• Child protection with Muslim communities: considerations for non-Muslim-based orthodoxies/paradigms in child welfare and social work

      O’Leary, Patrick; Abdalla, Mohamad; Hutchinson, Aisha; Squire, Jason; Young, Amy; Griffith University; University of South Australia; University of Bedfordshire; King’s College London; University of Johannesburg; et al. (Oxford University Press, 2019-07-20)
      The care and protection of children are a concern that crosses ethnic, religious and national boundaries. How communities act on these concerns are informed by cultural and religious understandings of childhood and protection. Islam has specific teachings that relate to the care and guardianship of children and are interpreted in diverse ways across the Muslim world. Islamic teachings on child-care mostly overlap with Western understandings of child protection, but there can be some contested positions. This creates complexities for social workers intervening in Muslim communities where the basis of their intervention is primarily informed by a non-Muslim paradigm or occurs in secular legal contexts. The purpose of this article is to address at a broad level the issue of how overarching concepts of child protection and Islam influence social work practice with Muslim communities. It addresses a gap in practical applications of the synergy of  Islamic thinking with core social work practice in the field of child protection. For effective practice, it is argued that social work practitioners need to consider common ground in Islamic thinking on child protection rather than rely on Western frameworks. This requires further research to build evidence-based practice with Muslim families.
    • The climatic challenge: which plants will people use in the next century?

      Borrell, J.S.; Dodsworth, Steven; Forest, Felix; Pérez-Escobar, Oscar Alejandro; Lee, M.A.; Mattana, E.; Stevenson, P.C.; Howes, M.-J.R.; Pritchard, Hugh W.; Ballesteros, D.; et al. (Elsevier, 2019-08-30)
      More than 31,000 useful plant species have been documented to fulfil needs and services for humans or the animals and environment we depend on. Despite this diversity, humans currently satisfy most requirements with surprisingly few plant species; for example, just three crops – rice, wheat and maize – comprise more than 50% of plant derived calories. Here, we synthesize the projected impact of global climatic change on useful plants across the spectrum of plant domestication. We illustrate the demographic, spatial, ecophysiological, chemical, functional, evolutionary and cultural traits that are likely to characterise useful plants and their resilience in the next century. Using this framework, we consider a range of possible pathways for future human use of plants. These are centred on two trade-offs: i) diversification versus specialization in the range of species we utilize, and ii) substitutionof the species towards those better suited to future climate versus facilitating adaptation in our existing suite of dominant useful plants. In the coming century, major challenges to agriculture and biodiversity will be dominated by increased climatic variation, shifting species ranges, disruption to biotic interactions, nutrient limitation and emerging pests and pathogens. These challenges must be mitigated, whilst enhancing sustainable production to meet the needs of a growing population and a more resource intensive standard of living. With the continued erosion of biodiversity, our future ability to choose among these pathways and trade-offs is likely to be diminished.
    • Contraceptive choice and power amongst women receiving opioid replacement therapy: qualitative study

      Werthern, Helena; Alhusein, Nour; Chater, Angel M.; Scott, Jenny; Family, Hannah; Neale, Joanne; King’s College London; University of New South Wales; University of Bristol; University of Bedfordshire; et al. (Taylor & Francis, 2021-07-26)
      ABSTRACT Background: Women receiving treatment for opioid use disorder have low levels of contraception use and high rates of unintended pregnancies, abortion and children being adopted or fostered. This paper aims to understand the relationship between contraceptive choice and power amongst women receiving Opioid Replacement Therapy (ORT). Methods: During 2016/17, semi-structured interviews were undertaken with 40 women (aged 22–49 years) receiving ORT in the South of England. Data relating to the latent concept of power were inductively coded and analysed via Iterative Categorisation. Findings: The power manifested itself through six interconnected ‘fields’: i. ‘information about fertility and contraception’; ii. ‘access to contraception’; iii. ‘relationships with professionals and services’; iv. ‘relationships with male partners’; v. ‘relationships with sex work clients’; and vi. ‘life priorities and preferences’. Each field comprised examples of women’s powerlessness and empowerment. Even whenwomen appeared to have limited power or control, they sometimes managed to assert themselves. Conclusions: Power in relation to contraceptive choice is multi-faceted and multi-directional, operating at both individual and structural levels. Informed decision-making depends on the provision of clear, non-judgemental information and advice alongside easy access to contraceptive options. Additional strategies to empower women to make contraceptive choices and prevent unplanned pregnancies are recommended.
    • DNA methylation and body-mass index: a genome-wide analysis

