and development perinatally, during childhood and subsequent adult life, and those that influence their parents' health and wellbeing. This protocol outlines methods for the recruitment phase of the study. METHODS: Most Bradford women attend for antenatal care and give birth at the Bradford Royal Infirmary, which has approximately 5,800 births per year. Women are eligible for recruitment if they plan to give birth here. Babies born from March 2007 are eligible to participate, recruitment is planned to continue until 2010. Fathers of babies recruited are invited to participate. Women are usually recruited when they attend for a routine oral glucose tolerance test at 26-28 weeks gestation. Recruitment of babies is at birth. Fathers are recruited whenever possible during the antenatal period, or soon after the birth. The aim is to recruit 10,000 women, their babies, and the babies' fathers. At recruitment women have blood samples taken, are interviewed to complete a semi-structured questionnaire, weighed, and have height, arm circumference and triceps skinfold measured. Umbilical cord blood is collected at birth. Within two weeks of birth babies have their head, arm and abdominal circumference measured, along with subscapular and triceps skinfold thickness. Fathers self-complete a questionnaire at recruitment, have height and weight measured, and provide a saliva sample. Participants are allocated a unique study number. NHS numbers will be used to facilitate record linkage and access to routine data. A wide range of hospital and community sources is being accessed to provide data for the women and children. Data are checked for accuracy and consistency. CONCLUSION: Born in Bradford will increase understanding of the factors that contribute to health and wellbeing, and identify factors that influence differences in them between people of Pakistani and European origin.
    • The Bradford Experience

      McGrath, T.; Haith-Cooper, Melanie (2007)
    • Brexit: the consequences and impact on the health sector

      McIntosh, Bryan; West, Sue (2017)
      Even prior to the conclusion of the European Union (EU) referendum (Brexit), the NHS was showing tremendous signs of strain. Immediately after the outcome was announced, promises of major re-investment of funds saved from payments to the EU were retracted. Since then, hospital closures, cuts and changes to health and social care have been revealed, with regular news broadcasts highlighting the crisis facing the NHS. The uncertainties about post-Brexit relationships, economy, politics and security are likely to further significantly impact the NHS and its sustainability. Higher Education Institutions (HEIs) and the NHS are inextricably linked through research and education of health and social care professionals – changes therefore having implications for both.
    • "Bringing heaven down to earth”: The purpose and place of religion in UK food aid

      Power, M.; Small, Neil A.; Doherty, B.; Stewart-Knox, Barbara; Pickett, K.E. (2017)
      This paper uses data from a city with a multi-ethnic, multi-faith population to better understand faith-based food aid. It aims to understand what constitutes faith-based responses to food insecurity; compare the prevalence and nature of faith-based food aid across different religions; and explore how community food aid meets the needs of a multi-ethnic, multi-faith population. Methodology The study involved two phases of primary research. In phase one, desk-based research and dialogue with stakeholders in local food security programmes was used to identify faith- based responses to food insecurity. Phase two consisted of 18 semi-structured interviews involving faith-based and secular charitable food aid organizations. Findings The paper illustrates the internal heterogeneity of faith-based food aid. Faith-based food aid is highly prevalent and the vast majority is Christian. Doctrine is a key motivation among Christian organizations for their provision of food. The fact that the clients at faith-based, particularly Christian, food aid did not reflect the local religious demographic is a cause for concern in light of the entry-barriers identified. This concern is heightened by the co-option of faith-based organizations by the state as part of the ‘Big Society’ agenda. Originality This is the first academic study in the UK to look at the faith-based arrangements of Christian and Muslim food aid providers, to set out what it means to provide faith-based food aid in the UK and to explore how faith-based food aid interacts with people of other religions and no religion.
    • Broadening the debate on creativity and dementia: A critical approach

      Bellass, S.; Balmer, A.; May, V.; Keady, J.; Buse, C.; Capstick, Andrea; Burke, L.; Bartlett, Ruth L.; Hodgson, J. (2019-11-01)
      In recent years there has been a growing interest in person-centred, ‘living well’ approaches to dementia, often taking the form of important efforts to engage people with dementia in a range of creative, arts-based interventions such as dance, drama, music, art and poetry. Such practices have been advanced as socially inclusive activities that help to affirm personhood and redress the biomedical focus on loss and deficit. However, in emphasizing more traditional forms of creativity associated with the arts, more mundane forms of creativity that emerge in everyday life have been overlooked, specifically as regards how such creativity is used by people living dementia and by their carers and family members as a way of negotiating changes in their everyday lives. In this paper, we propose a critical approach to understanding such forms of creativity in this context, comprised of six dimensions: everyday creativity; power relations; ways to operationalise creativity; sensory and affective experience; difference; and reciprocity. We point towards the potential of these dimensions to contribute to a reframing of debates around creativity and dementia.