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  1. Article ; Online: Financial adversity and subsequent health and wellbeing during the COVID-19 pandemic in the UK: A qualitative interview study.

    May, Tom / Aughterson, Henry / Fancourt, Daisy / Burton, Alexandra

    SSM. Qualitative research in health

    2023  Volume 3, Page(s) 100224

    Abstract: Aims: There are concerns that the economic impacts of the COVID-19 pandemic, including employment inactivity and job loss, will have consequences for the UK population's health and wellbeing. However, there is limited qualitative research into how ... ...

    Abstract Aims: There are concerns that the economic impacts of the COVID-19 pandemic, including employment inactivity and job loss, will have consequences for the UK population's health and wellbeing. However, there is limited qualitative research into how financial adversity contributes to poor health outcomes in this context. This study aimed to explore forms of financial adversity experienced during the pandemic and their subsequent impacts for health and wellbeing.
    Methods: Qualitative semi-structured interviews with 20 people who experienced a form of financial adversity during the pandemic and six service providers employed in social welfare support services. Data were analysed using reflexive thematic analysis.
    Results: Two main sources of financial adversity were identified: reductions in household incomes and increased living costs which engendered emotional and physical burdens. Coping strategies included increased financial borrowing, support from informal and formal networks and cutting back on energy use, food and non-essential items.
    Conclusion: Our study highlighted exposure to multiple financial adversities because of the pandemic and how these experiences led to poor mental and physical health. The findings underline the importance of measures attending to the immediate needs of individuals, including accessible, co-located financial and psychological services, as well as broader measures that seek to reduce social and economic inequalities.
    Language English
    Publishing date 2023-01-28
    Publishing country England
    Document type Journal Article
    ISSN 2667-3215
    ISSN (online) 2667-3215
    DOI 10.1016/j.ssmqr.2023.100224
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Exploring the provision and support of care for long-term conditions in dementia: A qualitative study combining interviews and document analysis.

    Rees, Jessica / Burton, Alexandra / Walters, Kate / Cooper, Claudia

    Dementia (London, England)

    2023  Volume 22, Issue 4, Page(s) 820–837

    Abstract: Background: The challenge of managing multiple long-term conditions is a prevalent issue for people with dementia and those who support their care. The presence of dementia complicates healthcare delivery and the development of personalised care plans, ... ...

    Abstract Background: The challenge of managing multiple long-term conditions is a prevalent issue for people with dementia and those who support their care. The presence of dementia complicates healthcare delivery and the development of personalised care plans, as health systems and clinical guidelines are often designed around single condition services.
    Objective: This study aimed to explore how care for long-term conditions is provided and supported for people with dementia in the community.
    Methods: In a qualitative, case study design, consecutive telephone or video-call interviews were conducted with people with dementia, their family carers and healthcare providers over a four-month period. Participant accounts were triangulated with documentary analysis of primary care medical records and event-based diaries kept by participants with dementia. Thematic analysis was used to develop across-group themes.
    Findings: Six main themes were identified from eight case studies: 1) Balancing support and independence, 2) Implementing and adapting advice for dementia contexts, 3) Prioritising physical, cognitive and mental health needs, 4) Competing and entwined needs and priorities, 5) Curating supportive professional networks, 6) Family carer support and coping.
    Discussion: These findings reflect the dynamic nature of dementia care which requires the adaptation of support in response to changing need. We witnessed the daily realities for families of implementing care recommendations in the community, which were often adapted for the contexts of family carers' priorities for care of the person living with dementia and what they were able to provide. Realistic self-management plans which are deliverable in practice must consider the intersection of physical, cognitive and mental health needs and priorities, and family carers needs and resources.
    MeSH term(s) Humans ; Document Analysis ; Dementia/therapy ; Dementia/psychology ; Qualitative Research ; Caregivers/psychology ; Health Personnel
    Language English
    Publishing date 2023-03-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2084045-7
    ISSN 1741-2684 ; 1471-3012
    ISSN (online) 1741-2684
    ISSN 1471-3012
    DOI 10.1177/14713012231161854
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Successful use of intravenous and oral levetiracetam in a goat to control refractory seizures secondary to suspected polioencephalomalacia.

    Stapley, Emma D / Breuer, Ryan M / Burton, Alexandra J

    Journal of the American Veterinary Medical Association

    2023  Volume 262, Issue 2, Page(s) 1–3

    Abstract: Objective: To assess the clinical efficacy and plasma concentrations of levetiracetam in a goat with seizures.: Animal: A 5-month-old doeling.: Clinical presentation, progression, and procedures: The goat was referred because of progressive ... ...