      Dick, Katherine J.; Nelson, Christopher P.; Tsaprouni, Loukia G.; Sandling, Johanna K.; Aïssi, Dylan; Wahl, Simone; Meduri, Eshwar; Morange, Pierre-Emmanuel; Gagnon, France; Grallert, Harald; et al. (Lancet Publishing Group, 2014-03-13)
      Background Obesity is a major health problem that is determined by interactions between lifestyle and environmental and genetic factors. Although associations between several genetic variants and body-mass index (BMI) have been identified, little is known about epigenetic changes related to BMI. We undertook a genome-wide analysis of methylation at CpG sites in relation to BMI. Methods 479 individuals of European origin recruited by the Cardiogenics Consortium formed our discovery cohort. We typed their whole-blood DNA with the Infinium HumanMethylation450 array. After quality control, methylation levels were tested for association with BMI. Methylation sites showing an association with BMI at a false discovery rate q value of 0·05 or less were taken forward for replication in a cohort of 339 unrelated white patients of northern European origin from the MARTHA cohort. Sites that remained significant in this primary replication cohort were tested in a second replication cohort of 1789 white patients of European origin from the KORA cohort. We examined whether methylation levels at identified sites also showed an association with BMI in DNA from adipose tissue (n=635) and skin (n=395) obtained from white female individuals participating in the MuTHER study. Finally, we examined the association of methylation at BMI-Associated sites with genetic variants and with gene expression. Findings 20 individuals from the discovery cohort were excluded from analyses after quality-control checks, leaving 459 participants. After adjustment for covariates, we identified an association (q value ≤middot&05) between methylation at five probes across three different genes and BMI. The associations with three of these probes - cg22891070, cg27146050, and cg16672562, all of which are in intron 1 of HIF3A - were confirmed in both the primary and second replication cohorts. For every 0·1 increase in methylation β value at cg22891070, BMI was 3·6% (95% CI 2·9) higher in the discovery cohort, 2·7% (1·2) higher in the primary replication cohort, and 0·8% (0·4) higher in the second replication cohort. For the MuTHER cohort, methylation at cg22891070 was associated with BMI in adipose tissue (p=1·72×10) but not in skin (p=0·882). We observed a significant inverse correlation (p=0·005) between methylation at cg22891070 and expression of one HIF3A gene-expression probe in adipose tissue. Two single nucleotide polymorphisms - rs8102595 and rs3826795 - had independent associations with methylation at cg22891070 in all cohorts. However, these single nucleotide polymorphisms were not significantly associated with BMI. Interpretation Increased BMI in adults of European origin is associated with increased methylation at the HIF3A locus in blood cells and in adipose tissue. Our findings suggest that perturbation of hypoxia inducible transcription factor pathways could have an important role in the response to increased weight in people. Funding The European Commission, National Institute for Health Research, British Heart Foundation, and Wellcome Trust.
    • Lessons learned from recruiting nursing homes to a quantitative cross-sectional pilot study

      Tzouvara, Vasiliki; Papadopoulos, Chris; Randhawa, Gurch; King’s College London; University of Bedfordshire (RCN Publishing, 2016-03-21)
      Recruitment strategies Previous Next Lessons learned from recruiting nursing homes to a quantitative cross-sectional pilot study Vasiliki Tzouvara Research associate, Florence Nightingale School of Nursing and Midwifery, King’s College London, UK Chris Papadopoulos Senior lecturer, Institute for Health Research, University of Bedfordshire, Luton, UK Gurch Randhawa Professor of diversity in public health, Institute for Health Research, University of Bedfordshire, Luton, UK Background A growing older adult population is leading to increased admission rates to long-term care facilities such as nursing homes and residential care homes. Assisted healthcare services should be flexible, integrated, and responsive to older adults’ needs. However, there is a limited body of empirical evidence because of the recruitment challenges in these settings. Aim To describe the barriers and challenges faced in recruiting to a recent pilot study, consider previously implemented and proposed recruitment strategies, and propose a new multi-method approach to maximising recruitment of care homes. Discussion The proposed multi-method approach harnesses key recruitment strategies previously highlighted as effective in navigating the many challenges and barriers that are likely to be encountered, such as mistrust, scepticism and concerns about disruption to routines. This includes making strategic use of existing personal and professional connections within the research team, engaging with care homes that have previously engaged with the research process, forming relationships of trust, and employing a range of incentives. Conclusion Implementing carefully planned recruitment strategies is likely to improve relationships between nursing homes and researchers. As a consequence, recruitment can be augmented which can enable the production of rigorous evidence required for achieving effective nursing practice and patient wellbeing.
    • Measuring health and broader well-being benefits in the context of opiate dependence: the psychometric performance of the ICECAP-A and the EQ-5D-5L

