Journal Papers

Some of our teams have gone on to publish their work in journals. Take a look at some of our published research - we hope you'll enjoy what we've produced so far! Authors labelled in bold and underlined are Polygeia researchers/editors!


Mulchandani. R,  Power, H.S & Cavallaro, F.L. (2020) The influence of individual provider characteristics and attitudes on caesarean section decision-making: a global review, Journal of Obstetrics and Gynaecology, 40:1, 1-9, DOI: 10.1080/01443615.2019.1587603


Caesarean section (CS) rates have risen worldwide in the past two decades, particularly in middle and high-income countries. In addition to changing maternal and health system factors, there is growing evidence that provider factors may contribute to rising unnecessary caesareans. The aim of this review was to assess the evidence for the association between individual provider characteristics, attitudes towards CS and decision-making for CS. A search was conducted in May 2018 in PubMed and Web of Science with 23 papers included in our final review. Our results show that higher anxiety scores and more favourable opinions of CS were associated with increased likelihood of performing CS. These findings highlight a need for appropriate interventions to target provider attitudes towards CS to reduce unnecessary procedures.

Zarifkar, P., Kamath, A., Robinson, C., Morgulchik, N., Shah, S. F. H., Cheng, T. K. M., Dominic, C., Fehintola A.O.,  Bhalla, G.,  Ahillan, T., Mourgue d'Algue, L., Lee. J, Pareek, A., Carey, M., Hughes, D.J.,, Miller.M., Woodcock, V. & Shrotri, M. (2020). Clinical Characteristics and Outcomes in Patients with COVID-19 and Cancer: a Systematic Review and Meta-analysis. Clinical Oncology, DOI: 10.1016/j.clon.2020.11.006


Much of routine cancer care has been disrupted due to the perceived susceptibility to SARS-CoV-2 infection in cancer patients. Here, we systematically review the current evidence base pertaining to the prevalence, presentation and outcome of COVID-19 in cancer patients, in order to inform policy and practice going forwards. A keyword-structured systematic search was conducted on Pubmed, Cochrane, Embase and MedRxiv databases for studies reporting primary data on COVID-19 in cancer patients. Studies were critically appraised using the NIH National Heart, Lung and Blood Institute's quality assessment tool set. The pooled prevalence of cancer as a co-morbidity in patients with COVID-19 and pooled in-hospital mortality risk of COVID-19 in cancer patients were derived by random-effects meta-analyses. In total, 110 studies from 10 countries were included. The pooled prevalence of cancer as a co-morbidity in hospitalised patients with COVID-19 was 2.6% (95% confidence interval 1.8%, 3.5%, I2: 92.0%). Specifically, 1.7% (95% confidence interval 1.3%, 2.3%, I2: 57.6.%) in China and 5.6% (95% confidence interval 4.5%, 6.7%, I2: 82.3%) in Western countries. Patients most commonly presented with non-specific symptoms of fever, dyspnoea and chest tightness in addition to decreased arterial oxygen saturation, ground glass opacities on computer tomography and non-specific changes in inflammatory markers. The pooled in-hospital mortality risk among patients with COVID-19 and cancer was 14.1% (95% confidence interval 9.1%, 19.8%, I2: 52.3%). We identified impeding questions that need to be answered to provide the foundation for an iterative review of the developing evidence base, and inform policy and practice going forwards. Analyses of the available data corroborate an unfavourable outcome of hospitalised patients with COVID-19 and cancer. Our findings encourage future studies to report detailed social, demographic and clinical characteristics of cancer patients, including performance status, primary cancer type and stage, as well as a history of anti-cancer therapeutic interventions.


Caulfield A, Vatansever D, Lambert G, Van Boatel, T. (2019). WHO guidance on mental health training: a systematic review of the progress for non-specialist health workers. BMJ Open 2019;9:e024059. doi:10.1136/ bmjopen-2018-024059


Training non-specialist workers in mental healthcare is an effective strategy to increase global provision and capacity, and improves knowledge, attitude, skill and confidence among health workers, as well as clinical practice and patient outcome. Areas for future focus include the development of standardised evaluation methods and outcomes to allow cross-comparison between studies, and optimisation of course structure. In this study, the researchers assessed existing literature on the effectiveness of mental health training courses for non-specialist health workers, based on the WHO guidelines (2008).


