Recent Submissions

  • The determination of finger flexor critical force in rock climbers

    Giles, David; Chidley, Joel;; Taylor, Nicola; Torr, Ollie; Hadley, Josh; Randall, Tom; Fryer, Simon; University of Derby (Human Kinetics, 2019-04)
    Purpose: To determine if the mathematical model used for the estimation of critical force (CF) and the energy store component W’ is applicable to intermittent isometric muscle actions of the finger flexors of rock climbers, using a multi-session test. As a secondary aim, the agreement of estimates of CF and W’ from a single-session test were also determined. The CF was defined as the slope coefficient and W’ the intercept of the linear relationship between total “isometric work” (Wlim) and time to exhaustion (Tlim). Methods: Subjects performed three (separated by either 20 m or >24 h) tests to failure using intermittent isometric finger flexor contractions at 45, 60 and 80% of their maximum voluntary contraction (MVC). Results: Force plotted against Tlim displayed a hyperbolic relationship, correlation coefficients of the parameter estimates from the work–time CF model were consistently very high (R2 > 0.94). Climbers mean CF was 425.7 ± 82.8 N (41.0 ± 6.2% MVC) and W’ 30882 ± 11820 N·s. Good agreement was found between the single and multi-session protocol for CF (ICC(3,1) = 0.900, 95% Confidence Interval [CI95%] 0.616 – 0.979), but not for W’ (ICC(3,1) = 0.768, CI95% 0.190 – 0.949). Conclusions: The results demonstrated the sensitivity of a simple test for the determination of CF and W’, using equipment readily available in most climbing gyms. While further work is still necessary, the test of CF described is of value for understanding exercise tolerance and determine optimal training prescription to monitor improvements the performance of the finger flexors.
  • Reducing avoidable pressure ulcers.

    Anthony, Denis; HODGSON, Heather; HORNER, Joanna; University of Leeds (Wounds UK., 2017-04-24)
    Risk assessment scales for pressure ulcers have been in use for over 50 years but there is no evidence that such scales reduce pressure ulcer incidence. Pressure ulcer interventions have been shown to be effective, sometimes alongside risk assessment scales. Care bundles are an example of multifaceted approaches that have been successfully used in a variety of clinical areas including for pressure ulcers. Pressure ulcers were monitored before and after implementation of a new scheme based on an existing care bundle. Avoidable pressure ulcers were significantly reduced following implementation of the scheme.
  • Successful up-scaled population interventions to reduce risk factors for non-communicable disease in adults: results from the International Community Interventions for Health (CIH) Project in China, India and Mexico.

    Dyson, Pamela A; Anthony, Denis; Fenton, Brenda; Stevens, Denise E; Champagne, Beatriz; Li, Li-Ming; Lv, Jun; Ramírez Hernández, Jorge; Thankappan, K R; Matthews, David R; University of Oxford (PLOS, 2015-04-13)
    Non-communicable disease (NCD) is increasing rapidly in low and middle-income countries (LMIC), and is associated with tobacco use, unhealthy diet and physical inactivity. There is little evidence for up-scaled interventions at the population level to reduce risk in LMIC.
  • An exploratory study to identify risk factors for the development of capecitabine-induced Palmar Plantar Erythrodysesthesia (PPE)

