# NG_samples

slug: change-management-organisation-development
title: Change Management & Organisation Development
academic_level: Graduate
subject: Change Management
type_of_paper: Coursework
citation_style: APA
meta_title: Change Management & Organisation Development
meta_keywords: change management
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created_at: 2025-06-23 16:09:05
updated_at: 2026-01-14 15:47:51
status: published
content:
  <p><span>Bucks New University</span></p>
  <p><span>Date of Submission: 2nd June 2024</span></p>
  <h2><span>Executive Summary</span></h2>
  <p><span>Sweet Treats Limited (STL) is a famous cake shop company that has its headquarters in a Warwick region. STL is founded by Julie Birds, along with James Bird at the head as the company's managing director today. STL has issues related to excessive hierarchy and communication, and there is a need for a more precise understanding of how the proposed restructuring will affect them. Employees who have been retained at STL and those who were hired earlier after the company acquired shops show a solid resistance to assuming new roles or responsibilities. Currently, through a restructuring process, the hope and trust of the employees have been battered, hence affecting their motivation to deliver in STL. In analysing the nature of the business environment that STL currently functions within, it is essential to note that it is a VUCA environment, and the challenges and prospects that it holds are evident. Concerning the approach to addressing resistance to change, OD practices enable organisations to promote a culture that is characterised by flexibility and a capacity to embrace change while learning.</span></p>
  <h3><span>1. Introduction</span></h3>
  <p><span>Change management is necessarily important for any organisation that undergo online service-based ordering and expansion of product offering ensuring a smooth transition in the restructuring process (Bushuyev and Verenych, 2018). This will not only improve the morale of the employees but will also enhance the communication among the employees and the managers maintaining the levels of productivity and reduced disruptions in the operations ensuring successful incorporation of new facilities and initiative in the shop expansion or service of online ordering. The purpose of this report is to analyse the change management model of Sweet Treats Limited and to provide them the effective ways through which the company can able to improve the existing hurdles faced due to the upcoming changes in organisational setup.&nbsp;</span></p>
  <h3><span>2. Company Background&nbsp;</span></h3>
  <p><span>Sweet Treats Limited (STL) is a famous cake shop company that has its headquarters in a Warwick region. However, its roots can be traced back to Julie Bird's entrepreneurial venture. Starting in Warwick, STL is founded by Julie Birds, along with James Bird at the head as the company's managing director today (Company-Information service, 2024). Featuring a wide and attractive selection of candies and maintaining a policy of the finest quality, STL has become a favourite among customers and has responded by opening more shops. Since after its establishment, the company has expanded to a series of six delightful shops in Warwick, which shows that it is popular and liked.</span></p>
  <h3><span>3. Strategic Change of STL&nbsp;</span></h3>
  <h4><span>3.1 Change Issues in STL</span></h4>
  <p><span>As with the previous organisations, STL has issues related to excessive hierarchy and communication, and there is a need for a more precise understanding of how the proposed restructuring will affect them. When explaining the rationale, the plan, and even the outcome, employees have complained of poor communication, which causes people to be unnecessarily sceptical and resistant (Sittrop and Crosthwaite, 2021). Employees who have been retained at STL and those who were hired earlier after the company acquired shops show a solid resistance to assuming new roles or responsibilities. This is because humans do not want to change and get uncomfortable with change. After all, it goes against the everyday culture that has been set in the societies.</span></p>
  <p><span>Currently, through a restructuring process, the hope and trust of the employees have been battered, hence affecting their motivation to deliver in STL. The position of the employees is somewhat unpredictable, and they are concerned about their future assignments and the overall changes that will occur while they continue working (Rath et al., 2021). STL expects incremental costs in the form of expenses related to recruiting a new e-commerce team and training costs for existing employees who may need to switch to new responsibilities as the company expands its internet business.</span></p>
  <h3><span>3.2 VUCA Environment</span></h3>
  <p><span>In analysing the nature of the business environment that STL currently functions within, it is essential to note that it is a VUCA environment, and the challenges and prospects that it holds are evident. Let us delve deeper into each component of VUCA and how it relates to STL's operations:&nbsp;</span></p>
  <p><span>Figure 1: VUCA environment</span></p>
  <p><span>Source: Wilson, 2023</span></p>
  <h5><span>3.2.1 Volatility</span></h5>
  <p><span>Fluctuations mean the behaviour of markets, which are characterised by variations in stability, mainly in aspects such as price (Khan and Ahmed, 2021). In the case of STL, it could mean changes in the market trends, having a negative or positive impact, or may lead to embracing new technologies that disrupt the market. In such circumstances, what has been considered tried and established forms of doing business may cease to be relevant tomorrow, and this is where fast thinking and immediate action come into play. Namely, the above challenges mean that STL may face pressure to respond to changes in consumer preferences, such as increased demand for gluten-free or vegan cakes.</span></p>
  <h5><span>3.2.2 Uncertainty</span></h5>
  <p><span>The issues which are still open are the efficacy of strategic operations and the pressures of new entrants. Even when a business goes to great lengths to study its environment and develop a strategic plan to launch, it still needs to be entirely sure how such entities will affect the business (Pearse, 2017). While using an online application to order, there may be some uncertainties on the side of STL, such as the viability of the online ordering service or the attitude of customers to changes in the management of the shop. This implies that flexibility and the ability to adapt to change should form part of the bargaining powers when making decisions on future changes so that an organisation can be in a position to address any unfavourable change and also take advantage of any change that may present itself in the near future.</span></p>
  <h5><span>3.2.3 Complexity</span></h5>
  <p><span>The challenges lie in the strategies associated with the shift into online sales and corporate changes (Hussain et al., 2018). As such, transitioning to online sales necessitates more than just setting up the necessary computer hardware and software &ndash; it calls for a realignment of logistical processes, customer relations, and promotional tactics (Zhang et al., 2021). Similarly, reorganisation of the STL includes the complicated and multifaceted process that involves the change in the roles of many people within the organisation and can be met with opposition from the employees of the firm. Managing such complexities also requires the formulation of suitable plans, implementation of adequate communication, and teamwork to guarantee that operations run smoothly and constantly during the change process.</span></p>
  <h5><span>3.2.4 Ambiguity</span></h5>
  <p><span>Uncertainty as to whether these developments are positive, negative or even more significant means that there is uncertainty as to the developmental trend of the business. There is likely to be uncertainty within STL concerning profit goals and the managerial decisions that have a bearing on them, employee enthusiasm, and customer contentment (Chawla and Lenka, 2018). Suppose the members of a group decide on no direction and goal. In that case, the management have a variance, which in turn results in confusion, and lack of decision-making and therefore magnified by missed opportunities (Moura et al., 2023). Hence, it becomes pivotal for STL to outline its vision about where it wants to go and how it will get there, to ensure that this vision is communicated effectively to all the stakeholders and to ensure that the organisation's structures have the capacity and direction to cope with the unforeseeable challenges of the future.</span></p>
  <h3><span>4. Change Management Model&nbsp;</span></h3>
  <p><span>To implement a planned change approach at STL, the Kurt Lewin&rsquo;s Change Management Model offers a structured framework consisting of 3 key steps including unfreezing, changing and refreezing.&nbsp;</span></p>
  <h4><span>4.1 Unfreezing</span></h4>
  <p><span>In the first step of the change process referred to as Unfreezing, STL will find it strategic to undertake preparations for future transitions of its workforce. It is important for creating a culture acceptance to lay initial foundation as it prepares the organization in developing acceptance for the change processes in anticipation in change management (Cameron and Green, 2019). In cases where rules must be altered or new rules be introduced, STL will make it a point to explain why the changes need to be made and establish how those changes will benefit the entity as a whole so as to decrease negativity and increase positive reception and participation from employees.</span></p>
  <p><span>Also, the unfreezing stage stresses the role of involving employees in the change process by encouraging them to become alert and receptive to change. Through getting suggestions from the frontline workers, middle managers, and other players at the organisations, STL aims at ensuring that most of the targeted participants feel part of the change process, they share the same responsibilities of change. In the same manner, STL also understands the concern of requiring more resources and assistance to be given to every employee in terms of dealing with many of the issues and risks that change entails.</span></p>
  <h4><span>4.2 Changing</span></h4>
  <p><span>The Change stage of change management that STL is undergoing is the process of transitioning from planning to action and establishing change in the company. The key concept of this stage is to create desire among the employees so that they can be committed towards change management process (Crosby, 2020). The following ways makes this possible: They engage the employees in management decision making and share with them the reasons why the changes are being made as well as listening to their concerns, and relating to their experiences. At the same time, attention is paid to training and disseminating information and materials for proper action and problem-solving in the context of institutional change. Indeed, taking time to monitor the developmental changes, the company provides training to the employees, ensures open communication, and facilitates easy access to information that may help the workforce in coping up with the change. When it comes to the implementation of change, STL prepares the entailed micro environment, thus creating the conditions that will allow the organisation to pursue its rebirth toward the desired state.</span></p>
  <h4><span>4.3 Refreezing&nbsp;</span></h4>
  <p><span>In the last step of the change management process, called the Refreezing stage, STL ensures that the changes occurred at the Change stage and become organizational norms and standard practice. This involves stabilizing changes through modification of physical policies, other working procedures, and structural organization in line with the new method of working (Rosdiana and Aslami, 2022). Compliance promotion and consolidation of desired behaviours is another important aspect in STL, which includes encouraging individuals and groups to engage in behaviours that are consistent with the objectives of change. Organisations should ensure that such behaviours are modelled by the leadership and the organisational culture demonstrates recovery of learning which is enhanced through feedback as element of improvement. Furthermore, STL endeavours to sustain and make the adjustments structural more permanent by reaching out to the organizational culture within the system, which makes the changes permanent. This means that regular, effective and assertive explanations and interactions have to be made with the employees to give them a fair understanding and make them embrace change. Last but not least, STL incorporates proactive strategies for maintaining feedback and control in order to guarantee that the innovations are still applicable and efficient in a changing business context. If STL follows Refreezing stage strategies which include consolidation, reinforcement, institutionalization and adaptation, then it would be possible for achieving Organizational Change Management in the organization.</span></p>
  <h3><span>5. Potential organisational and individual resistance against any proposed Changes.</span></h3>
  <p><span>Change resistance is the generic human behaviour that is evident in most people and can be described as a form of reluctance, opposition or refusal to embrace change in the operations of an organisation or to adopt new undertakings within an organisation (Rajan and Ganesan, 2017). It is usually a result of fear, uncertainty, powerlessness, perceived job loss, lack of decision-making and organisational ole, and their preferences for structure. Besides, employees at STL might feel that the changes are out of their control, making them powerless to prevent the change from taking place, thus, they will resist the change. To manage these potential resistances, several measures must be taken, such as:&nbsp;</span></p>
  <ul>
  <li>
  The management should ensure that the employees are informed and understand the reasons for the change, the management should involve the employees in the change process, By identifying these possible barriers to change, organisations can prepare in order to ensure the change process goes as smoothly as possible and causes as little disruption as possible to normal business activities.