Aldridge, R.W., Nellums, L.B., Bartlett, S., Barr, A.L., Patel, P., Burns, R., Hargreaves, S., Miranda, J.J., Tollman, S., Friedland, J.S. and Abubakar, I., 2018. Global patterns of mortality in international migrants: a systematic review and meta-analysis. The Lancet, 392 (10164), pp.2553-2566.


258 million people reside outside their country of birth; however, to date no global systematic reviews or meta-analyses of mortality data for these international migrants have been done. We aimed to review and synthesise available mortality data on international migrants.


Kazzazi, F., Pollard, C., Tern, P., Ayuso-Garcia, A., Gillespie, J. and Thomsen, I. (2017). Evaluating the impact of Brexit on the pharmaceutical industry. Journal of Pharmaceutical Policy and Practice, 10(1).


The UK Pharmaceutical Industry is arguably one of the most important industries to consider in the negotiations following the Brexit vote. Providing tens of thousands of jobs and billions in tax revenue and research investment, the importance of this industry cannot be understated. At stake is the global leadership in the sector, which produces some of the field's most influential basic science and translation work. However, interruptions and losses may occur at multiple levels, affecting patients, researchers, universities, companies and government.With thorough investigation of the literature, we propose four foundations in the advancement of negotiations. These prioritise: negotiation of 'associated country' status, bilaterally favourable trade agreements, minimal interruption to regulatory bodies and special protection for the movement of workforce in the life sciences industry.


Mi, E., Mi, E. and Jeggo, M. (2016). Where to Now for One Health and Ecohealth?. EcoHealth, 13(1), pp.12-17.


Whilst subdivided and with complex interactive origins, two broad groups, One Health and Ecohealth, currently characterise global efforts to tackle the health of people, animals and our environment. One Health and Ecohealth have much in common conceptually in the issues they address (although they differ in their emphasis) and institutionally in their emphasis on interdisciplinary collaboration, but both suffer from limited resources and support. We explore the possibilities for further convergence or unity.

Hamilton, W. L., Doyle, C., Halliwell-Ewen, M., & Lambert, G. (2016). Public health interventions to protect against falsified medicines: a systematic review of international, national and local policies. Health policy and planning, 31(10), 1448-1466.


Background: Falsified medicines are deliberately fraudulent drugs that pose a direct risk to patient health and undermine healthcare systems, causing global morbidity and mortality.

Objective: To produce an overview of anti-falsifying public health interventions deployed at international, national and local scales in low and middle income countries (LMIC).

Data sources: We conducted a systematic search of the PubMed, Web of Science, Embase and Cochrane Central Register of Controlled Trials databases for healthcare or pharmaceutical policies relevant to reducing the burden of falsified medicines in LMIC.

Results: Our initial search identified 660 unique studies, of which 203 met title/abstract inclusion criteria and were categorised according to their primary focus: international; national; local pharmacy; internet pharmacy; drug analysis tools. Eighty-four were included in the qualitative synthesis, along with 108 articles and website links retrieved through secondary searches.

Discussion: On the international stage, we discuss the need for accessible pharmacovigilance (PV) global reporting systems, international leadership and funding incorporating multiple stakeholders (healthcare, pharmaceutical, law enforcement) and multilateral trade agreements that emphasise public health. On the national level, we explore the importance of establishing adequate medicine regulatory authorities and PV capacity, with drug screening along the supply chain. This requires interdepartmental coordination, drug certification and criminal justice legislation and enforcement that recognise the severity of medicine falsification. Local healthcare professionals can receive training on medicine quality assessments, drug registration and pharmacological testing equipment. Finally, we discuss novel technologies for drug analysis which allow rapid identification of fake medicines in low-resource settings. Innovative point-of-purchase systems like mobile phone verification allow consumers to check the authenticity of their medicines.

Conclusions: Combining anti-falsifying strategies targeting different levels of the pharmaceutical supply chain provides multiple barriers of protection from falsified medicines. This requires the political will to drive policy implementation; otherwise, people around the world remain at risk.