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A major health concern for subjects with diabetes is weaker bones and increased fracture risk. Current clinical assessment of the bone strength is performed by measuring Bone Mineral Density (BMD), where low BMD-values are associated with an increased risk of fracture. However, subjects with Type 2 Diabetes (T2D) have been shown to have normal or higher BMD-levels compared to healthy controls, which does not reflect the recognized bone fragility among diabetics. Thus, there is need for more research about diabetes-related bone fragility to find other factors of impaired bone health. One potential biomarker that has recently been studied is Bone Marrow Fat (BMF). The data in this project consisted of whole-body water-fat Magnetic Resonance Imaging (MRI) volumes from the UK Biobank Imaging study (UKBB). Each subject in this data has a water volume and a fat volume, allowing for a quantitative assessment of water and fat content in the body. To analyze and perform quantitative measurements of the bones specifically, a Deep Learning (DL) model was trained, validated, and tested for performing fully automated and objective skeleton segmentation, where six different bones were segmented: spine, femur, pelvis, scapula, clavicle and humerus. The model was trained and validated on 120 subjects with 6-fold cross-validation and tested on eight subjects. All ground-truth segmentations of the training and test data were generated using two semi-automatic pipelines. The model was evaluated for each bone separately as well as the overall skeleton segmentation and achieved varying accuracy, performing better on larger bones than on smaller ones. The final trained model was applied on a larger dataset of 9562 subjects (16% type 2 diabetics) and the BMF, as well as bone marrow volume (BMV) and cortical bone volume (CBV), were measured in the segmented bones of each subject. The results of the quantified biomarkers were compared between T2D and healthy subjects. The comparison revealed possible differences between healthy and diabetic subjects, suggesting a potential for new findings related to diabetes and associated bone fragility.

Global Health MSc Thesis / The construct of loneliness is well explored within the arts and humanities, but has only recently been considered to be a condition that should be addressed by public health policy. Definitions explored include common sense, existential loneliness, and the cognitive approach. The governments of Japan and the UK have implemented policy that specifically addresses loneliness as a result of its recent identification as a health concern linked to dementia, heart disease, hypertension, and greater risk of morbidity. This thesis undertook an integrative literature review across the arts, humanities, sciences, and grey literature to provide a comprehensive picture of a modern conceptualization of loneliness. The results of this thesis find that loneliness is both a health risk and social problem that is being addressed at the municipal and federal levels in Japan and the UK. However, the question remains as to whether loneliness should be considered a public health concern or a social concern. More international collaboration on the impact of loneliness on populations is recommended. / Thesis / Master of Health Sciences (MSc) / The construct of loneliness is well explored within the arts and humanities, but has only recently been considered to be a condition that should be addressed by public health policy. The governments of Japan and the UK have implemented policy that specifically addresses loneliness as a result of its recent identification as a health concern linked with dementia, heart disease, hypertension, and greater risk of morbidity. This thesis undertook an integrative literature review across the arts, humanities, sciences, and grey literature to provide an expansive picture of a modern conceptualization of loneliness. The results of this thesis find that loneliness is both a health risk and social problem which can be appropriately addressed by government action. However, the question remains as to whether loneliness should be considered a public health concern or a social concern. More international collaboration on the impact of loneliness on populations is recommended.

No / Faith-based organisations (FBOs) have delivered services to vulnerable people for many years. They are frequently characterised by values also to be found within social work, notably a commitment to social justice. In the context of recent attempts by governments, notably in the USA, United Kingdom and Australia, to ‘roll-back’ the state, to ‘marketise’ and ‘privatise’ welfare services, FBOs are increasingly called-upon to tender for and volunteer to provide public services, including ‘social work’. In the United Kingdom, as elsewhere, religious beliefs are central to how many people conduct themselves, especially in response to personal crises and challenges. The authors’ previous research indicates that religious beliefs and traditions may have a profound impact (for good or ill or for both) on the actions of both individual service users and practitioners, but that social workers and agencies (whether faith-based or not) are often ill equipped to respond appropriately. They acknowledge both the positive contributions to public welfare of many faith-based organisations and the potential dangers inherent in relying on such agencies for services to vulnerable people. The authors argue that evaluations need to consider the effectiveness, appropriateness, ‘costs’ and ‘benefits’ of individual faith-based services in their particular contexts, and that their contribution needs to be analysed in relation to the varied nature and variable impact of such services. Social work has often struggled in its aim of challenging and addressing the structural causes of inequality as its efforts have been channelled towards meeting the needs of the individual. Current policy proposals provide potential opportunities to review and assess the contribution of neo-liberal approaches to welfare and to promote alliances amongst those members of different FBOs and other welfare providers to agree more collective, community-based approaches with an agreed agenda of creating a fairer society.

No / Accounts of the Catholic Church's response to those disclosing sexual abuse by clergy to diocesan safeguarding commissions (formerly child protection commissions) in England and Wales are analysed and compared. The accounts given and the conclusions reached by the Church and those it employs or has commissioned are considered alongside the experiences reported by survivors. The contrasts between these narratives are discussed using techniques underpinned by critical discourse analysis and highlighting service user perspectives. Reports for the period to 2010 and published in 2011 by the National Catholic Safeguarding Commission and Minister and Clergy Sexual Abuse Survivors are discussed in detail, with the resulting analysis of the narratives emerging arguably reflecting a broader discourse. It is suggested that, despite attempts to present the situation differently, the Roman Catholic Church in England and Wales continues to be hampered in its efforts to respond sensitively to the needs of those who have been abused, because, as an institution, it also continues to serve conflicting legitimacy communities, and that, as a result, it risks further alienating those victims and survivors who have been led to expect that their needs will be prioritised over the financial interests and reputation of the institution.