  </li>
  <li>
  Familiar with change communication strategies, it entails clear, unambiguous, and harmonised messaging of why the change is being made, what is expected of change, and how it advances the organisation's vision and mission. Employers divide the message among employees and listen to their feedback so that any misunderstandings or questions can be clarified.
  </li>
  <li>
  Ensure that the employees are prepared to optimise their adjustments in the new environment by offering them appropriate information, skills, and tools. Management ought to conduct extension training sessions, seminars, and coaching sessions to enable the workers to have the required competencies to perform in new positions or the integration of fresh processes and systems.
  </li>
  <li>
  It is essential to encourage and show support to the employees during the change process and to assure them that they are on the right path. Alleviate their concerns, encourage them to have the option to express their concerns by speaking in person, and appreciate their work and their input. In particular, trust in decision-makers and appreciation of change initiatives can result from employee-organisation relationship evidence that shows that managers care about their experiences and opinions.
  </li>
  </ul>
  <h4><span>5.1 Organisation Development</span></h4>
  <p><span>Organisation development (OD) involves organised efforts to enhance the capability of organisations to adapt by introducing change for improvement throughout the organisation and for the well-being of all its subordinates and staff (Alam, 2017). Concerning the approach to addressing resistance to change, OD practices enable STL to promote a culture that is characterised by flexibility and a capacity to embrace change while learning. Through increased acceptance of OD initiatives in STL the management significantly able to reduce the resistance to change, and the process becomes more accessible through the creation of a social work culture that encourages collaboration and innovation and improves timely employee development that empowers employees on the job. Other, more general OD processes such as team building, management training, and organisational culture surveys can also help STL to minimise the resistance to change. It also ensure that change initiatives are consistent with organisational vision and mission, and facilitate greater openness and flexibility in organisations.</span></p>
  <h2><span>Conclusion and Recommendations&nbsp;</span></h2>
  <p><span>With the temptation of having a mature market with a high growth rate, a changing competitive environment, employees' resistance to change, and the call for strategy, Sweet Treats Limited (STL) has the essential operational dilemma of how to cope with change. To thrive in this environment and drive sustainable growth and success, STL should consider the following recommendations:&nbsp;</span></p>
  <ol>
  <li>
  Human capital is a critical asset of STL, which means that employee training and development, on-the-job skill development, and employee empowerment should also be the key investment areas. Based on the reviewed research, it can be concluded that with proper growth, promotion, and training programs, STL can improve and promote employee satisfaction and performance, as well as create a flexible environment dedicated to change.
  </li>
  <li>
  Because STL is exposed to constant change in the market environment, it is necessary to encourage values of innovations, risks, and continuous change. This paper discusses how, by being receptive to change, accepting innovative ideas, and advocating for innovation, STL can become one of the market leaders who would then target paradigm shifts in the market and cover the potential threats that may stem from them.
  </li>
  <li>
  Dismantling the hierarchy and encouraging interdisciplinary interconnectivity is crucial to enhancing organizational agility and streamlined functioning in STL. As we link up teams, exchange novel approaches to work and issues, and tap into people's different skills and experiences within the organisation; we can promote improved decision-making and problem-solving in STL while also building common identity and strength within the firm.
  </li>
  <li>
  By adopting these recommendations, STL can further develop the organisational capacities within the firm and improve the competitive stance of the organisation in the long run by creating an organisational capacity for future growth and success. Suppose STL emphasise communication as a management tool, employee training, innovation and collaboration. In that case, this company will be capable of handling all these issues and become one of the key players in the cake shop business.
  </li>
  </ol>
  <h3><span>References&nbsp;</span></h3>
  <ul>
  <li>
  Alam, P.A., (2017). Measuring organisational effectiveness through performance management system and McKinsey's 7 S model. Asian Journal of Management, 8(4), pp.1280-1286.
  </li>
  <li>
  Bushuyev, S. and Verenych, O., (2018). Organisational maturity and project: Program and portfolio success. In Developing organisational maturity for effective project management (pp. 104-127). IGI Global.
  </li>
  <li>
  Cameron, E. and Green, M., (2019). Making sense of change management: A complete guide to the models, tools and techniques of organisational change. Kogan Page Publishers.
  </li>
  <li>
  Chawla, S. and Lenka, U., (2018). Leadership in the VUCA environment. Flexible strategies in VUCA markets, pp.213-224.
  </li>
  <li>
  Company-Information service (2024). SWEET TREATS LTD more information - Find and update company information - GOV.UK. (n.d.). Find-And-Update.company-Information.service.gov.uk. Retrieved May 30, 2024, from<a style="background-color: rgb(255, 255, 255);" href="https://find-and-update.company-information.service.gov.uk/company/09336446/more"> https://find-and-update.company-information.service.gov.uk/company/09336446/more</a>&nbsp;
  </li>
  <li>
  Crosby, G. (2020). Planned change: Why Kurt Lewin's social science is still best practice for business results, change management, and human progress. Productivity Press.
  </li>
  <li>
  Hussain, S.T., Lei, S., Akram, T., Haider, M.J., Hussain, S.H. and Ali, M., (2018). Kurt Lewin's change model: A critical review of the role of leadership and employee involvement in organisational change. Journal of innovation &amp; knowledge, 3(3), pp.123-127.
  </li>
  <li>
  Khan, M. M., and Ahmed, S. S. (2021). The emerging paradigm of leadership for future: The use of authentic leadership to Lead innovation in VUCA environment. Frontiers in Psychology, 12, 759241.
  </li>
  <li>
  Moura, R. L. D., Carneiro, T. C. J., and Dias, T. L. (2023). VUCA environment on project success: The effect of project management methods. BBR. Brazilian Business Review, 20, 236-259.
  </li>
  <li>
  Pearse, N.J., (2017). Change management in a VUCA world. In Visionary leadership in a turbulent world (pp. 81-105). Emerald Publishing Limited.
  </li>
  <li>
  Rajan, R. and Ganesan, R., (2017). A critical analysis of John P. Kotter's change management framework. Asian Journal of Research in Business Economics and Management, 7(7), pp.181-203.
  </li>
  <li>
  Rath, C.R., Grosskopf, S. and Barmeyer, C., (2021). Leadership in the VUCA world-a systematic literature review and its link to intercultural competencies. European Journal of Cross-Cultural Competence and Management, 5(3), pp.195-219.
  </li>
  <li>
  Rosdiana, N., and Aslami, N. (2022). The Main Models of Change Management in Kurt Lewin's Thinking. Jurnal Akuntansi, Manajemen dan Bisnis Digital, 1(2), 251-256.
  </li>
  <li>
  Sittrop, D. and Crosthwaite, C., (2021). Minimising risk&mdash;the application of Kotter's change management model on customer relationship management systems: A case study. Journal of Risk and Financial Management, 14(10), p.496.
  </li>
  <li>
  Wilson, S., (2023). Leadership in a VUCA context: Some foundational considerations. Journal of Applied Journalism &amp; Media Studies, 12(2), pp.169-183.
  </li>
  <li><strong id="docs-internal-guid-56e50d21-7fff-da0b-8554-678749b9a8c3">Zhang, W., Zhao, K., Li, P., Zhu, X., Ye, F., Jiang, W., and Wang, T. (2021, September). Learning to Navigate in a VUCA Environment: Hierarchical Multi-expert Approach. In 2021 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS) (pp. 9254-9261). IEEE.</strong></li>
  </ul>

meta_description:
  Change management is necessarily important for any organisation that undergo online service-based ordering and expansion of product offering ensuring a smooth transition in the restructuring process.