      Frew, Emma; Goranitis, Ilias; Coast, Joanna; Day, Ed; Copello, Alex; Freemantle, Nick; Seddon, Jennifer L.; Bennett, Carmel; University of Birmingham; University of Bristol; et al. (Elsevier Ltd, 2019-03-26)
      Background Measuring outcomes in economic evaluations of social care interventions is challenging because both health and well-being benefits are evident. The ICEpop CAPability instrument for adults (ICECAP-A) and the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) are measures potentially suitable for the economic evaluation of treatments for substance use disorders. Evidence for their validity in this context is, however, lacking. Objectives To assess the construct validity of the ICECAP-A and the EQ-5D-5L in terms of convergent and discriminative validity and sensitivity to change on the basis of standard clinical measures (Clinical Outcomes in Routine Evaluation-Outcome Measure, Treatment Outcomes Profile, Interpersonal Support Evaluation List, Leeds Dependence Questionnaire, and Social Satisfaction Questionnaire). Methods A secondary analysis of pilot trial data for heroin users in opiate substitution treatment was conducted. Baseline convergence with clinical measures was assessed using the Pearson correlation coefficient. Discriminative validity was assessed using one-way analysis of variance and stepwise regressions. Sensitivity to changes in clinical indicators was assessed at 3 and 12 months using the standardized response mean statistic and parametric and nonparametric testing. Results Both measures had the same level of construct validity, except for clinical indicators of well-being, for which the ICECAP-A performed better. The ICECAP-A was sensitive to changes in both health and well-being indicators. The EQ-5D-5L had lower levels of sensitivity to change, and a ceiling effect (27%), particularly evident in the dimensions of self-care (89%), mobility (75%), and usual activities (72%). Conclusions The findings support the construct validity of both measures, but the ICECAP-A gives more attention to broader impacts and is more sensitive to change. The ICECAP-A shows promise in evaluating treatments for substance use disorders for which recovery is the desired outcome.
    • Nance-Horan Syndrome-like 1 protein negatively regulates Scar/WAVE-Arp2/3 activity and inhibits lamellipodia stability and cell migration

      Law, Ah-Lai; Jalal, Shamsinar; Pallett, Tommy; Mosis, Fuad; Guni, Ahmad; Brayford, Simon; Yolland, Lawrence; Marcotti, Stefania; Levitt, James A.; Poland, Simon P.; et al. (Nature Research, 2021-09-28)
      Cell migration is important for development and its aberrant regulation contributes to many diseases. The Scar/WAVE complex is essential for Arp2/3 mediated lamellipodia formation during mesenchymal cell migration and several coinciding signals activate it. However, so far, no direct negative regulators are known. Here we identify Nance-Horan Syndrome-like 1 protein (NHSL1) as a direct binding partner of the Scar/WAVE complex, which co-localise at protruding lamellipodia. This interaction is mediated by the Abi SH3 domain and two binding sites in NHSL1. Furthermore, active Rac binds to NHSL1 at two regions that mediate leading edge targeting of NHSL1. Surprisingly, NHSL1 inhibits cell migration through its interaction with the Scar/WAVE complex. Mechanistically, NHSL1 may reduce cell migration efficiency by impeding Arp2/3 activity, as measured in cells using a Arp2/3 FRET-FLIM biosensor, resulting in reduced F-actin density of lamellipodia, and consequently impairing the stability of lamellipodia protrusions.
    • Overcoming hurdles to intervention studies with autistic children with profound communication difficulties and their families