    Law, Annie; Dyson, Sue; Anthony, Denis; De Montfort University; University Hospitals of Leicester NHS Trust; UK; Middlesex University; UK; University of Leeds; UK (Wiley., 2015-02-20)
    AIMS: To identify pre-treatment risk factors for the development of Palmar Plantar Erythrodysesthesia in participants receiving capecitabine monotherapy. Specifically the hypothesis that avoidance of activities that cause friction and pressure cause Palmar Plantar Erythrodysesthesia was tested. BACKGROUND: Previous literature showed contradictory evidence on the subject of predictors of chemotherapy-induced Palmar Plantar Erythrodysesthesia. There is a lack of empirical evidence to support the theory that Palmar Plantar Erythrodysesthesia is caused by damage to the microcapillaries due to everyday activities that cause friction or pressure to the hands or feet. DESIGN: Prospective epidemiological study of risk factors. METHODS: Prospective data collection. All patients prior to commencing capecitabine monotherapy between 11 June 2009-31 December 2010, were offered recruitment into the study and followed up for six cycles of treatment (n = 174). Data were collected during semi-structured interviews, from participants' diaries, physical examination of the hands and feet and review of notes. Data relating to activities that cause friction, pressure or heat were collected. Data were analysed using bivariate (chi-square and independent groups Student's t) tests where each independent variable was analysed against Palmar Plantar Erythrodysesthesia. RESULTS: The only variables that were associated with an increased risk of Palmar Plantar Erythrodysesthesia were a tendency to have warm hands and pre-existing inflammatory disease. CONCLUSIONS: This study gives no support for the hypothesis that avoidance of activities that cause friction and pressure cause Palmar Plantar Erythrodysesthesia.
  • Reducing health risk factors in workplaces of low and middle-income countries.

    Anthony, Denis; Dyson, Pamela A.; Lv, Jun; Thankappan, Kavumpurathu R.; Matthews, David R.; University of Leeds; Healthcare; University of Leeds; Leeds UK; Oxford Centre for Diabetes, Endocrinology & Metabolism; University of Oxford; Oxford UK; School of Public Health; Peking University Health Science Center; Beijing China; Achutha Menon Centre for Health Science Studies; Sree Chitra Tirunal Institute for Medical Sciences and Technology; Trivandrum India; Fundación Interamericana del Corazón México; Mexico City Mexico; Harris Manchester College; University of Oxford; Oxford UK (Wiley., 2015-03-19)
    Objective: To reduce risk factors in workplace settings in low- and middle-income countries. Design and Sample: Workplace interventions were utilized as part of the Community Interventions for Health program, a nonrandomized, controlled study undertaken in three communities in China, India, and Mexico. Exactly, 45 industrial, 82 health and 101 school workplace settings with a target population of 15,726. Two independent cross-sectional surveys of workers were conducted at baseline and follow-up, after 18–24 months of intervention activities. Measures: Culturally appropriate interventions to reduce tobacco use, increase physical activity, and improve dietary intake were delivered in the intervention areas. Results: Exactly, 12,136 adults completed surveys at baseline, and 9,786 at follow-up. In the intervention group, the prevalence of tobacco use reduced significantly in men (-6.0%, p < .001) and the proportion eating five portions of fruit and vegetables daily increased (+6.9%, p < .001) compared with the control group. There were no significant differences between the groups for changes in physical activity or prevalence of overweight. Conclusions: Workplace interventions improved risk factors in China, India, and Mexico.
  • Community Interventions for Health can support clinicians in advising patients to reduce tobacco use, improve dietary intake and increase physical activity.

    Anthony, Denis; Dyson, Pamela A; Lv, Jun; Thankappan, Kavumpurathu Raman; Champgane, Beatriz; Matthews, David R; University of Leeds; University of Oxford; Sree Chitra Tirunal Institute for Medical Sciences and Technology; International American Heart Organisation; University of Leeds; Leeds UK; Oxford Centre for Diabetes, Endocrinology & Metabolism; University of Oxford; Oxford UK; School of Public Health; Peking University Health Science Center; Beijing China; Centre for Health Science Studies; Sree Chitra Tirunal Institute for Medical Sciences and Technology; Trivandrum India; International American Heart Organisation; Dallas TX USA; Harris Manchester College; University of Oxford; Oxford UK (Wiley, 2016-07-25)
    AIMS AND OBJECTIVES: To increase clinical interventions to reduce modifiable risk factors for noncommunicable disease in low- and middle-income countries. BACKGROUND: Noncommunicable disease is the leading cause of death in the world and is common in low- and middle-income countries. Risk factors for noncommunicable disease are modifiable and health professionals are in an unique position to intervene and influence them. DESIGN: Clinical interventions were used as part of the Community Interventions for Health programme, a nonrandomised, controlled study undertaken in three communities - one each in China, India and Mexico. METHODS: All clinicians in intervention and control areas of the study were invited to complete surveys. A total of 2280 completed surveys at baseline and 2501 at follow-up. Culturally appropriate interventions to reduce tobacco use, improve dietary intake and increase physical activity were delivered in the intervention areas. RESULTS: Clinicians in the intervention group felt more prepared to advise smoking cessation and improvement of diet. They were more likely to test serum cholesterol and blood pressure, but less likely to take measurements of height, hip, waist and skin-fold thickness. There were more resources available to clinicians in the intervention group and they used counselling more and complementary medicine less than those in the control group. CONCLUSIONS: Community interventions which have been shown to have a positive effect in the community and workplace also change clinical practice. RELEVANCE TO CLINICAL PRACTICE: Community interventions make clinicians, including nurses, more likely to feel prepared to offer advice and more likely to use counselling. This would be expected to reduce risk factors in patients.
  • Conflict management styles used by nurses in Jordan