slug: the-use-of-nicotine-painkiller-and-cannabidiol-products
title: The Use of Nicotine, Painkiller and Cannabidiol Products
academic_level: Undergraduate
subject: Sport
type_of_paper: Literature Review
citation_style: APA
meta_title: The Use of Nicotine, Painkiller and Cannabidiol Products
meta_keywords: nicotine, painkiller and cannabidiol products
canonical_url: https://www.cheap-essay-writing.co.uk/
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created_at: 2025-06-23 16:30:56
updated_at: 2026-01-14 15:47:45
status: published
content:
  <h2>The Use of Nicotine, Painkiller and Cannabidiol Products and the Effects They Have on Sporting Performance</h2>
  <p><strong>Abstract</strong></p>
  <p>The usage of Nicotine Products, Cannabidiol (CBD) and pain killers among the athletes of professional sports has reportedly increased. The research focused on an in depth investigation regarding usage, its reason, benefits and limitation associated with the aforementioned drugs. To internalize diversified variables associated with the usage of drugs among the athletes, the research integrated the usage of narrative literature review that focused on effects of nicotine, painkillers and CBD on athletes&rsquo; performance. The inclusion of diversified literature, from a variety of sources on athletes, the research concluded that nicotine absorbed through combustion e.g. smoking, was found to have negative effects on sporting performance. Whereas snus, another nicotine product was not found to carry these effects but instead aided in concentration and alertness. Painkillers showed effects of aiding sporting performance however, could be argued ethically and whether they just prolong the diagnosis of injury or not. Cannabidiol also was found mainly to aid sporting performance with little argument against other than potential drowsiness.</p>
  <p>Key Words: Nicotine, Cigarettes, Vapes, E-cigarettes, Painkillers, NSAIDs, Sporting performance, effects, Cannabidiol (CBD).</p>
  <p>Acknowledgements</p>
  <p>I would like to thank my family and parents especially for always going out of their way to support me in anything I desire.&nbsp;</p>
  <h3>1. Introduction</h3>
  <h4>1.1 Background</h4>
  <p>In the domains of sports science and medicine, the use of drugs like nicotine, cannabidiol (CBD), and painkillers by athletes has generated a lot of discussion and interest (Kasper and Close, 2021). Even though these drugs are frequently used for their alleged advantages, there are possible side effects involved and ethical issues that need to be carefully considered. The inclusion of nicotine among the archery or shooting professionals is found to be common due to its ability to enhance motor skills and increase focus of the users. However, Bravo-Gutierrez et al. (2021) argued that the reduced lung capacity from nicotine has readily negated the aforementioned advantage with compromised stamina among the athletes. Similarly, CBD is widely known for improvement in sleep quality, alleviation of pain, and recovery from physical exercise. Contrarily, Leyk et al. (2023) argued that usage of CBD can disturb digestive system, appetite of an individual and cause a lower blood pressure; each of which are vital for maintenance of athletes&rsquo; health.&nbsp;</p>
  <p>The perception of usage of nicotine, pain killers, and CBD has readily enabled the performance of athletes to increase in an unnatural manner (Sansone et al., 2023). The usage of CBD is critically evaluated against high occurrence of positive doping results among the athletes (Williams and Nutbrown, 2021). Contrarily, Gustavsen et al. (2021) stated that the lack of information on CBD leads to their overdose without the consultation of a health practitioner. However, sporting industry is highly competitive with scientific advancements that has demanded elongated careers of sporting athletes. Meanwhile, each of the additive material incorporated in this research is scrutinised to shorten the span of career for an athlete resulting in performance depreciation in the long run. Zandonai et al. (2023) determined that a 22.7% of athletes used nicotine, from a sample size of 13804. Therefore, it is analysed that the use of nicotine is increasingly common among the athletes, with no particular method of nicotine consumption on focus. Contrarily, sporting boards are also concerned about the usage of the drugs which has formulated anti-doping agencies in all form of sports which regulates the environment of illicit consumption of drugs among the athletes.</p>
  <h4>1.2 Problem Statement</h4>
  <p>The existing researches have been increasingly focused to be against the usage of nicotine and painkillers while presenting a mixed review regarding the usage of CBD for athletes due to marginalising in athletes&rsquo; performance when analysed with a longer time interval (Zandonai et al., 2023; Sansone et al., 2023). However, the studies have widely ignored the perception of athletes in consuming the drugs and the factors associated with the benefit of consumption of nicotine, painkillers and CBD. Thus, it is important that a research in incorporated in which the benefits and limitation of each of the preceding drug is readily incorporated and the impact on athletes&rsquo; performance and longevity of their career is critically analysed for disruptive findings that can motivate or discourage the athletes from consumption of such substances.&nbsp;</p>
  <h4>1.3 Research Objectives</h4>
  <p>The purpose of this piece of writing is to present a thorough analysis of the literature on the use of these drugs in sports, examining their properties, reasons for use, potential side effects and possible effects on sporting performance. Furthermore, the following objectives were formed to address the problem statement of the research:</p>
  <ol>
  <li>
  To critically evaluate the usage of nicotine products and their side-effects on sporting performance.&nbsp;
  </li>
  <li>
  To critically investigate different types of pain killers along with their effects on sporting performance.
  </li>
  <li>
  To critically understand the role of cannabidiol and its side effects on sporting performance.
  </li>
  </ol>
  <h4>1.4 Research Significance&nbsp;</h4>
  <p>The study can readily enable coaches and athletes to learn about the advantages and limitations of usage of performance enhancement drugs which include painkillers and CBD, along with the habitual usage of nicotine among the athletes. The coaches can form an intervention for the athletes in case they develop addiction of nicotine, CBD or painkillers; otherwise, strategize an alternative method for athletes&rsquo; replacement to ensure standardisation of their respective team&rsquo;s performance. Atakan (2012) identified that the athletes are widely unaware of the downside of CBD and are oversold on the advantages they perceive on the open sources. However, overuse of Tetrahydrocannabinol (THC) has shown increased involvement with positive doping results that leads to temporary or permanent ban on the athletes due to usage of performance enhancement drugs. Furthermore, limited involvement of health practitioners in prescribing CBDs has readily limited the approach of athletes in getting the drugs in a formalised manner that may not impact their long-term performance in sports. Therefore, the research can play a pivotal role as a foundational study for the use of nicotine, painkillers and CBD among the athletes.</p>
  <h3>2. Method and Search Strategy</h3>
  <h4>2.1 Data Collection Method</h4>
  <p>For this research, collection of data from secondary sources was prioritised in the research in pursuit to ease the data collection process as the athletes are readily concerned about their public image and can raise significant ethical concerns for the study. Bell, Bryman and Harley (2022) determined that the secondary data collection strategy is incorporated by the studies which are reliant on already collected data to ensure an extensive dataset. The study incorporated use of secondary data which allowed the research to integrate extensive dataset and findings regarding the athletes and their usage of the aforementioned products. Nicotine products, painkillers and CBD are rarely used by athletes at the same time; therefore, usage of secondary data in this research enabled the study to have an acceptable approach towards data collection method which assisted the researcher in achieving the identified objectives of the study.&nbsp;</p>
  <h4>2.2 Electronic Search Strategy</h4>
  <p>The electronic search strategy was extensively diversified for this research due to a highly specific field of interest, which were athletes&rsquo; usage of CBD, painkillers and nicotine. Since the results on Pubmed were limited in terms of specific research on athletes&rsquo; and nicotine; therefore, the research also incorporated the use of Google Scholar to ensure that a wide variety of dataset can be integrated into the research. Furthermore, advanced filters on Pubmed, Google Scholar and CINAHL were used to incorporate desired level of data set in this research. Boolean operators including &ldquo;and&rdquo;, &ldquo;or&rdquo;, and &ldquo;not&rdquo; were integrated in the electronic search strategy to narrow down the results of research papers according to the requirements of objectives of the research. It primarily enabled the research to have a focused search of articles which significantly eased the electronic search process for the researcher. Since Google Scholar is depicted as a fundamental researching tool for published articles, the results presented without usage of Boolean operators are readily diversified resulting in significant discrepancy for the researcher. Therefore, usage of Boolean operators was imperative for the researcher to continue with electronic search.&nbsp;</p>
  <p>Boolean operators were found to be significantly useful in searching through PubMed where search with term &ldquo;Nicotine Usage&rdquo; resulted in 357 results from 2020-2024. However, after adding a Boolean operator in the preceding term with &ldquo;Nicotine usage and athletes&rdquo;, the search results were limited to two articles only which enabled extensive efficiency for electronic search strategy. Similarly, search of &ldquo;CBD performance enhancement&rdquo; showcased results that amounted to 119 results from 2020-2024; however, after addition of &ldquo;and&rdquo; operator to incorporate the filter of athletes, the search result was narrowed down to 7 results which enabled the research to shortlist efficiently. Furthermore, a similar search strategy was incorporated for painkiller as well where the initial results that were incorporated in search of painkillers using &ldquo;painkillers side effects&rdquo; yielded 24759 results, meanwhile the search with Boolean operator &ldquo;and&rdquo; to filter side effects on athletes resulted in 235 results.&nbsp;</p>
  <h4>2.3 Inclusion and Exclusion Criteria</h4>
  <p>The following table showcased the inclusion and exclusion criteria incorporated in this research to standardize and collect data:</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="170"><col width="189"><col width="265"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Inclusion</p>
  </td>
  <td>
  <p>Exclusion&nbsp;</p>
  </td>
  <td>
  <p>Rationale</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Published in English language</p>
  </td>
  <td>
  <p>In any other language other than English</p>
  </td>
  <td>
  <p>To standardize the understanding of the secondary search by the researcher.</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Published after 2020</p>
  </td>
  <td>
  <p>Researches published before 2020</p>
  </td>
  <td>
  <p>To enable the search of modernized studies regarding athletes and professional sports</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Keywords included: Athletes, painkillers, CBD, nicotine</p>
  </td>
  <td>
  <p>Any other keyword apart from the mentioned list</p>
  </td>
  <td>
  <p>To standardize the process of data collection and ensure that the researches incorporated are relevant to the objectives</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Abstract must include one of the aforementioned keywords</p>
  </td>
  <td>
  <p>Abstract does not include the mention of athletes or the words: painkillers, CBD and nicotine</p>
  </td>
  <td>