    Abstract Objective: To assess the clinical efficacy and plasma concentrations of levetiracetam in a goat with seizures.
    Animal: A 5-month-old doeling.
    Clinical presentation, progression, and procedures: The goat was referred because of progressive anorexia and lethargy over 3 days. Clinical signs consisted of weakness, obtundation, opisthotonos, anisocoria, and cortical blindness. Initial evaluation was most consistent with polioencephalomalacia.
    Treatment and outcome: Neurologic improvement occurred within 4 hours of thiamine administration, with appetite returning over 12 hours. On day 3 of hospitalization, the goat suffered acute onset repetitive seizures that were incompletely responsive to standard interventions over 3 hours. Administration of IV levetiracetam (60 mg/kg) produced resolution of seizure activity within 20 minutes. Levetiracetam was continued twice daily IV, then PO after day 6. Plasma concentrations were above or within therapeutic ranges (5 to 45 μg/mL) as previously established for other species, following both IV and PO levetiracetam. Oral administration (60 mg/kg, PO, q 12 h) resulted in plasma levetiracetam concentrations of 48.1 μg/mL 2 hours after a dose and 23.4 μg/mL 2 hours prior to the next dose.
    Clinical relevance: Levetiracetam is a newer anticonvulsant commonly used in humans and small animals due to its efficacy, cost, and wide safety margin. Its use has not previously been reported in domestic small ruminants. In this case, levetiracetam showed excellent clinical efficacy in the face of refractory seizures, with no apparent side effects. Plasma concentrations during oral administration were at the high end of the therapeutic range, indicating absorption in a nonmonogastric species. Further studies are warranted to determine optimal dosing in small ruminants.
    MeSH term(s) Humans ; Animals ; Levetiracetam/therapeutic use ; Piracetam/therapeutic use ; Piracetam/adverse effects ; Goats ; Anticonvulsants/therapeutic use ; Anticonvulsants/adverse effects ; Seizures/drug therapy ; Seizures/etiology ; Seizures/veterinary ; Goat Diseases/drug therapy
    Chemical Substances Levetiracetam (44YRR34555) ; Piracetam (ZH516LNZ10) ; Anticonvulsants
    Language English
    Publishing date 2023-11-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 390811-2
    ISSN 1943-569X ; 0003-1488
    ISSN (online) 1943-569X
    ISSN 0003-1488
    DOI 10.2460/javma.23.09.0514
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Protecting the mental health of groups needing NHS care this winter.

    Burton, Alexandra / Bradbury, Alexandra

    BMJ (Clinical research ed.)

    2021  Volume 375, Page(s) n3063

    MeSH term(s) COVID-19/complications ; COVID-19/prevention & control ; Humans ; Mental Health Services ; SARS-CoV-2 ; Seasons ; State Medicine ; United Kingdom
    Language English
    Publishing date 2021-12-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.n3063
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: An exploration of how specialist dementia nurses perceive and maintain the skills and competencies that frame their specialism: A qualitative survey.

    Brown, Pat / Cooper, Claudia / Dening, Karen Harrison / Hoe, Juanita / Burton, Alexandra

    Heliyon

    2024  Volume 10, Issue 7, Page(s) e27856

    Abstract: Background: UK policy for complex and long-term health conditions including dementia has recommended that specialist nursing intervention is offered across the trajectory of the condition, but there is a lack of agreement regarding the skills and ... ...

    Abstract Background: UK policy for complex and long-term health conditions including dementia has recommended that specialist nursing intervention is offered across the trajectory of the condition, but there is a lack of agreement regarding the skills and competencies that specialist nurses are expected to possess. Admiral Nurses are the largest UK group of specialist dementia nurses.
    Objective: To explore how Admiral Nurses met and were supported to meet competencies as defined in the Admiral Nurse Competency Framework, and to develop and maintain skills as dementia specialists.
    Design: Cross-sectional, semi-structured survey.
    Setting: Online national survey.
    Participants: Admiral (specialist dementia) Nurses.
    Methods: We co-designed our survey with Admiral Nurses; then invited Admiral Nurses to complete it in 2022-23 Data were analysed thematically.
    Results: 68 (20% of all Admiral Nurses) completed the survey; most were female (85.2%), from a white ethnic group (88.2%); they reported on average 24 years of nursing experience. We identified three themes in responses:
    Conclusions: Admiral Nurse roles enabled respondents to develop as autonomous practitioners and to access resources that supported them to build and sustain their dementia specialist practice. Learning was practice based, through partnerships with family carer clients, peer support and self-directed learning. Specialist nursing models may help address the global health workforce emergency, through enabling creative practice development and valued roles that support retention of experienced nurses.
    Language English
    Publishing date 2024-03-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2835763-2
    ISSN 2405-8440
    ISSN 2405-8440
    DOI 10.1016/j.heliyon.2024.e27856
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The Impact of the COVID-19 Pandemic and Associated Societal Restrictions on People Experiencing Homelessness (PEH): A Qualitative Interview Study with PEH and Service Providers in the UK.