    Al-Hamdan, Zaid; Norrie, Peter; Anthony, Denis; University of Leeds; Jordan University of Science and Technology, Jordan; De Montfort University, Leicester; Assistant Professor, Faculty of Nursing, Jordan University of Science and Technology, Jordan; Principal Lecturer and Senior Research Fellow, School of Nursing and Midwifery, De Montfort University, UK; Professor of Nursing, School of Nursing and Midwifery, De Montfort University, UK (Sage, 2012-11-30)
    The aim of this study is to investigate the conflict management styles used by nurse managers in Jordan. There are five main styles which nurse managers use to deal with conflict. At present research into their utilisation is dominated by reports from Western countries. This research is the second to investigate their use by nurses in an Arab country and it illustrates both similarities and differences with this earlier work, allowing an initial profile to be constructed which may be applicable to the larger Arab world of health care. Cross sectional quantitative survey of nurse managers in Jordan. The Rahim Organisation Conflict Inventory (ROCI II) questionnaire was completed by 350 (83% response).The nurse managers were most likely to use an integrating style of conflict management, followed in rank order by comprising, obliging, dominating and avoiding. A tentative model of the styles which nurse managers in Arab countries use to manage conflict is proposed, which suggests that these managers are likely to provide stable workplaces.
  • A comparison of the performance of the Braden Q and the Glamorgan paediatric pressure ulcer risk assessment scales in general and intensive care paediatric and neonatal units.

    Willock, Jane; Habiballah, Laila; Long, Deborah; Palmer, Kelli; Anthony, Denis; University of Leeds; University of Oxford (Elsevier, 2016-03-15)
    Aims To compare the predictive ability of two risk assessment scales used in children. Background There are several risk assessment scales (RASs) employed in paediatric settings but most have been modified from adult scales such as the Braden Q whereas the Glamorgan was an example of a scale designed for children. Methods Using incidence data from 513 paediatric hospital admissions, receiver operating characteristic (ROC) was employed to compare the two scales. The area under the curve (AUC) was the outcome of interest. Results The two scales were similar in this population in terms of area under the curve. Neonatal and paediatric intensive care were similar in terms of AUC for both scales but in general paediatric wards the Braden Q may be superior in predicting risk. Conclusion Either scale could be used if the predictive ability was the outcome of interest. The scales appear to work well with neonatal, paediatric intensive care and general children’s wards. However the Glamorgan scale is probably preferred by childrens’ nurses as it is easy to use and designed for use in children. There is some suggestion that while the two scales are similar in intensive care, for general paediatrics the Braden Q may be the better scale.
  • Community Interventions for Health (CIH): A monograph