      McKinney, Ailbhe; Weisblatt, Emma J.L.; Hotson, Kathryn L.; Ahmed, Zahra Bilal; Dias, Claudia; BenShalom, Dorit; Foster, Juliet; Murphy, Suzanne; Villar, Sofia S.; Belmonte, Matthew K.; et al. (Sage, 2021-04-07)
      Autistic children and adults who are non-verbal/minimally verbal or have an intellectual disability have often been excluded from Autism Spectrum Disorder research. Historical, practical and theoretical reasons for this exclusion continue to deter some researchers from work with this underserved population. We discuss why these reasons are neither convincing nor ethical, and provide strategies for dealing with practical issues. As part of a randomised controlled trial of an intervention for children with profound autism, we reflected as a multi-disciplinary team on what we had learnt from these children, their families and each other. We provide 10 strategies to overcome what appeared initially to be barriers to collecting data with this population. These hurdles and our solutions are organised by theme: interacting physically with children, how to play and test, navigating difficult behaviours, selecting suitable outcome measures, relating with parents, managing siblings, involving stakeholders, timing interactions, the clinician’s role in managing expectations, and recruitment. The aim of this article is to provide researchers with the tools to feel motivated to conduct research with children with profound autism and their families, a difficult but worthwhile endeavour. Many of these lessons also apply to conducting research with non-autistic children with intellectual disabilities.
    • Personalised adherence support for maintenance treatment of inflammatory bowel disease: a tailored digital intervention to change adherence-related beliefs and barriers

      Chapman, Sarah; Sibelli, Alice; St-Clair Jones, Anja; Forbes, Alastair; Chater, Angel M.; Horne, Robert; UCL School of Pharmacy; University of Bath; King’s College London; Brighton and Sussex University Hospitals NHS Trust; et al. (Oxford University Press, 2020-05-07)
      Background and aims: Interventions to improve adherence to medication may be more effective if tailored to the individual, addressing adherence-related beliefs about treatment and overcoming practical barriers to daily use. We evaluated whether an algorithm tailoring support to address perceptual and practical barriers to adherence reduced barriers and was acceptable to patients with IBD. Methods: Participants with IBD, prescribed azathioprine and/or mesalazine were recruited via patient groups, social media and hospital clinics and allocated to Intervention or Control Groups. The online intervention comprised messages tailored to address beliefs about IBD and maintenance treatment and provide advice on overcoming practical difficulties with taking regular medication. The content was personalised to address specific perceptual and practical barriers identified by a pre-screening tool. Validated questionnaires assessed barriers to adherence and related secondary outcomes at baseline, one and three months of follow-up. Results: 329 participants were allocated to the Intervention (n=153) and Control (n=176) Groups; just under half (46.2%) completed follow-up. At one and three months the Intervention Group had significantly fewer concerns about IBD medication (p≤.01); and, at three months only, fewer doubts about treatment need, fewer reported practical barriers and lower nonadherence (p<.05). Relative to controls at follow-up, the Intervention Group were more satisfied with information about IBD medicines, and viewed pharmaceuticals in general more positively. Questionnaires, interviews and intervention usage indicated the intervention was acceptable. Conclusions: Personalised adherence support using a digital algorithm can help patients overcome perceptual (doubts about treatment necessity and medication concerns) and practical barriers to adherence.
    • Point OutWords: protocol for a feasibility randomised controlled trial of a motor skills intervention to promote communicative development in non-verbal children with autism

      McKinney, Ailbhe; Hotson, Kathryn L.; Rybicki, Alicia; Weisblatt, Emma J.L.; Días, Claudia; Foster, Juliet; Villar, Sofia S.; Murphy, Suzanne; Belmonte, Matthew K.; Nottingham Trent University; et al. (Springer, 2020-01-23)
      Background: Point OutWords is a caregiver-delivered, iPad-assisted intervention for non-verbal or minimally verbal children with autism. It aims to develop prerequisite skills for communication such as manual and oral motor skills, sequencing, and symbolic representation. This feasibility trial aims to determine the viability of evaluating the clinical efficacy of Point OutWords. Methodology: We aim to recruit 46 non-verbal or minimally verbal children with autism and their families, approximately 23 per arm. Children in the intervention group will use Point OutWords for half an hour, five times a week, for 8 weeks. Children in the control group will have equal caregiver-led contact time with the iPad using a selection of control apps (e.g. sensory apps, drawing apps). Communication, motor, and daily living skills are assessed at baseline and post-intervention. Parents will keep diaries during the intervention period and will take part in focus groups when the intervention is completed. Discussion: Point OutWords was developed in collaboration with children with autism and their caregivers, to provide an intervention for a subgroup of autism that has been historically underserved. As autism is a heterogeneous condition, it is unlikely that one style of intervention will address all aspects of its symptomatology; the motor skills approach of Point OutWords can complement other therapies that address core autistic symptoms of social cognition and communication more directly. The current feasibility trial can inform the selection of outcome measures and design for future full-scale randomised controlled trials of Point OutWords and of other early interventions in autism. Trial registration: ISRCTN, ISRCTN12808402. Prospectively registered on 12 March 2019. Keywords: Autism spectrum disorder, Minimally verbal, Non-verbal, Motor, Language, Communication, iPad, Feasibility, Randomised controlled trial
    • Proteomic analysis of age-related changes in ovine cerebrospinal fluid

