SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
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Item Restricted The Association Between Head and Neck Injuries Requiring Medical Attention and Behavioural Problems Among 7- and 14-Year-Old Adolescents Living in the United Kingdom A Secondary Data Analysis of the UK Millennium Cohort Study (MCS)(University College London, 2024-09) AlRugaibah, Norah; Blokland, Alex; Sifaki, MariaBackground: Injuries are major public health problems that affect children’s lives. Behavioural problems have been linked to increased risk of injury incidence. However, few studies discussed the association between externalising and internalising behavioural problems and head and neck injuries among children and adolescents. Aim: This study aims to examine the association between head and neck injuries requiring medical attention and behavioural problems among 7- and 14-year-old youth living in the UK. Methods: A secondary analysis of data from the Millennium Cohort Study (MCS) was conducted using the fourth and sixth sweeps when the participants were 7 and 14 years old. The outcome indicated whether the child had sustained any head and neck injuries since the last survey. Behavioural problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) subscales of externalising and internalising behaviour. In the analysis both scales were dichotomised (10% highest scores) to discern those experiencing severe difficulties. Demographic, family, and socioeconomic factors were used as covariates. Weighted analysis using regression modelling was used to examine the associations between behavioural problems and head and neck injuries. Results: The prevalence of head and neck injuries for 7- and 14-year-olds were 9.35% and 6.23% respectively. Externalising behavioural problems at age 7 were reported for just under 10% of the children, and nearly 9% were reported to experience Internalising problems. At age 14, over 10% of the sample presented with externalising behavioural problems, and nearly 8% with Internalising behaviours. Children aged 7 years who presented with externalising difficulties had a significantly higher risk of head and neck injuries in the crude model (OR=1.41, 95%CI: 1.02–1.93). However, this association became non-significant after controlling for child characteristics. In the crude model, there was no difference in head and neck injury odds between children with internalising behavioural problems and their peers at age 7 (OR=1.00, 95%CI: 0.67–1.48). The association remained non-significant after subsequent adjustments. For 14-year-olds, those who with externalising problems appeared to have higher odds of head and neck injuries compared to their peers, although not statistically significant in the crude model (OR=1.25, 95%CI: 0.79–1.98) or after adjustments (final model: OR=1.27, 96%CI: 0.80 – 2.02). There was no difference between children aged 14 experiencing internalising difficulties and their peers in the crude model (OR=0.69, 95%CI: 0.35–1.36) or after adjustments (final model: OR=0.69, 96%CI: 0.36 – 1.32). Conclusion: This study indicated that children aged 7 with externalising behavioural problems were at higher risk for head and neck injuries. However, after adjusting for confounding factors, this association became non-significant. In early adolescence (age 14), such injuries were not significantly associated with externalising difficulties. Internalising problems showed no significant association with head and neck injuries in either age group.22 0Item Restricted Childhood Obesity and Weight Stigma: A Public Health Nutrition Approach(University of Glasgow, 2024-04-20) Abuznada, Salma; Combet, Emilie; Garcia, AdaPoor understanding of obesity, its causes and consequences contribute to weight-related stigma in the UK. Children’s understanding of obesity shapes their views and perceptions towards obesity as a disease, body image, and weight stigma behaviours. Exploring children’s and adolescents’ knowledge, perceptions and views of obesity, weight stigma, and nutrition is essential to establishing effective health promotion programmes that cater to young people’s needs, understanding and perspectives. Successful programmes also need continuous monitoring and evaluation, which are currently lacking in the UK. Perceptions and views around obesity among the public vary in different cultures and among healthcare professionals. These different perspectives lead to debates on defining, managing and treating obesity. Weight stigma research in adults tends to focus on weight stigma due to the poor understanding of obesity both among the public (especially women of white ethnicity) and healthcare professionals rather than children and adolescents. This thesis uses systematic reviews and a mixed-methods approach to explore weight stigma across the age spectrum, including children, adolescents and adults. Furthermore, the research investigates children’s and adolescents’ views on obesity and nutrition knowledge. Study 1 systematically reviewed existing observational, quantitative and qualitative studies focusing on the sources, frequency and implications of weight stigma on children’s and adolescents’ mental health, well-being and eating behaviours. The Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) were followed for study selection, screening and data extraction. Synthesis Without Meta-Analysis (SWiM) guidelines were applied to report the synthesis and results. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies from the National Heart, Lung, and Blood Institute (NHLBI) was used to assess the quality of the included studies. Twenty observational studies were included in the final text analysis. Synthesised evidence highlighted that bullying and victimisation play a fundamental role in developing and perpetuating weight-related stigma. Weight-related bullying was correlated with participants’ low self-esteem. Most of the included studies (N=15/20) were of fair quality (average score 5 to 8), although two were of poor quality (average score 0 to 4), and most of the quality criteria were not met. One of the main gaps identified during the literature search in Study 1 was children and adolescents were poorly represented in the studies, with an overemphasis on white adult women. After identifying existing gaps in the literature (e.g., the overemphasis on recruiting white women), Studies 2, 3 and 4 were developed to explore underrepresented groups and gain a deeper understanding of their views and opinions of obesity and weight stigma. Children’s and adolescents’ views and opinions of obesity and nutrition knowledge were explored in Study 2, using a cross-sectional questionnaire and phone interviews. The questionnaire was structured in six sections, exploring sociodemographic characteristics, anthropometric measurements, views and perceptions of obesity, nutrition knowledge, general health, and eating habits and lifestyle. Online interviews followed a narrative focusing on obesity knowledge and experience, obesity perception and the relationship between nutrition and obesity. Study 2 recruited a total of n=317 participants, 54% boys, 72% White/British, with