    Dyson,Pamela; Anthony, Denis; University of Oxford (Oxford Health Alliance, 2015)
    Non communicable disease (NCD), including cardiovascular disease, cancer, diabetes and chronic respiratory diseases, accounted for over 65.5% of deaths in 2010, with more than 80% of these occurring in low and middle income countries (LMIC). Approximately 30% of the deaths in LMIC occur prematurely and are largely preventable. NCD is also associated with increased morbidity and reduced quality of life, and it has been estimated that the global economic impact of NCD could total US$47 trillion over the next twenty years, equivalent to 5% of GDP. The causes of NCD have their roots in three major modifiable risk factors; tobacco use, physical inactivity and unhealthy diet and prevention of NCD by addressing these factors at the community level is fast becoming an area of interest. Most authorities, including the United Nations (UN), the World Health Organisation (WHO) and the US Center for Disease Control and Prevention (CDC) recommend evidence based strategies for lifestyle interventions, but there is limited high grade evidence for population or community based approaches and most of the available evidence is derived from studies conducted in high risk individuals in high income countries. The population approach is inclusive and addresses many factors including health education, structural environmental change, engagement of health providers, transport and education ministries, policy and legislative initiatives and partnerships and coalitions with community organisations. In 2008, the Oxford Health Alliance, a UK registered health charity (No 1117580), began its Community Interventions for Health (CIH) program which was designed to utilise this population approach and which adopted multi factorial, comprehensive strategies for prevention of NCD by addressing modifiable lifestyle risk factor reduction. CIH is an international collaborative study that took place between 2008 2011 in communities in China, India and Mexico and was designed to reduce the risk of NCD by targeting the three main risk factors of tobacco use, physical inactivity and unhealthy diet. The aim of CIH was to evaluate culturally specific strategies to (i) decrease the prevalence of smoking and smokeless tobacco use, (ii) improve diet by increasing intake of fruit and vegetables and reducing use of salt and (iii) increase levels of physical activity in local communities in India, China and Mexico. CIH was conducted over 5 years, and showed that population based strategies to improve health were effective in adults, and had a positive impact on risk factors for NCD by improving dietary intake and ameliorating secular trends for reduced physical activity and increases in overweight and obesity.
  • Increased knowledge of the effects of smoking and second-hand smoke encourages smoke-free homes.

    Fenton, Brenda; Thankappan, Kavumpurathu Raman; Champagne, Beatriz; Lv, Jun; Anthony, Denis; University of Leeds; Director, Community-based Research and Evaluation, MATRIX Public Health Solutions Inc., USA; Professor, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India; Executive Director, InterAmerican Heart Foundation, USA; Associate Professor, Department of Epidemiology &amp; Biostatistics, School of Public Health, Peking University Health Science Center, China; Statistical consultant, Oxford Health Alliance, UK; Chair in Applied Health Research, University of Leeds, UK (Sage, 2014-04-15)
    Objective: To establish the drivers for smoke-free homes among current daily smokers. Design: A cross-sectional study employing interviews (adults) and self-completed surveys (schoolchildren). Sample: Children aged 12 and 14 in schools in four cities in China, India, Mexico and England.Adults in the community. Measurements: Knowledge, attitude, beliefs and behaviour relevant to second-hand smoke in home. Intervention: None. Results: A total of 8994 adults and 14,756 children were surveyed. Knowledge of some of the effects of tobacco is high, but other effects are poorly understood in all cities.
  • Alcohol health literacy in young adults with Type 1 diabetes and its impact on diabetes management.