Yes / Over the last few decades the number of women becoming pregnant later on in life has markedly increased. Medical experts have raised concerns about the increase in the number of women having babies later, owing to evidence that suggests that advancing maternal age is associated with both a decline in fertility and an increase in health risks to both mother and baby. In recognition of these risks, experts have warned that women should aim to have their children between the ages of twenty and thirty-five. As a consequence, women giving birth past the age of thirty-five have typically been positioned as “older mothers.” In this paper we used a social constructionist thematic analysis in order to analyse how “older mothers” are represented in newspaper articles in the British press. We examined how the topics of “choice” and “risk” are handled in discussions of delayed motherhood, and found that the media position women as wholly responsible for choosing the timing of pregnancy and, as a consequence, as accountable for the associated risks. Moreover, we noted that newspapers also constructed a “right” time for women to become pregnant. As such, we discuss the implications for the ability of women to make real choices surrounding the timing of pregnancy.

No / The purpose of this paper is to interrogate ways in which sex and sexual orientation are excluded from the agenda of work relationships in one probation service. The research was conducted through conversational interviews with members of a team responsible both for supervision of colleagues and for development of supervisory practice. Straight and lesbian officers responded to a perceived lack of skills to effectively “work with” sexuality issues. Responses lead to discussion of the discursive “silence” of sex, and to the specific positioning of lesbian identity. Specifically, it critiques approaches to supervision that do not explicitly value lesbian experience. This small study does not include the voices of black or gay male officers. It also does not explore the experience of bisexuality. The finding of this research can be used to support development of good supervisory practice. The paper sheds light on day to day interactions that “silence” experience of sexual orientation. The paper draws on original research interrogating both lesbian and straight experience. In so doing it sheds light on both discursive practices of a sexual agenda and practice issues in supervision.

Yes / The central aim of the paper is to examine the nature and function of higher education in Africa, and to explore the potential for partnerships between institutions in the Global North and South to assist in meeting the current capacity challenge. The paper starts with a critical exploration of the contemporary shifts taking place in higher education around the world and how this is transforming academic and professional identities. Following this is an analysis of the rationales that drive the process of ¿internationalisation¿ of higher education. We argue that internationalisation and globalisation present both a challenge and an opportunity for the rapidly expanding systems of higher education in Africa. We then go on to consider how international partnerships might support the development of Higher Education institutions in Africa and we present a critical analysis of the pitfalls and potentials of such collaborations. We also reflect on a long-term collaborative relationship between the Universities of Bradford (UK) and Mzumbe (Tanzania). From this we take the view that robust and strategic long-term partnerships can avoid neo-colonial relationships and offer potential for both partners, but this requires institutional commitment at all levels. This literature review serves as a foundational study, which will feed into further papers reflecting on the evolution and practice of the partnerships in place between JEFCAS (University of Bradford) and HE institutions in Africa.

No / Debates on participatory tend to be abstract, with references to experiences in Athens over 2000 years ago. This book uses recent experience in participatory innovations at the city level to explore the practice of participation. Taking examples from Latin America and the UK it argues the case for revitalizing democracy through participation.

Yes / Studies have shown that a significant proportion of people with epilepsy use complementary and alternative medicine (CAM). CAM use is known to vary between different ethnic groups and cultural contexts; however, little attention has been devoted to inter-ethnic differences within the UK population. We studied the use of biomedicine, complementary and alternative medicine, and ethnomedicine in a sample of people with epilepsy of South Asian origin living in the north of England. Interviews were conducted with 30 people of South Asian origin and 16 carers drawn from a sampling frame of patients over 18 years old with epilepsy, compiled from epilepsy registers and hospital databases. All interviews were tape-recorded, translated if required and transcribed. A framework approach was adopted to analyse the data. All those interviewed were taking conventional anti-epileptic drugs. Most had also sought help from traditional South Asian practitioners, but only two people had tried conventional CAM. Decisions to consult a traditional healer were taken by families rather than by individuals with epilepsy. Those who made the decision to consult a traditional healer were usually older family members and their motivations and perceptions of safety and efficacy often differed from those of the recipients of the treatment. No-one had discussed the use of traditional therapies with their doctor. The patterns observed in the UK mirrored those reported among people with epilepsy in India and Pakistan. The health care-seeking behaviour of study participants, although mainly confined within the ethnomedicine sector, shared much in common with that of people who use global CAM. The appeal of traditional therapies lay in their religious and moral legitimacy within the South Asian community, especially to the older generation who were disproportionately influential in the determination of treatment choices. As a second generation made up of people of Pakistani origin born in the UK reach the age when they are the influential decision makers in their families, resort to traditional therapies may decline. People had long experience of navigating plural systems of health care and avoided potential conflict by maintaining strict separation between different sectors. Health care practitioners need to approach these issues with sensitivity and to regard traditional healers as potential allies, rather than competitors or quacks.