  <p>Since the study is highly specific on incorporating data regarding athletes, shortlisting through abstract enabled the research to filter efficiently.</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <h3>3. Literature Review</h3>
  <h4>3.1 Introduction</h4>
  <p>Usage of substance is highly common among the athletes to enhance their performance and longevity of their careers. However, the abuse of substance has led to marginalization of career spans of athletes resulting in abrupt ending of their career due to irrecoverable injuries. As a result, the following literature review, in line with the objectives of the research, is focused on secondary data&rsquo;s finding regarding the impact of nicotine, CBD and painkillers on athletes&rsquo; performance while establishing an understanding regarding the forms of their usage in modernized environment. Furthermore, the literature review also displays the conclusive finding through evidence of studies regarding usage of aforementioned products.&nbsp;</p>
  <h4>3.2 Nicotine Products</h4>
  <h5>3.2.1 Understanding Nicotine and Nicotine-Products&nbsp;</h5>
  <p>The usage of nicotine is commonly associated with chewable form of nicotine, cigarettes and cigar which are prevalently normalized by the society and has conditioned the individuals to embrace its acceptability despite the extensive research on negative impacts associated with unnatural release of dopamine through use of nicotine based products (Joseph &amp; Pearl, 2024). Nicotine is the main psychoactive agent found in tobacco leaves and is highly addictive which has led to over 1 billion smokers across the world (Read et al., 2024). An estimated 1.3 Billion people use some form of tobacco product worldwide, making it the third most popular drug in the world behind general medicine and alcohol according to the World Health Organization (2024). Conventionally, athletes were fond of nicotine and were ambassadors of nicotine based products to enhance their acceptability. However, through disruptive research on the health outcomes of the individuals, specially the athletes, the acceptance of nicotine based products was significantly marginalised. Furthermore, increased marketing and perceived quality of nicotine products has also enhanced the prevalence of usage of nicotine products among athletes.&nbsp;</p>
  <p>Cigarette smoking is the main cause of preventable death amongst developed countries (Ren &amp; Lotfipour, 2019); however, this does not mean that all forms of nicotine consumption will have the same physical effects on the human body. The use of snus is seen to be very popular among Scandinavian athletes across all sports, this may be due to the culture which embraces the use of snus (S&aelig;b&oslash;, 2017; Zandonai et al, 2019). Football, as a sporting division, has been aggressively against the use of nicotine based products that they have banned the consumption of the product to facilitate the standardisation of advantage for all teams (Johnson, 2023). Since snugs are reported to calm the nerves of users and control their anxiety, it was determined as a performance enhancement drug. Whereas studies of Zandonai et al. (2019) and Joseph and Pearl (2024) have also been found to achieve the same results through an experimental research. Fixtures between Aston Villa and Arsenal along with Liverpool against Newcastle caught the act of 2 footballers, Bertrand Traore and Mark Gillespie inserting the snus pouches into their mouth while the cameras were on them (Taylor, 2023). However, the association of football across different states have failed to implement ban on a unanimous scale due to interference in personal life of the athletes. Contrarily, their main objective is to eliminate the usage of such products during the game. Meanwhile, private teams have been eagerly monitoring athletes&rsquo; consumption of harmful drugs by handing them a pre-agreed contract regarding their consumed item list.&nbsp;</p>
  <p>Following are the types of nicotine products that are widely consumed by athletes from a variety of sports:</p>
  <ul>
  <li>
  Cigarettes: A cigarette is a cylinder shaped rolled piece of tobacco which is consumed through lighting one end and inhaling the smoke through the other (Martin, 2023). From 2011 to 2022 the number of people who smoke cigarettes of all ages under 65 has dramatically decreased while the number of 65 year olds and above has remained relatively the same in the United States (Meza et al, 2023).&nbsp;
  </li>
  <li>
  E-Cigarette and Vape: E-cigarette use has now surpassed standard cigarette use as the most popular way to smoke tobacco globally (Bravo-Gutierrez et al, 2021). Manufacturers claim that e-cigarettes are a safer alternative to smoking cigarettes and they are marketed as a way of cutting down on or quitting smoking (Rom et al., 2014). With the decrease in cigarette smokers this has largely contributed to the number of e-cigarette or vape users increasing. This was explained in a study carried out by Bandi et al (2023) who found that the number of e-cigarette users in the United States was largely made up of those who were formally cigarette smokers. In the same study it was found that 53% of e-cigarette users were people who had never smoked cigarettes before.&nbsp;
  </li>
  <li>
  Snus and Nicotine Pouches: The overall research surrounding snus is a lot less than that around both cigarettes and e-cigarettes due to snus being a lot newer and not as popular. Snus, originating from Sweden and Norway, is a small pouch of smokeless tobacco which is usually placed under the lip against the gums (Clarke, 2019). The use of snus has been said to be another form of nicotine product which people use when trying to quit smoking as it is argued to have less side effects especially on the respiratory system as nothing is being inhaled into the lungs (Lund et al, 2010).&nbsp;
  </li>
  </ul>
  <h5>3.2.2 Side-effects on Athlete&rsquo;s Health</h5>
  <p>The negative effects of smoking have been thoroughly researched due to the long period of time which cigarettes have been around. Cigarette smoking is understood to cause diseases globally, specifically cardiovascular which is the leading cause of death worldwide and lung disease is also a risk due to the toxicity of the smoke inhaled (Munzel et al, 2020). Furthermore, tobacco smoke contains chemicals which harm the linings of the blood vessels causing an accumulation of plaque to build up which then can lead to atherosclerosis (Howard, 1998). The preceding condition can cause further problems as it restricts blood flow which can then increase the risk of peripheral artery disease, heart attacks and strokes which can directly impact athletes&rsquo; functionality and motor movements (Read et al., 2024). Furthermore, nicotine pouches and other products have also been found to increase both a person's heart rate and blood pressure which puts a higher demand on an individual&rsquo;s cardiovascular system (Felber Dietrich et al, 2007). The study explains how the nicotine products contains mutagens and carcinogens which cause genetic changes and cancerous cell development. Lung cancer is not the only cancer associated with cigarette smoking however, others include cancer of the mouth, esophagus, pancreas, kidney bladder and cervix (Khani, 2018).&nbsp;</p>
  <p>Bravo-Gutierrez et al (2021) reviewed 79 studies conducted on the use of electronic cigarettes and found the results very similar to those of the persistent use of standard cigarettes. With negative effects on oral health involving oral cancer which led them to advise that these products be avoided. Although it is suggested that e-cigarettes have the same negative side effects as standard cigarettes this is not completely accurate. When analysing the effects of smoking versus vaping on the respiratory system, Darabseh et al (2020) discovered that the irritation of the bronchial tubes which cigarette causes was not present in the use of e-cigarettes. Furthermore, the same study did express how the prolonged use of e-cigarettes could lead to a lack of oxygen delivery around the body due to the increased levels of carbon monoxide leading to an increase in muscle fatigue. For the athletes, circulation of oxygen is vital for their movements and ability to have strong presence of mind regarding their game awareness (Dawkins et al., 2016). The preceding study revealed that the responsiveness level of athletes with active nicotine usage was slow compared to athletes with natural diet and healthier preferences. Furthermore, the mental health issues have become apparent, the rate of them involved with e-cigarettes is still not as high as those associated with standard cigarette smoking (Masaki et al, 2022).&nbsp;</p>
  <p>The use of snus has been promoted further in the nicotine industry as safer than using cigarettes and e-cigarettes due to the product not being a product of combustion however, that does not mean the product is completely risk free (Lee, 2013). Snus is a nicotine product which means it can be highly addictive similar to cigarettes, however, the main danger which has been discovered in the use of snus is the negative effect on an individual&rsquo;s oral health (Hellqvist, 2012). Snus is consumed through places a pouch of nicotine against your gum usually under a person's upper lip, meaning long term snus use can result in gum recession and tooth discoloration along with an increased risk of leukoplakia (Ford and Rich, 2021). This constant exposure to the gums can also lead to an increased risk of oral cancer although the risk of cancer from snus is still greatly lower than those associated with smoking (Janbaz et al, 2014). Similar to cigarettes and e-cigarettes the content of nicotine within snus pouches can lead to an increase in a person&rsquo;s blood pressure and heart rate allowing for them to become at risk from heart disease. However, this correlation between snus and heart or cardiovascular disease has been found to be very low (Hanson et al, 2009).&nbsp;</p>
  <h5>3.2.3 Reason for Proactive Usage among Athletes</h5>
  <p>There are many reasons why people still smoke cigarettes despite understanding many of the negative side effects associated with the act. A study conducted by Ho, (1989) identified 4 main reasons for why people smoked cigarettes which included: social acceptance, addiction, pleasure and boredom. Smoking for social acceptance was touched upon by Masaki et al (2022) when they explained how both men and women aged between 17 and 24 thought smoking made them appear more acceptable, sophisticated and mature due to branding and prevalent misconception of the society. However, it is the acceptance aspect that leads to athletes frequent consumption of nicotine products with their existing mental state that does not allow to maintain required level of calmness for in-game decision making. Shiffman et al. (2015) discovered a distinct pattern among intermittent smokers (people who did not smoke daily). This pattern was that the intermittent smokers would rarely smoke in the morning and were more likely to smoke in the evenings of the weekend, amongst other people and including the presence of alcohol. This trend can be associated with social acceptance.&nbsp;</p>
  <p>For athletes, use of smoking was defended by being a stress reliever during pressure situations; however, Benowitz (2009) readily dismissed the stress alleviation capability of cigarettes by analysing the placebo effect a cigarette had on human mind. Fiddler and West (2009) conducted a survey where they found that enjoyment and stress relief were the 2 biggest factors that people gave as to why they smoked, with enjoyment making up 51% of the reasons and stress relief being 47%. Women gave the answer of weight control and stress relief more than men who gave the reasoning enjoyment more often. As mentioned, weight control can also be a reason for individuals wanting to smoke. Tomeo et al (1999) researched the use of tobacco amongst youth in America. The findings identified that both girls and boys contemplate smoking as a method of controlling their weight with the thought of experimentation being positively related to weight controlling behaviours.</p>