    Barnard, K. D.; Dyson, P.; Sinclair, J. M. A.; Lawton, J.; Anthony, Denis; Cranston, M.; Holt, R. I. G.; University of Leeds; Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK; OCDEM; University of Oxford; OCDEM Churchill Hospital; Oxford UK; Clinical and Experimental Sciences Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK; Centre for Population Health Sciences; University of Edinburgh; Edinburgh UK; School of Healthcare; University of Leeds; Leeds UK; Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK; Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK (Wiley, 2014-05-13)
    AIMS: To investigate the knowledge of alcohol and carbohydrate content of commonly consumed alcoholic drinks among young adults with Type 1 diabetes and to explore alcohol consumption while identifying diabetes self-management strategies used to minimize alcohol-associated risk. METHOD: We conducted an open-access, multiple-choice web survey to investigate knowledge of alcohol and carbohydrate content of typical alcoholic drinks using images. Respondents to the survey also recorded their current alcohol consumption and diabetes self-management strategies when drinking. RESULTS: A total of 547 people aged 18-30 years responded to the survey (341 women; 192 men; mean (sd) age 24.5 (3.7) years), of whom 365 (66.7%) drank alcohol. In all, 84 (32.9%) women and 31 (22.6%) men scored higher than the cut-off score for increased-risk drinking. Knowledge accuracy of alcohol units was poor: only 7.3% (n = 40) correctly identified the alcohol content of six or more out of 10 drinks. Knowledge of carbohydrate content was also poor: no respondent correctly identified the carbohydrate content of six or more out of 10 drinks. Various and inconsistent strategies to minimize alcohol-associated risk were reported. CONCLUSIONS: Alcohol consumption was common among the survey respondents, but knowledge of alcohol and carbohydrate content was poor. Greater alcohol-related health literacy is required to minimize alcohol-associated risk. Further research should help develop effective strategies to improve health literacy and support safe drinking for young adults with Type 1 diabetes.
  • Creative ageing: the social policy challenge.

    Hogan, Susan; Bradfield, E.; University of Derby (Routledge, 2018-11-27)
    By 2071, the number of people over 65 could double to nearly 21.3 million, while the number of people aged 80 and over could more than treble to 9.5 million. Over the next 30 years, the number of people with dementia in the UK could double to 1.4 million. The current policy landscape marks a shift in thinking, away from ‘deficit’ models of later life towards a paradigm shift which ‘allows people to realise their potential for physical, social, and mental wellbeing throughout the life-course and to participate in society’ (World Health Organisation 2002, p. 3). Where previous models of later-life care have focused on supporting acute illness in older age, health-care systems are now forced to find ways to support individuals to take responsibility for their own health within their own communities. In 2008, the New Economics Foundation (NEF) was commissioned by the UK Government’s Foresight Project on Mental Capital and Wellbeing to review the interdisciplinary work of more than 400 researchers from across the world. The aim was to identify a set of evidencebased actions to improve wellbeing which individuals could be encouraged to build into their daily lives. This was distilled down to the Five Ways to Wellbeing, which is now a major driver of health policy in the UK. They are: connect, be active, take notice, keep learning, give This chapter will look at how different types of creativity in older age can meet the social policy recommendations embodied within the Five Ways to Wellbeing with specific detailed examples. The chapter will also relate this to the ongoing work on wellbeing, post-2008. Though some commentators have suggested this formulation is absurdly reductive, Five Ways to Wellbeing has had considerable success in being accessible to a wide-range of audiences and easy to embed in policy statements and to communicate to community-based organisational teams. Following a brief introduction to the British policy context, this chapter looks at ways in which Five Ways to Wellbeing can be realised through arts engagement providing detailed examples of arts practices that help sustain a creative older age.
  • The body of work as a legitimate form of independent scholarship.

    Bird, Jamie; Stephanou, Mary; Wellen, Allessandar; University of Derby (Routledge, 2018-10-25)
    This chapter will outline key principles that underpin the use of creativity within final-year projects of undergraduate and postgraduate programmes. It will set forth a rational for directing students towards using a particular form of arts-based research that aids critical thinking and reflexivity whilst engaging in art practice. The programmes referenced in this chapter are delivered at the University of Derby. The undergraduate programme – Creative Expressive Therapies – is outlined in detail within other chapters of this book. The post-graduate programmes include Art Therapy, Dramatherapy and Dance and Movement Psychotherapy. Those postgraduate programmes are regulated by various professional bodies and lead to students being able to practice in their chosen field. What those programmes share is the placing of creativity, art-making and performance at the heart of their pedagogic philosophy and practice. What they also share is a focus upon the therapeutic use of creativity and the therapeutic use of self. Whilst the undergraduate programmes are positioned within an arts in health and arts in education paradigm, the post-graduate programmes are broadly psychotherapeutic in their approach to creativity and therapeutic relationships. Either way, a better understanding of the role of the therapeutic use of creativity and self is enhanced by embedding both into the process of independent scholarship.
  • Exploring the potential role of coaching skills.