      Chen, Carl P.C.; Preston, Jane E.; Zhou, Shaobo; Fuller, Heidi R.; Morgan, David G.A.; Chen, Ruoli; King’s College London; Chang Gung University; University of Bedfordshire; RJAH Orthopaedic Hospital; et al. (Elsevier, 2018-04-21)
      Cerebrospinal fluid (CSF) circulates through the brain and has a unique composition reflecting the biological processes of the brain. Identifying ageing CSF biomarkers can aid in understanding the ageing process and interpreting CSF protein changes in neurodegenerative diseases. In this study, ovine CSF proteins from young (1-2 year old), middle aged (3-6 year old) and old (7-10 year old) sheep were systemically studied. CSF proteins were labelled with iTRAQ tagging reagents and fractionated by 2-dimensional high performance, liquid chromatography. Tryptic peptides were identified using MS/MS fragmentation ions for sequencing and quantified from iTRAQ reporter ion intensities at m/z 114, 115, 116 and 117. Two hundred thirty one peptides were detected, from which 143 proteins were identified. There were 52 proteins with >25% increase in concentrations in the old sheep compared to the young. 33 of them increased >25% but <50%, 13 increased >50% but <1 fold, 6 increased >1 fold [i.e. haptoglobin (Hp), haemoglobin, neuroendocrine protein 7B2, IgM, fibrous sheath interacting protein 1, vimentin]. There were 18 proteins with >25% decrease in concentrations in the old sheep compared to the young. 17 of them decreased >25% but <50%, and histone deacetylase 7 (HDAC7) was gradually decreased for over 80%. Glutathione S-transferase was decreased in middle aged CSF compared to both young and old CSF. The differential expressions of 3 proteins (Hp, neuroendocrine protein 7B2, IgM) were confirmed by immunoassays. These data expand our current knowledge regarding ovine CSF proteins, supply the necessary information to understand the ageing process in the brain and provide a basis for diagnosis of neurodegenerative diseases.
    • Public knowledge and attitudes towards consent policies for organ donation in Europe: a systematic review

      Molina-Pérez, Alberto; Rodríguez-Arias, David; Delgado-Rodríguez, Janet; Morgan, Myfanwy; Frunza, Mihaela; Randhawa, Gurch; Reiger-Van de Wijdeven, Jeantine; Schiks, Eline; Wöhlke, Sabine; Schicktanz, Silke; et al. (Elsevier, 2018-10-02)
    • Spotlight on equality of employment opportunities: a qualitative study of job seeking experiences of graduating nurses and physiotherapists from black and minority ethnic backgrounds.