  <p>Similar to vaping, the use of snus is seen as a less harmful way of consuming nicotine as opposed to smoking, which can be seen as a big factor in why people use it, especially those who are younger and have not smoked before (Tjora et al, 2020). A further reason for why people use snus is due to their addiction for nicotine, snus acts in the same way as smoking where the nicotine creates chemical releases of dopamine which is associated with making someone &lsquo;feel good&rsquo; or &lsquo;happy&rsquo; (Peloquin, 2018). Another similarity between snus and vaping which can cause people to use the product is the flavours in which it is available. Vedoy and Lund (2020), conducted research into whether flavours of snus should be limited in Norway. Their findings allowed them to come to the conclusion that flavours should be limited as the variety of flavours mixed with the nicotine can create a huge problem of addiction.&nbsp;</p>
  <h5>3.2.4 Impact of Nicotine Product&rsquo;s on Sporting Performance of Athletes</h5>
  <p>Smoking is massively discouraged in the sporting world due to its negative impact on athletes&rsquo; stamina. Through Tetelepta et al (2019) research, it was discovered that athletes who trained more frequently had a greater VO2 max; however, when comparing athletes who smoked, their V02 max results were significantly lower, regardless of how often they were training. Thus, smoking has a negative impact on athletes V02 max which is imperative for elite athletes as they need to be able to produce and use oxygen efficiently in pursuit to perform well for the duration of their sport (Daniels, 1974). The preceding study generated the results from secondary researches where data of diversified physiological differences were identified for athletes. Reduced pulmonary function has been found among smokers compared to non-smokers, according to Patersen et al. (2007) which supports findings of Tetelepta et al (2019) that smoking can reduce athlete&rsquo;s ability to perform at high intensities for long periods of time. Telepatha et al. (2019) reached a conclusion through the incorporation of young athletes from the age of 18 to 25-year-old which is of high relevance for majority of athletes across various range of sports.&nbsp;</p>
  <p>Smoking has been found to negatively impact a person&rsquo;s ability to build muscle due to it impairing the muscle protein synthesis and increasing the effect of myostatin which is the regulator of hypotrophy within the muscles of the body (Patersen et al, 2007). Similarly, to muscle growth smoking has also been found to negatively correlate with muscular strength (Kok et al, 2012). These 2 findings allow us to understand that smoking does not help athletes to grow the muscles they may need to perform in their sport, for example, trying to gain size to compete in rugby. It also impacts the maximal exertion in which an athlete can produce, for example, an Olympic weightlifter would not be able to lift the same amount of weight as they would if they were a non-smoker. Overall, smoking has a hugely negative effect on athlete&rsquo;s with no evidence supporting any positive effects on athlete&rsquo;s sporting performance.</p>
  <p>The research surrounding snus shows positive findings in relation to snus use and; increased alertness and focus, reduced anxiety and helping with weight management. Snus has been said to help with weight control due to nicotine acting as an appetite suppressant (Simm, 2021) meaning athlete&rsquo;s may be able to make weight in boxing for example, with the use of snus to help not over eating. Zandonai et al (2018), discovered that the use of snus during 30 minutes of exercise, increased muscular and cerebral oxygenation significantly, however this did not affect the athletes&rsquo; perception of being fatigued or their time till exhaustion results. This study explains that snus may help athletes be more awake and focused throughout their sport however, it will not impact their cardiovascular endurance in any positive way. A further survey conducted by Zandonai et al (2018), found that regular snus users reported a greater effect on their psychological state compared to occasional users. Furthermore, in the same research the results found that regular snus use may cause early cognitive improvement which in sporting terms may help athlete&rsquo;s in decision making and concentrating under pressure. With the main risk of snus being in regard to people's oral health (Hellqvist, 2012), there is a lack of evidence showing that snus has any negative effects on athletes&rsquo; lung capacity or V02 max. This means that evidence shows it does not conclusively come with the risk of athletes not being able to carry out exercise for any less period of time to those who are non snus users, the same way it does with smokers versus non-smokers Zandonai et al (2013). Overall, snus does not provide the same negative effects on sporting performance compared to smoking.</p>
  <h4>3.3 Painkillers</h4>
  <h5>3.3.1 Understanding Painkillers and their Variations</h5>
  <p>The use of painkillers is medically defended to overshadow the feeling of pain. However, it does not enable an athlete or user to recover from the pain without a therapeutic intervention. Contrarily, they are proved to be vital in easing the user with calmness and numbness around the injured region. In professional tennis 2.8% of players are reported to use analgesic while 54.2 professional football players used analgesic (Leyk et al., 2023). There are many different types of pain killers including nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, opioids, antidepressants, anticonvulsants, local anaesthetics and corticosteroids (Van Rensburg and Reuter, 2019). The effects of these are all similar in the fact that they are used to reduce the amount of pain people experience through blocking or reducing signals to the brain to reduce the perception of pain (Mischkowski et al, 2016). Leyk et al. (2023) determined that the active usage of muscles, accumulation of lactic acid and other inflammation that causes injury has readily inclined the athletes towards usage of painkillers.&nbsp;</p>
  <ul>
  <li>
  Nonsteroidal Anti-inflammatory Drugs (NSAIDs): NSAIDs are better known as painkillers such as ibuprofen, naproxen and aspirin. The prostaglandin synthesis-related enzymes cyclo-oxygenase-1 (COX-1) and COX-2 are inhibited by NSAIDs, which have the analgesic, anti-inflammatory, and antipyretic effects that they do (Day and Graham, 2013). These forms of painkillers are usually used for mild to moderate types of pain, inflammation or fevers such as headaches (Jahnavi et al, 2019).
  </li>
  <li>
  Acetaminophen: Acetaminophen is better known as paracetamol and tylenol. These are a form of potent antipyretic and moderate analgesic which is believed to reduce pain through inhibiting the synthesis of prostaglandins in the brain (Toussaint et al, 2010). However, more research is needed to fully understand the way in which these painkillers really work.
  </li>
  <li>
  Opioids: Opioids are better in forms such as morphine, fentanyl and codeine amongst others. Opioids work through binding to the opioid receptors in the brain and spinal cord, thus blocking the transmission of pain receptors to the brain which reduces a person&rsquo;s perception of their pain (Kanjhan, 1995). The use of opioids is usually for moderate to severe pain such as post-surgical pain, injury related pain or even cancer related pain (Levvy et al, 2019).
  </li>
  <li>
  Antidepressants: Examples of antidepressants include amitriptyline and duloxetine. Antidepressants work by altering the levels of neurotransmitters in the brain which can help modulate people&rsquo;s pain perception (Khushboo et al, 2022). Antidepressants are commonly used for more chronic pain, in particular nerve pain (Verdu et al, 2008).&nbsp;
  </li>
  <li>
  Anticonvulsants: Examples of antidepressants include gabapentin and pregabalin. These painkillers work by stabilising nerve activity through biochemical and electrophysiological processes which reduce pain signals (DeLorenzo, 1988). Anticonvulsants are used for neuropathic pain conditions such as post herpetic neuralgia (Backonja, 2002), which is the most common complication of shingles.
  </li>
  <li>
  Local Anesthetic: An example of local anesthetic is lidocaine. Local anesthetics can come in the forms of injections, gels, creams or sprays (Kumar et al, 2015). Local anesthetics work by blocking neuronal transmitters and stabilising electrically excitable membranes (French and Sharp, 2012), these work to numb specified areas of the body to reduce the feeling of touch. This form of painkiller is used for localised pain relief for procedures such as dental work, minor surgeries and some chronic pain conditions (Chou et al, 2016).&nbsp;
  </li>
  <li>
  Corticosteroids: An example of this form of painkiller are cortisone injections. These injections have become a very popular form of painkiller which is used by athletes across different sports. Cortisol injections are a form of steroid injection, used to reduce inflammation and accelerate the healing process of injuries and joint pain in conditions such as arthritis or tendinitis (Fadale and Wiggins, 1994).
  </li>
  </ul>
  <h5>3.3.2 Side-effects of Painkillers on Athlete&rsquo;s Health</h5>
  <p>Although painkillers are useful for short term benefits, misuse of them can lead to potential negative effects on the body (Eric, 2017). The body may also build up a tolerance to the painkillers if they are overused which is also a negative as the painkillers lose their desired effect of reducing pain felt within the body (Lauwerier et al, 2011). The main risks associated with NSAIDs is their gastrointestinal which can lead to issues such as stomach ulcers and bleeding (Laine, 2006). The results of the preceding study were generated through an investigation of patients&rsquo; data who actively used NSAIDs to treat their complications. Since athletes share the same physiology, the results of preceding study were implied on athletes as well. Additionally, there are risks which are more associated with the long term use of NSAIDs. These risks include an increased risk of heart attack or stroke (Pisano, 2016). However, the reasons behind NSAIDs and increased risk of cardiovascular events is not completely known and importantly, requires further research due to mortality rate associated with cardiovascular events (Park and Bavry, 2014).&nbsp;</p>
  <p>Hepatotoxicity, chemically driven liver damage is caused by acetaminophen which is found in painkillers (Guggenheimer and Moore, 2011). The preceding study also showed that the dosage amount between therapeutic and toxic doses was a very small margin, which if misused could lead to a drug overdose. Although opioids have been found to be very successful in treating acute pains, research has found that the drugs are very addictive with people becoming very dependent on them especially when exposed to them for a prolonged period of time (H&oslash;jsted and Sj&oslash;gren, 2007). Darnell et al (2012), discovered that long-term opioid use in women came with many risk factors including, reduced fertility, higher cardiac risks and endocrinopathy. Although opioid use is often safe, death by respiratory depression caused from opioid misuse is still regularly reported (Dahan, 2010).</p>
  <p>These forms of painkillers have the least known side effects which can be classed as deadly or overly harmful to the body, with potential side effects from use being drowsiness or dizziness (Bet et al, 2013). However, antidepressants have been recently understood to be linked with the potential risk of seizures, although the risk a person is at of experiencing one depends on their predisposing factors along with their dosage (Skowron and Stimmel, 1992). Newer generation antidepressants have also been found to have adverse effects by causing people to experience sweating and sleep disturbances along with nausea, diarrhea and more (Carvalho et al, 2016). Local anesthesia overall is considered to be very safe however, all procedures are never completely risk free so there are some potential risks or side effects which can occur from its use.&nbsp;</p>