    de Witt, Julie T; University of Derby (2018-07-04)
    Part of our role is to develop and inspire the leaders of the future; so they will go onto deliver high quality healthcare services for all of us. However, inspiring leaders of the future is not as simple as including in a curriculum. Various reports examining the failures within the UK NHS seem to emphasize this unfortunately (Francis, 2012: Keogh, 2012: Morecambe Bay, 2015). Addressing intrinsic motivation is key in embedding the concept of leadership into our graduates, as future clinical leaders within the NHS. This is also where a coaching approach in both personal tutoring and in the class setting (team coaching) can work. Using a coaching approach we may begin to tap into that area below the waterline and encourage the student to reach their own solution; one which addresses their inherent motivation. In this invited talk I will outline some of those strategies and why you should consider building some of them into your practice.
  • Trigeminal neuralgia: Imaging and the patient experience of Magnetic Resonance Imaging (MRI) of the brain: Findings from an on-line survey of patient experience of MRI imaging.

    de Witt, Julie T; Gallagher, S; University of Derby (2018-10-06)
    Background This is the first study to explore the experience of this group of patients and their experience of having an MRI brain scan. It is also unique in specifically focusing on MRI brain scan alone. This gives a new perspective on the nature of patient-centred service we should be delivering, not only to patients with this rare condition, but perhaps when scanning anyone with a pain condition – or indeed in personalizing an examination for any patient. Aims/Objectives To understand the patient’s lived experience of having an MRI brain scan, to understand what made a positive difference and what the patient would like or expect the radiographer to know about their condition. Methods Qualitative method utilized an online survey (Lime survey) with free text responses and some limited demographic data. Survey was advertised on closed social media group and on National charity website (Trigeminal Neuralgia Association UK). 96 responses were received, with 50 free text responses to the open questions. These were analysed using thematic analysis. Results Five themes emerged, with a number of subthemes within each. These are that there are some good stories, there are some not so good experiences, that care and communication makes a difference, that Trigeminal neuralgia (TN) pain is more than just a headache and finally that we need to be involving our patients in their scan. In describing the experience of having an MRI brain scan it was striking that narratives seemed to be clear cut in terms of ‘good or bad’ , but an interesting key difference seemed to be the perceived ‘kindness’ of the staff. Conclusions A recommendation is given in terms of working with a TN patient and their pain triggers, this is for everyone’s benefit as this is also more likely to result in a timely scan with minimal blur artefacts if the patient’s pain is minimized.
  • Fatigue interventions in long term, physical health conditions: a scoping review of systematic reviews.

    Hulme, Katrin; Safari, Reza; Thomas, Sarah; Mercer, Tom; White, Claire; Van der Linden, Marietta; Moss-Morris, Rona; University of Derby; King’s College London; Staffordshire University; Bournemouth University; Queen Margaret University (PLOS, 2018-10-12)
    Fatigue is prominent across many long term physical health conditions. This scoping review aimed to map the fatigue intervention literature, to ascertain if certain interventions may be effective across conditions, and if novel interventions tested in specific long term conditions may be promising for other conditions.
  • A systematic review of variables used to assess clinically acceptable alignment of unilateral transtibial amputees in the literature.