      Hammond, John; Marshall-Lucette, Sylvie; Davies, Nigel; Ross, Fiona; Harris, Ruth; Kingston University; St George’s, University of London; University of Bedfordshire; King’s College London (Elsevier, 2017-08-01)
      There is growing attention in the UK and internationally to the representation of black and minority ethnic groups in healthcare education and the workplace. Although the NHS workforce is very diverse, ethnic minorities are unevenly spread across occupations, and considerably underrepresented in senior positions. Previous research has highlighted that this inequality also exists at junior levels with newly qualified nurses from non-White/British ethnic groups being less likely to get a job at graduation than their White/British colleagues. Although there is better national data on the scale of inequalities in the healthcare workforce, there is a gap in our understanding about the experience of job seeking, and the factors that influence disadvantage in nursing and other professions such as physiotherapy. This qualitative study seeks to fill that gap and explores the experience of student nurses (n=12) and physiotherapists (n=6) throughout their education and during the first 6-months post qualification to identify key experiences and milestones relating to successful employment particularly focusing on the perspectives from different ethnic groups. Participants were purposively sampled from one university to ensure diversity in ethnic group, age and gender. Using a phenomenological approach, in-depth semi-structured interviews were conducted at course completion and 6 months later. Two main themes were identified. The 'proactive self' ('It's up to me') theme included perceptions of employment success being due to student proactivity and resilience; qualities valued by employers. The second theme described the need to 'fit in' with organisational culture. Graduates described accommodating strategies where they modified aspects of their identity (clothing, cultural markers) to fit in. At one extreme, rather than fitting in, participants from minority ethnic backgrounds avoided applying to certain hospitals due to perceptions of discriminatory cultures, 'I wouldn't apply there 'cos you know, it's not really an ethnic hospital'. In contrast, some participants recognised that other graduates (usually white) did not need to change and aspects of their identity brought unsolicited rewards 'if your face fits then the barriers are reduced'. The findings indicate that success in getting work is perceived as determined by individual factors, and fitting in is enabled by strategies adopted by the individual rather than the workplace. Demands for change are more acute for graduates from black and minority ethnic backgrounds. This is an issue for healthcare organisations seeking to be inclusive and challenges employers and educators to acknowledge inequalities and take action to address them. BACKGROUND AIM PARTICIPANTS METHODS RESULTS CONCLUSIONS
    • Stimulation of GLP-1 secretion downstream of the ligand-gated ion channel TRPA1

      Emery, Edward C.; Diakogiannaki, Eleftheria; Gentry, Clive; Psichas, Arianna; Habib, Abdella M.; Bevan, Stuart; Fischer, Michael J.M.; Reimann, Frank; Gribble, Fiona M.; ; et al. (American Diabetes Association Inc., 2014-10-16)
      Stimulus-coupled incretin secretion from enteroendocrine cells plays a fundamental role in glucose homeostasis and could be targeted for the treatment of type 2 diabetes. Here, we investigated the expression and function of transient receptor potential (TRP) ion channels in enteroendocrine L cells producing GLP-1. By microarray and quantitative PCR analysis, we identified trpa1 as an L cell-enriched transcript in the small intestine. Calcium imaging of primary L cells and the model cell line GLUTag revealed responses triggered by the TRPA1 agonists allyl-isothiocyanate (mustard oil), carvacrol, and polyunsaturated fatty acids, which were blocked by TRPA1 antagonists. Electrophysiology in GLUTag cells showed that carvacrol induced a current with characteristics typical of TRPA1 and triggered the firing of action potentials. TRPA1 activation caused an increase in GLP-1 secretion from primary murine intestinal cultures and GLUTag cells, an effect that was abolished in cultures from trpa1-/- mice or by pharmacological TRPA1 inhibition. These findings present TRPA1 as a novel sensory mechanism in enteroendocrine L cells, coupled to the facilitation of GLP-1 release, which may be exploitable as a target for treating diabetes.
    • Systematic review of the prevalence of mental illness stigma within the Greek culture

      Tzouvara, Vasiliki; Papadopoulos, Chris; Randhawa, Gurch; King’s College London; University of Bedfordshire (SAGE, 2016-02-17)
      BACKGROUND: A number of primary studies have now assessed mental illness stigma within the Greek culture. A synthesis and appraisal of all available evidence is now required and will contribute to our growing understanding of the relationship between the cultural context and the formation of stigmatising attitudes. AIM: To systematically review the prevalence of mental illness public stigma within the Greek and Greek Cypriot culture. METHOD: Empirical articles with primary data pertaining to the prevalence of mental illness public stigma among Greek and/or Greek Cypriot populations were retrieved. Included studies were assessed for quality and extracted data were narratively synthesised. RESULTS: A total of 18 studies met the inclusion criteria. Methodological quality was highly variable; only 1 study was adequately statistically powered, 10 studies employed at least some element of probability sampling and obtained response rates of at least 70%, while 10 and 13 studies employed reliable and validated prevalence tools, respectively. Studies sampled the general population (n = 11), students (n = 4), healthcare professionals (n = 2), police officers, employers and family members (all n = 1). Stigma was consistently identified in moderate and high proportions across all of these groups, particularly in terms of social discrimination and restrictiveness, social distance and authoritarianism. However, some evidence of benevolence and positivity towards high-quality social care was also identified. CONCLUSION: The review highlights the wide-scale prevalence of mental illness stigma within the Greek culture and the need for further rigorous research including culturally tailored stigma interventions.