  <p>Inconveniences such as pain at the injection side (if a needle is used for delivery), bruising or numbness beyond the desired area are all side effects which may occur from the painkillers use (Lalonde and Wong, 2014). Rarer and more severe risks associated with its use include systemic toxicity which is where if too much anesthetic is injected or the drug is injected into the blood vessel then dizziness and seizures can be caused or in severe cases, cardiac arrest (McCaughey, 1992). Side effects from corticosteroids are common in both short and long term use. Short term side effects include cutaneous effects (affecting skin structure and function), hypertension and hyperglycemia (Buchman, 2001). The long term effects of corticosteroid use include more serious risks such as osteoporosis and gastrointestinal, hepatic, and ophthalmologic problems (Buchman, 2001).</p>
  <h5>3.3.3 Painkiller Assistance in Athlete&rsquo;s Performance</h5>
  <p>The reasons for use across all of the painkillers are the same and that is to reduce the amount of pain which a person feels whether that is due to injury, illness or in preparation for a medical procedure (Mischkowski et al, 2016). Depending on the pain severity or what the painkiller is treating then this will determine which of the products will be provided to an individual. This is a much more generalised reasoning for painkiller use as opposed to athlete specific. In terms of athlete&rsquo;s, they may use painkillers for many different reasons including injury management. Injury management is where athlete&rsquo;s will use painkillers in order to manage acute injuries (Overbye, 2021), whether this means a reduction of pain so they can continue or a painkiller to help them deal with the pain while they rest. Painkillers may be used by athletes to treat chronic pains such as arthritis in order for them to reduce the pain and continue to perform to their desired potential (Harle et al, 2018). Post-surgical pain is a further reason why athletes may use painkillers, as this can help reduce the pain during their recovery phase and rehabilitation (Zideman et al, 2018).&nbsp;</p>
  <p>Painkillers are very popular for use across many sports and age groups with even student athletes confirming that they had used painkillers in order to mask their injuries and continue to participate in their sport (Tricker, 2000). Since athletes aim to make most of their career, their reliance on painkillers to continue their run in the game is significantly high (Maurice et al, 2021). This means that the use of painkillers for athlete&rsquo;s may be the only option they have in order to be able to perform in their sport even when being injured (Young, and White, 1999), this may just be so they can keep their livelihood and cannot afford to risk losing their job. Some people view the use of painkillers as the same behavior as doping where people are seeking a situational opportunity to gain an advantage (Melzer et al, 2022). Athlete&rsquo;s also have to be very careful when using some painkillers such as opioids and corticosteroids are subject to regulations by some governing bodies (Preuss et al, 2019), which means misuse could result in an athlete receiving a doping ban. The doping bans were found to be on a list of Olympians which popularly included Adri&aacute;n Annus, Geisa Arcanjo , and Olga Kuzenkova.&nbsp;</p>
  <h5>3.3.4 Critical Review of Painkillers and Athlete&rsquo;s Performance and Practical Application</h5>
  <p>Painkillers are determined to overshadow the feeling of pain and masking discomfort among the athletes which maybe caused the movement in an injured muscle (Young, and White, 1999). Painkillers can allow athletes to not be distracted by pain during their sport allowing them to fully focus on their task in hand and psychologically be fully invested in their performance outcomes (Taylor and Taylor, 1998). Furthermore, painkillers can help athletes achieve their desired full range of motion as they will not feel as much, if any pain from whatever injury they might have (Schneider et al, 2019). This will allow athletes to play to their full potential and not hinder their performance due to their injury. This is particularly important for athletes with joint pain or specific muscle pain which is required for their sport. For example, reduced knee pain for runners.&nbsp;</p>
  <p>However, painkillers could in fact also have negative effects on athletes' performance. The masking of injuries may be beneficial for athletes short-term but the use of painkillers could in fact hurt them more in the long run due to a delayed diagnosis of their injury (Mar et al, 2009), thus making the original injury worse. This is closely linked with the point that athletes could then have improper recovery due to not feeling as much pain (Goldsmith et al, 2018). This can cause athletes to be out of action for longer recovering from a more severe injury due to them trying to push through one that was less severe, causing more problems.</p>
  <p>Some painkillers such as opioids (steroids) may affect a person's cognitive function (Chapman et al, 2002), which is imperative when playing sports. If an athlete's coordination or reaction time is affected, then this may cause them to make wrong decisions or not be able to perform to the best of their ability. Some painkillers can also cause a person to feel drowsiness and fatigue (Zlott and Byrne, 2010). This can hinder an athlete&rsquo;s performance as they may not be able to perform correct decision making or last the duration of their sport. Similarly, painkillers such as opioids can disturb people's sleep (Onen et al, 2005), making them more restless and unable to get the rest required. Lack of sleep has been found to result in a person having a lower and less accurate cognitive function and performance (Fullagar et al, 2015). In a sporting setting, this again can cause incorrect decision making but also psychologically cause an athlete to not be fully invested in their performance.</p>
  <h4>3.4 Cannabidiol (CBD)</h4>
  <h5>3.4.1 Understanding CBD and its Variations</h5>
  <p>Cannabidiol is more commonly known as CBD, is the non psychoactive compound which can be found in the cannabis sativa plant (Martinez et al, 2020). CBD is the non psychoactive compound which means it does not produce the &lsquo;high&rsquo; effect which the other compound, tetrahydrocannabinol or THC, is commonly known for (Atakan, 2012). CBD is a disruptive new product which has grown more popular in recent years due to its potential healing and therapeutic benefits which can come in forms of capsules, oils, creams and liquids and more (Sherman and Chin, 2019). For athletes, the usage of CBD has been common for its unique healing process which enables them to recover from their energy faster and get on track again. Following are the types of CBD that are commonly found in the market:</p>
  <ul>
  <li>
  Cannabidiol (CBD) Oil and Spray: CBD oil is a liquid extract of CBD which is consumed through placing a specified amount of drops underneath your tongue for rapid absorption (Evans, 2020). There are variations to CBD oils as some oils can contain different ingredients. Full spectrum CBD oil contains cannabidiol, terpenes and negligible amounts of tetrahydrocannabinol (THC) (Vigil et al, 2020).&nbsp;
  </li>
  <li>
  Capsules and Gummies: CBD capsules and gummies are edible forms of CBD which are either swallowed with a drink or chewed making for convenient dosing (Grogan, 2020). The effects of CBD gummies and capsules take longer to feel as they are ingested however, once the effects are felt they should then last longer compared to other products (Filipenko, 2022).&nbsp;
  </li>
  <li>
  Cannabidiol (CBD) Vapes: CBD can be vaporized and inhaled with a vaping device, allowing for quick absorption and effects (Spindle et al, 2020). This form of CBD consumption goes straight to the lungs where it can be delivered into the bloodstream and offer fast relief (Varlet et al, 2016). Many types of vaping products are available such as CBD vape pens, CBD e-liquid, disposable CBD vapes and CBD vape cartridges (Choi et al, 2021).&nbsp;
  </li>
  <li>
  Powdered Form: Powdered CBD is also known as CBD isolate and unlike other forms of CBD product, only contains cannabidiol (Marinotti and Sarill, 2020). Powdered CBD can be added to foods or drinks and then ingested through eating or drinking (Evans, 2020).&nbsp;
  </li>
  <li>
  Topical: CBD can come in forms of balms, creams and lotions which can be applied to areas and absorbed through the skin for localized relief (Gomes, 2021).
  </li>
  </ul>
  <h5>3.4.2 Side-effects of CBD on Athlete&rsquo;s Health</h5>
  <p>CBD oil has not been found to come with many severe side effects. Side effects such as dry mouth have been reported due to the CBD content decreasing the saliva production within the mouth (Scully, 2007). It can cause athletes to unnecessarily hydrate themselves which can increase their weight and restrict their mobility (Gustavsen et al, 2021). During research carried out by Dos Santos et al. (2024) into the adverse effects of CBD, one person withdrew from the group due to the effect of nausea which can happen especially if it is taken on an empty stomach in high doses.</p>
  <p>CBD, when ingested has been found to cause a reduction in a person&rsquo;s appetite, this can cause individuals to lose weight which can directly impact an athlete&rsquo;s ability to perform as they require sufficient energy to optimize their capability during the time of the game (Pinto and Martel, 2022). This could be a negative or a positive depending on the individual and their goals. All of these ingested forms of CBD have similar side effects with one being the ability to elevate liver enzymes which can cause hepatotoxicity (Lo et al, 2023). People who consume these types of CBD products also have to be wary of the possible clash they can have with medication such as antidepressants. CBD has been found to help with conditions such as anxiety and depression. However, if mixed with antidepressants, it may cause an alter in the drug's efficiency and may also affect liver function (Swank, 2024).&nbsp;</p>
  <p>The side effects of topical CBD products are common with those of all topical, skincare or healing products known. The main potential side effect of topical CBD is the risk of skin irritation, this could be due to the CBD or the additives that may be found within the product not reacting well with the skin (Maghfour et al, 2021). Similarly, it is important to check the ingredients found in the product, in order to make sure there is nothing which may cause an allergic reaction (Baswan et al, 2020), as that can cause further irritation. Overall, the risks from topical CBD are very low (Xu et al, 2020), meaning it is a very safe product to use providing the product does not trigger any allergies. Topical CBD does not have the same potential side effects as other CBD products as it is absorbed through the skin (Makhakhe, 2022).</p>
  <h5>3.4.3 Understanding the Motivation of Athletes to use CBD</h5>
  <p>All these consumable forms of CBD have the same potential, positive benefits and reasons for use. The first reason athletes may use CBD products is due to its ability to help in relieving pain, whether this be chronic or acute (Boyaji et al, 2020). Another reason people may use CBD products is because they have been proven to help with athlete&rsquo;s mental health issues such as anxiety along with helping reduce people&rsquo;s stress levels, making them calmer (Williams and Nutbrown, 2021). Similarly, the preceding study found that CBD can help to create an increase of serotonin in the brain, which effectively can make a person happier and feel better in general. CBD can also be taken to help with a person&rsquo;s sleep (Kuhathasan et al, 2019; Moltke and Hindocha, 2021). This is due to its ability to cause fatigue which is why many people choose to take the product at night for an undisturbed rest.&nbsp;</p>
  <p>Anti-inflammatory properties have also been found in CBD meaning it can help reduce inflammation and may help with certain illnesses or conditions such as arthritis (Atalay et al, 2019). Although THC has been used to treat seizure sufferers for years, studies suggest that CBD can have the same effects on treating seizures while avoiding the psychoactive effects of THC (Rosenberg et al, 2015). Overall, CBD has been found to have many benefits and there is still research being conducted to find out the full potential of the products as they are still fairly new. Topical of CBD can also be used to treat acute or chronic pain. The effectiveness of the topical CBD was proven by Eskander et al (2020), who found that hemp derived CBD cream provided significant pain and symptom relief for the case study who had chronic back pain. Topical CBD products have also been found to help with skin conditions when applied to such dermatological issues (Sivesind et al, 2022).</p>