a median age of 16 years (interquartile range (IQR) 15- 18). There was an overall lack of understanding of obesity and its causes and consequences. There was also a lack of consensus and agreement about whether obesity is a sign of disease, a disease, or merely a body shape. There was agreement that obesity can be a personal responsibility (median=4: likely, IQR 3: neutral – 4: likely). Food knowledge was low, with 83% correctly answering three questions or fewer out of six. Although participants reported and believed that they knew what obesity was, most participants linked obesity to body image and placed the responsibility of having obesity on the individuals or their parents. This can lead to increased stigmatising behaviours and isolation of children and adolescents with obesity. Proper education about obesity is imperative to help support children in understanding the general concepts behind obesity’s complexity as a disease. Study 3 used a cross-sectional questionnaire and phone interviews to explore weight stigma and its implications on weight stigma attitudes and body image perceptions in children. In Study 3 (n=667, 62% boys, 70% White/British, median age 16 years (IQR 15-18)), 50% of participants who experienced weight stigma had a BMI ≥30 kg/m². Almost two-thirds of participants who experienced weight stigma (n=259) said it happened at local community places (e.g., clubs, during extracurricular activities) (n=149, 58%). Over a quarter (n=67,26%) reported that it was extremely harsh. Participants who self-reported having obesity (n=214) experienced more weight stigma (n=114, 53%) than those who believed they have overweight (n=87, 41%) or underweight (n=13, 6%). More than half of the sample (n=408, 61%) were dissatisfied with their body image. Most participants who self-reported having obesity were dissatisfied with their body image, demonstrating a significant relationship between self-reported weight problems ‘underweight, overweight, obesity’ and body image satisfaction levels ‘dissatisfied, neutral and satisfied’". In summary, unsurprisingly, most participants who reported weight stigma had a BMI ≥30 kg/m2. Interestingly, more boys than girls who reported experiencing weight stigma believed there was weight stigma in society. To better understand the contribution and impact of childhood lived experiences of weight stigma on adult perceptions and beliefs around overweight and obesity, Study 4 employed similar methods to Study 3. In Study 4 (n=738, 52% men, 76% White/British, 39% BMI ≥30 kg/m2, median age=26 years (IQR=24-31)), less than a quarter of participants had experienced weight stigma as children (n=154, 21%). More women (n=108/154, 70%) experienced weight stigma during childhood than men (n=46/154, 30%, p≤0.001). Participants were mostly undecided about whether obesity is a disease (median=3: undecided, IQR=1: strongly disagree – 3: undecided). Experiencing weight stigma in childhood was positively associated with parents reporting their children’s weight stigma experiences. Parents dissatisfied with their body image (n=62) were more likely to be dissatisfied with their children’s body image (n=23/62, 37%) than satisfied (n=17/62, 24%). Understanding and awareness of obesity are essential in developing public health strategies and health education programmes that are child-oriented and specific to children and adolescents regarding location and intervention tools. The findings in this thesis highlight the negative impact of weight stigma on children and adolescents' physical and mental health. Moreover, a poor understanding of obesity was evident in this research. The work of this research is beneficial in informing programs explicitly targeting the gaps explored and found. This thesis attempts to improve the knowledge of public and academic domains in elements surrounding perceptions, views, and attitudes regarding obesity and weight stigma, the reasonings behind perceptions, and strategies to address obesity stigmatising behaviour.18 0Item Restricted The relationship between Musculoskeletal Disorders and Pain, and Smartphone use amongst adolescents: systematic review(Saudi Digital Library, 2023-11-19) Alanazi, Basmah; Evans, TraceyIntroduction: Over the last few years, smartphone usage, particularly amongst adolescents, has risen exponentially. This has led to concern regarding the link between smartphone utilisation and musculoskeletal issues. The latter could have a detrimental impact on the growth, normal development and well-being of adolescents. Currently, there are few reviews which have investigated the influence of using smartphones on the musculoskeletal system, and specifically, in the adolescent population. Aim: The aim of this research was to perform a systematic review with respect to contemporary publications on musculoskeletal pain and disorder related to the usage of smartphones in adolescents. Methods: A literature search was carried out in a number of electronic databases in order to recognise publications that could be identified using keywords relating to the use of smartphone, musculoskeletal symptoms, such as pain or discomfort, and exposures. The identified publications underwent screening, pertinent information was retrieved and an evaluation of the quality of the study methods used was performed. Narrative synthesis was presented of the study findings owing to the lack of uniformity between studies. Results: Eight quantitative studies were included and were rated as moderate (n=7) and high (n=1) quality. The findings of the review indicated that long durations of smartphone utilisation are linked with musculoskeletal system pain and disorder; this was a consensus opinion amongst all the included studies. The greater the number of hours a smartphone was used for; the more anatomical sites were determined to be impacted by musculoskeletal pain. Reviewed studies indicated that the neck was the most frequent source of discomfort, but that the shoulder, back, arm, elbow and wrist were also affected. Discussion: It was determined from this systematic review that there was only limited evidence and low number of studies linking the use of smartphones, together with a number of parameters relating to their utilisation, such as degree of use, length of time used and tasks performed, with symptoms and discomfort in the musculoskeletal system. To some extent, these findings were attributed to the predominantly moderate quality of evidence presented in the single case-control study, and in the seven cross-sectional studies encompassed within the review. The review did not include any longitudinal epidemiological publications. Nevertheless, the results obtained from this systematic review offer an improved comprehension of the relationships between musculoskeletal pain and disorder and the use of smartphones, an activity which has become a component of the daily life of most adolescents. The data presented could be incorporated into recommendations and interventions in order encourage the judicious usage of smartphones within this population, and could be of value to scientists, policy-makers, teachers, parents and the adolescents per se.19 0