    Dawes, Jo / May, Tom / Fancourt, Daisy / Burton, Alexandra

    International journal of environmental research and public health

    2022  Volume 19, Issue 23

    Abstract: People experiencing homelessness (PEH) faced unique challenges during the COVID-19 pandemic, including changes to accommodation availability, societal restrictions impacting access to essentials like food, and services moving to online and remote access. ...

    Abstract People experiencing homelessness (PEH) faced unique challenges during the COVID-19 pandemic, including changes to accommodation availability, societal restrictions impacting access to essentials like food, and services moving to online and remote access. This in-depth qualitative research aims to add to the existing, but limited research exploring how the pandemic affected PEH. 33 semi-structured qualitative interviews (22 with PEH during the pandemic and 11 with homelessness sector service providers) were undertaken in the United Kingdom between April 2021 and January 2022. Interviews were audio-recorded, transcribed and analysed using reflexive thematic analysis. To ensure consistency of coding, 10% of interviews were coded by two researchers. The PEH sample was 50% female, aged 24-59 years, 59% white British, and included people who had lived in hostels/hotels, with friends/family, and on the streets during the COVID-19 pandemic. Providers came from varied services, including support charities, housing, and addiction services. Five key themes were identified: (i) the understanding of and adherence to public health guidance and restrictions; (ii) the experience of people accommodated by the 'Everyone In' initiative; (iii) the impact of social distancing guidelines on PEH experiences in public spaces; (iv) the importance of social support and connections to others; and (v) how homelessness services adapted their provision. Policy makers and public health communicators must learn from PEH to maximize the effectiveness of future public health strategies. Housing providers and support services should recognize the implications of imposing a lack of choice on people who need accommodation during a public health emergency. The loss of usual support for PEH triggered a loss of ability to rely on usual 'survival strategies', which negatively influenced their health. This research highlights successes and difficulties in supporting PEH during the COVID-19 pandemic and informs planning for similar public health events.
    MeSH term(s) Female ; Humans ; Male ; COVID-19/epidemiology ; Pandemics ; Social Problems ; Qualitative Research ; Physical Distancing
    Language English
    Publishing date 2022-11-23
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph192315526
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Community and cultural engagement for people with lived experience of mental health conditions: what are the barriers and enablers?

    Baxter, Louise / Burton, Alexandra / Fancourt, Daisy

    BMC psychology

    2022  Volume 10, Issue 1, Page(s) 71

    Abstract: Background: Community and cultural engagement can support recovery, help symptom management and increase social connections for people with lived experience of mental health conditions. However, research suggests that people with mental health ... ...

    Abstract Background: Community and cultural engagement can support recovery, help symptom management and increase social connections for people with lived experience of mental health conditions. However, research suggests that people with mental health conditions experience significant barriers to participation. The aim of this study was to explore barriers and enablers of participation in community and cultural activities among people with mental health conditions.
    Methods: A qualitative interview study with 23 people with mild-to-moderate mental health conditions was undertaken. Data were analysed thematically, and themes were mapped to domains of the Capability, Opportunity and Motivation Model of Behaviour (COM-B).
    Results: Eleven themes were identified from the analysis. Three themes involved participant Capability: physical skills, psychological traits and physical health limitations and three themes related to Opportunity: affordability and accessibility, structure and nature of the group, and support from others to attend. Five themes mapped to Motivation: creative identity, recovery and coping, enjoyment and fun, connecting with others, and information and planning. Participants were motivated to engage with community and cultural activities through "a creative identity", belief that engagement would help recovery from mental illness, and a desire to connect with others and make friends. Motivation to participate was sustained by the enjoyable nature of activities. However, participants' ability to engage was hampered by the expense, inaccessibility and sometimes unstructured nature of activities, and social anxiety associated with attending. Some participants had physical limitations such as fatigue or physical health problems to overcome. Interventions that could address these barriers include peer support, training for social prescribers to account for identity and previous experiences of participation, training for community organisations in providing a welcoming and structured environment, and provision of long-term sustainable funding to community organisations to subsidise attendance, transport or equipment costs.
    Conclusion: People with mental health conditions may be at risk of experiencing barriers to community and cultural engagement due to existing social inequalities and social anxiety, however believing that involvement will support mental health was an enabler to participation. Future studies are needed to test the effectiveness of potential interventions to address the barriers and harness the facilitators identified here, to enable a more socially inclusive community and voluntary sector, and a potentially more responsive and effective social prescribing service in the UK for people experiencing mental health problems.
    MeSH term(s) Humans ; Mental Disorders/psychology ; Mental Disorders/therapy ; Mental Health ; Motivation ; Qualitative Research ; Socioeconomic Factors
    Language English
    Publishing date 2022-03-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2705921-2
    ISSN 2050-7283 ; 2050-7283
    ISSN (online) 2050-7283
    ISSN 2050-7283
    DOI 10.1186/s40359-022-00775-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Socioeconomic and Psychosocial Adversities Experienced by Freelancers Working in the UK Cultural Sector During the COVID-19 Pandemic: A Qualitative Study.