  <h5>3.4.4 Impact of CBD on Athlete&rsquo;s Performance and Practical Application</h5>
  <p>As mentioned CBD is still a fairly new product and as it comes from the cannabis plant some athletes may have been skeptical to use it due to not wanting to risk a doping ban, but now CBD has been cleared among professional athletes (Rojas-Valverde and Fellas-Campos, 2023). Many athletes have since been open about using CBD and the benefits they have felt such as Nate Diaz (Mixed Martial Arts), Kieran Kevan (Bodybuilding) and Paul Pierce (Basketball) (Howarth, 2023). CBD&rsquo;s pain management effects may help an athlete perform without the distraction of pain allowing them to play to their full potential for the duration of their sport (Boyaji et al, 2020). As CBD can help with a person&rsquo;s sleep (Kuhathasan et al, 2019).&nbsp;</p>
  <p>CBD can help an athlete&rsquo;s recovery which can reduce their chances of injury and allow them to be fully energized to perform. CBD&rsquo;s ability to help with stress and anxiety levels (Williams and Nutbrown, 2021), could help with calming athletes of nerves allowing them to make correct decisions and maintain steady breathing. Neuroprotective effects have been found in CBD allowing for better cognitive function (Callejas et al, 2018). This can further help with athlete&rsquo;s decision making but also help them recover from brain injuries such as concussion quicker. In contrast, the fatigue effects of CBD may cause athlete&rsquo;s to feel drowsy prior to competition if they take it in high doses (Gustavsen et al, 2021), this could negatively impact athlete&rsquo;s performance as they could have reduced energy levels therefore, not being able to perform to their full desired standard.&nbsp;</p>
  <h4>3.5 Chapter Summary</h4>
  <p>Despite the advantages portrayed in the literature review regarding usage of CBD, it was depicted that the lack of data and proven case studies regarding CBD has enhanced the commonality of the substance among the athletes. Meanwhile, the literature also criticized the usage of nicotine among athletes where the long-term impact of use of nicotine was found to be harmful for overall health of the athletes. Similarly, painkillers were depicted to be a short-term solution to ensure athlete&rsquo;s availability at the time of discomfort. Therefore, each of the preceding substances were readily analyzed with their impact on performance of an athlete.&nbsp;</p>
  <h3>4. Conclusion</h3>
  <p>Overall, from this literature review, the findings show that any form of combustion in the process of consuming nicotine has a negative effect on sporting performance due to mainly decreasing an athlete's V02 max and lung capacity. This means athletes cannot perform at high intensities for long periods. Snus however, has been found to not have these negative effects and instead may actually benefit sporting performance through increasing muscular and cerebral oxidation and improving alertness. This can help athletes in correct decision making. Painkillers are mostly good for an athlete&rsquo;s sporting performance as they can reduce pain distractions allowing athletes to concentrate and provide them with full range of motion to carry out their needs. However, they could cause delays in diagnosis causing them to miss more sport in the long run. CBD can have positive effects on sporting performance, especially on cognitive function, which can help athletes with decision making. However, drowsiness may be a potential risk if taken in high doses, especially close to time of competition, this would negatively impact sporting performance.&nbsp;</p>
  <h4>4.1 Areas for Future Research</h4>
  <p>After the completion of this research, future studies can identify the variables from findings section of the research and continue with:&nbsp;</p>
  <ul>
  <li>
  Future research should look at the effects of snus on the cardiovascular and respiratory systems in detail in order to find out if it is really risk free.
  </li>
  <li>
  Future research could look at the possible effects of the 2 products working together to aid in pain relief.
  </li>
  <li>
  Future research could look at CBD and its impact on longevity of the career of an athlete while analysing the performance enhancement aspect of CBD that may unnaturally gain advantage for athlete.&nbsp;
  </li>
  </ul>
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  <p>&nbsp;</p>

meta_description:
  These drugs are frequently used for their alleged advantages, there are possible side effects involved and ethical issues that need to be carefully considered.


slug: strategies-to-support-the-cognitive-development-of-autistic-children
title: Strategies To Support The Cognitive Development Of Autistic Children
academic_level: Undergraduate
subject: Nursing
type_of_paper: Literature Review
citation_style: APA
meta_title: Strategies To Support The Cognitive Development Of Autistic Children
meta_keywords: autistic children
canonical_url: https://www.cheap-essay-writing.co.uk/
meta_robots: index,follow
created_at: 2025-06-23 17:16:30
updated_at: 2026-01-14 15:47:38
status: published
content:
  <p>Dissertation&nbsp;</p>
  <p>Student&rsquo;s name</p>
  <p>Student&rsquo;s number&nbsp;</p>
  <p>Date&nbsp;</p>
  <h2>Chapter 1 Introduction&nbsp;</h2>
  <h3>1.1 Background&nbsp;</h3>
  <p>Prevalence of psychological issues among children living in the UK has created healthcare burden on the care providers. Reportedly, it is recognised that up to 1.2 million populations of children in the United Kingdom are affected by autism spectrum disorder (ASD) (The Guardian, 2024). Autism is a relatively highly diagnosed health condition whose prevalence has been on the rise in the past decades; however, it is still not clear whether this condition is due to the actual rise in the occurrence of the disease or due to better diagnostic abilities (Hertz-Picciotto and Delwiche, 2009). Other possible causes of higher rates of diagnosed ASD may include enlarged diagnostic scope, higher rate of awareness among parents and teachers, and environmental factors such as use of pesticides, harmful and contaminated environment (Lord and Bishop, 2010). It is estimated that more than 700,000 people in the Great Britain have an autism spectrum disorder (BMA, 2020). Different literature has marked genetics as one of the factor associated with the occurrence of autism while heritability rate is estimated to range from 45% to a high of 90% in people (Persico and Napolioni, 2013). Some of the factors that may enhance the risk to the autism among children include; high parental age and preterm births (Fuchs et al. 2018). Environmental sources such as exposure to air pollutants and pesticides during fetal development might be involved, but there is a scarcity of advocacy research on this topic (Leiss and Kotch, 2010). The language abilities in autistic children are described as delayed, while other children with no autism have been observed to develop language skills earlier than these children. Other general cognitive impairments such as issues in cognitive processing, learning, and memory are often observed among the children with autism (Ramey and Regier, 2019). Autism is believed to arise from atypical neural connections, and this could explain why different children with autism may have varying developmental syndromes such as neurofibromatosis (NF1 and NF2 genes), X-linked Rett (MECP2 gene) (Genovese and Butler, 2023). Interventions that has been used for the development of cognition in autistic children include the early behavioral interventions, the speech and language therapy, occupational therapy with a focus on sensory integration, social skills development programs and training, educational assistance, picture exchange communication system, and medications that are used to treat other related conditions such as the attention deficit hyperactivity disorder (Chung et al. 2024). Parent training programs also exist and are helpful for managing the health issues of such children at homes. Specifically, development of individual education plans along with proper instruction and behavior management interventions for every child are paramount. This is because ongoing assessment can easily allow the continuation of the intervention since the child is continually growing. According to NICE (National Institute for Health and Care Excellence) guidelines, children with attention deficit hyperactivity disorder should be given proper care and the treatment and be supported by a coordinated care plan that incorporates a multi-disciplinary team of health, education and social care services (NICE, 2019). NICE guidelines for parents states that; parents should be trained on autism-awareness, classroom accommodations, social skills development and identification for learning disorders and psychiatric disorders as well. It must respect the child&rsquo;s age, abilities and characteristics concerning the development stages. The NHS goals for Autism services are to increase the availability of access and support throughout the life span (NHS, 2023). These are areas that require more focus; the support of women, other adults, and those with less severe conditions, yet affected. Although people&rsquo;s understanding of autism as well as its occurrence has improved significantly, the support and assistance offered to those on the spectrum should increase to meet the increasing demand. It can be stated as, with the continuation of research and further education of people, the situation of autistic people in the UK will improve.&nbsp;</p>
  <h3>1.2 Problem statement&nbsp;</h3>
  <p>Despite the findings and studies presented, much is still unknown on the best practices that can be employed to enhance the learning of these children. It is important to consider that most existing interventions aimed at children with ASD are focused on the enhancement of social communication and the reduction of problematic behaviors, with the absence of certain essential cognitive outcomes (Watkins et al. 2017). Some methods that may help the child learn and develop are incorporating daily structure and schedules, using visual aids and supports, identifying the child&rsquo;s interests and including them in activities/learning, using sequential breaking down of tasks, providing real-life examples and practical learning, encouraging the usage of reinforces, modifying the language in development and the type and manner in which communication is done, addressing issues of sensitivity, adapting curriculum and assignments, encouraging the child to The techniques that have been applied involve individualized approaches such as encouraging learning, communication, organization, and focus as a way of helping autistic children improve their cognitive abilities. Furthermore, there are certain gaps mainly concerning the overall guidelines about implementing cognitive-based interventions for children with ASD by considering the difference in the level of support they require for making the intervention universal and easy to perform. In addition, while such techniques as computerised training, behavioural interventions, and cognitive-behavioral therapies have been found to be effective, there is still need for more investigation with these strategies (Baker-Ericz&eacute;n et al. 2023). To date, however, there is no systematic follow-up that examines the impact of cognitive interventions for autistic children in the long-term.&nbsp;</p>
  <h3>1.3 Aims and Objectives&nbsp;</h3>
  <p>The aim of this research is to explore the effective strategies that can manage cognitive skills of the children with Autism in the UK. This aim is accompanied by the following objectives:&nbsp;</p>
  <ol>
  <li>
  To explore the effectiveness of psychotherapies and strategies adopted by care providers in the UK to manage the cognitive issues of the Autism children (5-10 years).
  </li>
  <li>
  To study the factors that impact on the effectiveness of cognitive strategies.&nbsp;
  </li>
  </ol>
  <h3>1.4 Research Questions&nbsp;</h3>
  <ol>
  <li>
  How cognitive strategies and therapies can serve in cognitive development of the autism children (5-10 years) in the UK?