    Tafti, Nahid; Hemmati, Fatemeh; Safari, Reza; Karimi, Mohammad Taghi; Farmani, Farzad; Khalaf, Ali; Mardani, Mohammad Ali; University of Derby; University of Social Welfare and Rehabilitation Sciences; Shiraz University of Medical Sciences; Hamedan University of Medical Sciences (Sage, 2018-08-08)
    Prosthetic alignment is a subjective concept which lacks reliability. The outcome responsiveness to prosthetic alignment quality could help to improve subjective and instrument assisted prosthetic alignment. This study was aimed to review variables used to assess clinically acceptable alignment in the literature. The search was done in some databases including: Google Scholar, PubMed, EBSCO, EMBASE, ISI Web of Knowledge and Scopus. The first selection criterion was based on abstracts and titles to address the research questions of interest. The American Academy of Orthotics and Prosthetics checklists were used for paper risk of bias assessment. A total of 25 studies were included in this study. Twenty-four studies revealed the critics of standing position or walking to locate clinically acceptable alignment, only one study measured outcomes in both situations. A total of 253 adults with transtibial amputations and mean age of 48.71 years participated in included studies. The confidence level of included studies was low to moderate, and before-after trial was the most common study design (n = 19). The joint angle, load line location with respect to joints and center of pressure-related parameters were reported as sensitive outcomes to prosthetic alignment quality in standing posture. The amount of forces at various parts of gait cycle and time of events were sensitive to prosthetic alignment quality during walking. Standing balance and posture and temporal parameters of walking could help to locate clinically acceptable alignment.
  • Local authorities and the education of young people with sickle cell disorders in England.

    Dyson, Simon M.; Abuateya, Hala; Atkin, Karl; Culley, Lorraine A.; Dyson, Sue E.; Rowley, David T. (Routledge, 2008)
    The successful inclusion of minority ethnic pupils with sickle cell disorders (SCD) raises a number of challenges for educational systems. In England, local education authorities were important drivers for innovative responses to complex needs and the former Inner London Education Authority produced guidance in 1989 on SCD in schools. Local education authorities, however, have been superseded by centralised curricula on the one hand and by local management of schools on the other. We know little about the impact of these changes on managing chronic conditions such as SCD. A survey was conducted with 107 local authorities in England to assess responses to needs of pupils with SCD. The majority of authorities did not know the numbers of children with SCD under their jurisdiction, even though most agreed with government guidance that all such children should have individual healthcare plans. Only two had policies on SCD and most authorities referred to generic guidance on pupils with medical needs in schools. The paper concludes, however, that such generic guidance fails in a number of ways to meet the needs of young people with SCD, in terms of prevention, challenging disability discrimination and, crucially, in failing to recognise how ethnicity and racism mediate the experiences of young black disabled students. Developing policies suitable for the education needs of young people with SCD would also help develop the very narrow guidance currently suggested for inclusion of pupils with medical conditions.
  • Education and young people with sickle cell disorder: a knowledge review.

    Abuateya, Hala; Atkin, Karl; Culley, Lorraine A.; Dyson, Sue E.; Dyson, Simon M. (Radcliffe Publishing, 2008-06)
    Sickle cell disorders (SCD) are a group of chronic inherited blood conditions. The majority of studies on SCD have a clinical focus and deal with how those living with SCD 'manage' what is constructed as a given: the 'condition' of SCD. Consequently, many studies present the psychological impact, referring uncritically to what are termed 'coping strategies'. Current debates on SCD and other chronic conditions rarely engage with the broader social context. In part response to this, our paper presents a critical review of the literature on SCD, young people and education. The paper evaluates literature that touches on education and SCD, before concluding with a broad discussion of future research and policy priorities. Throughout, we reflect on how the process of constructing a knowledge base from available literature is problematic. We specifically discuss how current research presents a skewed picture of the experience of SCD, which is of limited value to those responsible for education policy and practice. The paper concludes that research should move beyond describing the basic health needs of people with SCD by including the social context of their lives. Existing literature on the individual educational experiences of young people living with SCD is, however, either dated or limited by being based on conceptual argument rather than empirical data. Consequently, there is a need for well-designed studies to establish the best way to meet the educational needs of young people with SCD, reflecting not only their health needs in school, but the whole context of living with SCD, including interaction with disabling or racist structures. Furthermore, this holistic approach could contribute to a wider understanding of the educational needs of young people from minority ethnic backgrounds and of young people living with chronic illnesses.

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