    May, Tom / Warran, Katey / Burton, Alexandra / Fancourt, Daisy

    Frontiers in psychology

    2022  Volume 12, Page(s) 672694

    Abstract: There are concerns that the socioeconomic consequences of COVID-19, including unemployment and financial insecurity, are having adverse effects on the mental wellbeing of the population. One group particularly vulnerable to socioeconomic adversity during ...

    Abstract There are concerns that the socioeconomic consequences of COVID-19, including unemployment and financial insecurity, are having adverse effects on the mental wellbeing of the population. One group particularly vulnerable to socioeconomic adversity during this period are those employed freelance within the cultural industry. Many workers in the sector were already subject to income instability, erratic work schedules and a lack of economic security before the pandemic, and it is possible that COVID-19 may exacerbate pre-existing economic precarity. Through interviews with 20 freelancers working within the performing arts, visual arts, and film and television industries, this article explores the impact of the pandemic on their working lives. Findings suggest the pandemic is affecting the psychological wellbeing of freelancers through employment loss, financial instability and work dissonance, and illustrates the need for urgent economic and psychosocial support for those employed within the cultural sector.
    Language English
    Publishing date 2022-01-13
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2563826-9
    ISSN 1664-1078
    ISSN 1664-1078
    DOI 10.3389/fpsyg.2021.672694
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: What are the active ingredients of 'arts in health' activities? Development of the INgredients iN ArTs in hEalth (INNATE) Framework.

    Warran, Katey / Burton, Alexandra / Fancourt, Daisy

    Wellcome open research

    2022  Volume 7, Page(s) 10

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2022-04-29
    Publishing country England
    Document type Journal Article
    ISSN 2398-502X
    ISSN 2398-502X
    DOI 10.12688/wellcomeopenres.17414.2
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  10. Article ; Online: Exploring Barriers and Facilitators to Physical Activity during the COVID-19 Pandemic: A Qualitative Study.

    Roche, Charlotte / Fisher, Abigail / Fancourt, Daisy / Burton, Alexandra

    International journal of environmental research and public health

    2022  Volume 19, Issue 15

    Abstract: Quantitative data show that physical activity (PA) reduced during the COVID-19 pandemic, with differential impacts across demographic groups. Qualitative research is limited; thus, this study aimed to understand barriers and facilitators to PA during the ...

    Abstract Quantitative data show that physical activity (PA) reduced during the COVID-19 pandemic, with differential impacts across demographic groups. Qualitative research is limited; thus, this study aimed to understand barriers and facilitators to PA during the pandemic, focusing on groups more likely to have been affected by restrictions, and to map these onto the capability, opportunity, motivation model of behaviour (COM-B). One-to-one interviews were conducted with younger (aged 18-24) and older adults (aged 70+), those with long-term physical or mental health conditions, and parents of young children. Themes were identified using reflexive thematic analysis and were mapped onto COM-B domains. A total of 116 participants contributed (aged 18-93, 61% female, 71% White British). Key themes were the importance of the outdoor environment, impact of COVID-19 restrictions, fear of contracting COVID-19, and level of engagement with home exercise. Caring responsibilities and conflicting priorities were a barrier. PA as a method of socialising, establishing new routines, and the importance of PA for protecting mental health were motivators. Most themes mapped onto the physical opportunity (environmental factors) and reflective motivation (evaluations/plans) COM-B domains. Future interventions should target these domains during pandemics (e.g., adapting PA guidance depending on location and giving education on the health benefits of PA).
    MeSH term(s) Aged ; COVID-19/epidemiology ; Child ; Child, Preschool ; Exercise/psychology ; Female ; Humans ; Male ; Motivation ; Pandemics ; Qualitative Research
    Language English
    Publishing date 2022-07-27
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph19159169
    Database MEDical Literature Analysis and Retrieval System OnLINE

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