  </li>
  <li>
  What factors can affect the effective usage and outcomes of cognitive strategies?
  </li>
  </ol>
  <h3>1.5 Rationale and Significance of the study&nbsp;</h3>
  <p>The main idea behind this study is to explore the effectiveness of strategies that can serve in the cognitive development of autistic children in the UK. Autism spectrum disorder is a developmental disability which affects the individual's ability to communicate with others, interact with them, and have repetitive behaviours (Watkins et al. 2017). ASD is recognised globally with the UK having one child in every 100 diagnosed with the disorder (The Guardian, 2024). Though a lot of effort has been devoted to studying and implementing interventions regarding social skills and behaviour among children with autism, little has been done as regards the identification of approaches along with their drawbacks to support the cognitive development of such children. Skills such as memory, attention, planning, and problem-solving are the building blocks of learning and growing up in children (Brown and DeLoache, 2013). Identifying ways and means through which the cognitive skills in such children could be enhanced could go a long way in determining the child&rsquo;s academic achievement as well as the quality of their life. This study will therefore seek to fill this research gap by seeking to establish communication, treatment and teaching strategies that can be employed by parents, therapists and caregivers to enhance cognitive abilities in children with ASD. Despite large population-based studies, smaller trials have assessed the effectiveness of specific interventions like music therapy, cognitive approaches and healthy lifestyles; however, there is relatively little evidence about the kind of interventions to enhance cognition in this population in the UK context (Northey et al. 2018). To better understand the current practices that are implemented to enhance the cognitive skills of autistic children, a survey with professionals working in the field and focus groups with parents and teachers are planned. Thus, having presented the easily understandable and evidence-based recommendations, this study can improve autistic services and provide parents and teachers with valuable means that can contribute to setting the home and school learning environments.&nbsp;</p>
  <h2>Chapter 2 Research Methodology&nbsp;</h2>
  <h3>2.1 PICO Framework</h3>
  <p>The PICO Framework is provided below:</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="149"><col width="465"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>PICO Framework</p>
  </td>
  <td>
  <p>Factors</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Population/patients&nbsp;</p>
  </td>
  <td>
  <p>Children with Autism and the Age group of 5-10 years</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Intervention/interest&nbsp;</p>
  </td>
  <td>
  <p>Psychotherapies such as cognitive therapy, music therapy and family-based interventions</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Comparison/context</p>
  </td>
  <td>
  <p>Traditional treatment approaches</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Outcomes&nbsp;</p>
  </td>
  <td>
  <p>Improvements in cognitive skills</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <h3>2.2 Research design&nbsp;</h3>
  <p>Research design is defined as, the plan, methods, procedures and techniques that the researchers employ in the performance of any research study (Abutabenjeh and Jaradat, 2018). It consists of three major phases namely data gathering, data analysis and data interpretation. This research study has adopted a qualitative research design in order to determine the efficacy of cognitive therapies and strategies that may enhance the cognitive development and skills of children with autism in the UK. According to Worthington (2013), qualitative research design is a research method that uses structured or unstructured interviews, text analysis and non-numerical data to study people and their experiences in the social world. Not only does it facilitate the development of hypotheses but also enables the quantitative researchers to follow up the findings of the studies to gain more understanding and knowledge. This research study has incorporated the qualitative research method to employ the systematic literature review. It is a type of research design that is secondary in nature and is used to evaluate the strengths and weaknesses of the available literature on the research topic in question (Dziopa and Ahern, 2011). Similarly, it helped in the systematic execution of the critical investigation of the chosen study variables which cannot be possible while adopting other research methods like mixed methods and quantitative methods. Thus, a systematic review is an appropriate strategy to collate the research concerned with intervention for autistic children's cognitive advancement. In some cases, an individual study could report an insignificant result perhaps due to a low statistical power, or vice versa; a systematic review could therefore combine results from the various studies to assess the outcomes more comprehensively. It enables one to compare and find out which part of a certain technique is efficient in dealing with a certain problem. Included in the practical limitations of conducting this systematic review of such a vast amount of autism intervention literature is the risk of bias of viewing only those studies that were selected. A comprehensive description is helpful in better defining the intervention's effectiveness, clients, and context. This also affirms conclusions and assists in providing recommendations for the strategies that may be efficient in addressing the concerns of this diverse group.</p>
  <h3>2.3 Research approach&nbsp;</h3>
  <p>Research approach refers to the process or the method that is used in gathering, analyzing and interpreting data that has been collected (Teherani et al. 2015). Since the current research study has chosen the quantitative research design, the most suitable research approach was the deductive research approach in order to make conclusions based on the theories and previous findings from the literature. The inductive approach is a process of searching for patterns in observations and building the explanation based on the collected data (Liu, 2016). It also assists the researchers in identifying the pattern of reasoning from general information to specific results. As for the methodology, the significance of the inductive approach was seen in this research as it helped in arriving at the overall conclusions of the study and presented the important implications related to the research topic. An inductive research approach is appropriate for conducting a systematic literature review on the strategies used towards fostering the cognitive development of children with autism. While in a deductive approach, the researcher begins by positing a theory, inductive research enables conclusions to develop from the data through the thematic approach. Since there are numerous possible approaches to cognitive support and no specific theoretical framework indicating that some strategies are more effective than others for autistic children, an inductive approach allows the researcher to get acquainted with the existing approaches and trends, free from any preconceptions. This enables one to think of new categories and fresh theoretical perspectives in a bottom-up manner by examining a multitude of literature via qualitative analysis of an assortment of studies. Inductive orientation is more appropriate for developing knowledge about this multifaceted issue in a grounded, highly That is why an inductive orientation is suitable when working on this topic in an unimposing, loosely structured manner according to the phenomenon.</p>
  <h3>2.4 Selection criteria&nbsp;</h3>
  <p>The inclusion and exclusion criteria of this review are given below.</p>
  <p>Table 1 Selection criteria</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="311"><col width="303"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Inclusion criteria</p>
  </td>
  <td>
  <p>Exclusion criteria</p>
  </td>
  </tr>
  <tr>
  <td>
  <ul>
  <li>
  Articles published between 2014 and onwards were considered to include recent data and findings regarding the chosen topic
  </li>
  <li>
  Only those articles are selected that are available in the English language.
  </li>
  <li>
  Open-access and full articles were included for this study and analysis.
  </li>
  <li>
  Authentic databases like Ebsco, PubMed and Google Scholar as search engines were used for searching studies.&nbsp;
  </li>
  <li>
  The primary research articles on autism, cognitive development, children in the UK, risk factors and management approaches were screened for analysis&nbsp;
  </li>
  <li>
  Articles related to cognitive development, autistic children, the UK and strategic approaches were searched to be included in the analysis.&nbsp;
  </li>
  </ul>
  </td>
  <td>
  <ul>
  <li>
  Articles published before 2014 were not considered.
  </li>
  <li>
  Paid articles and journals are not selected for this study.&nbsp;
  </li>
  <li>
  Blogs and news from social media are not selected for this study.&nbsp;
  </li>
  <li>
  Articles other than English language were not screened to avoid any chances of issues in understanding the findings and errors in interpretation&nbsp;
  </li>
  </ul>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <h3>2.5 Search Strategy&nbsp;</h3>
  <p>The databases used for the present review were PubMed, Ebsco and Google Scholar Search Engine to aimed at presenting strategies which could be useful to enhance cognitive development in children with ASD. The following key terms were used while accessing the chosen databases:</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="91"><col width="467"><col width="66"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Databases&nbsp;</p>
  </td>
  <td>
  <p>Key terms&nbsp;</p>
  </td>
  <td>
  <p>Results&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>PubMed</p>
  </td>
  <td>
  <p>((autis* OR ASD) AND (cognition OR cognitive OR learning OR memory OR attention OR perception OR thinking OR intelligence OR comprehension)) AND ((therapy OR intervention OR program* OR strategy* OR support OR training OR instruction OR teaching OR remediation) AND (child* OR pediatric OR youth)).</p>
  </td>
  <td>
  <p>3412</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Google Scholar&nbsp;</p>
  </td>
  <td>
  <p>((autis* OR ASD) AND (cognition OR cognitive OR learning OR memory OR attention OR perception OR thinking OR intelligence OR comprehension)) AND ((therapy OR intervention OR program* OR strategy* OR support OR training OR instruction OR teaching OR remediation) AND (child* OR pediatric OR youth)).</p>
  </td>
  <td>
  <p>7213</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Cochrane Library&nbsp;</p>
  </td>
  <td>
  <p>((autis* OR ASD ADHD OR Hypersensitive disorder) AND (cognition OR cognitive OR learning OR memory OR attention OR perception OR thinking OR intelligence OR comprehension)) AND ((therapy OR intervention OR program* OR strategy* OR support OR training OR instruction OR teaching OR remediation) AND (child* OR pediatric OR youth)).</p>
  </td>
  <td>
  <p>521</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>CINAHL</p>
  </td>
  <td>
  <p>((autis* OR ASD OR ADHD OR Hypersensitive disorder) AND (cognition OR cognitive OR learning OR memory OR attention AND Hypertensive disorder OR perception OR thinking OR intelligence OR comprehension)) AND ((therapy OR intervention OR program* OR strategy* OR support OR training OR instruction OR teaching OR remediation) AND (child* OR pediatric OR youth)).</p>
  </td>
  <td>
  <p>117</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>These terms were then connected by Boolean operators such as AND and OR. Additional filters applied included Boolean Operators and English language to be published between the year 2010 and the present. The types of evidence sought were systematic reviews of randomised control trials, quasi-experimental research, cross-sectional studies, case reports, and qualitative work. The reference lists of the relevant articles were scanned and further relevant studies were searched for if any.&nbsp;</p>
  <h3>2.6 PRISMA Framework</h3>
  <p><img src="https://lh7-rt.googleusercontent.com/docsz/AD_4nXdVf2V4h4kUmb8olxSev5G_ScTkkTQtz-Yz6YRYjhO1-iCZnghiyJEtsMT-iCWRHhOwpmzgdNsYhrAtdQQGIyGJgs55B7qmLM9JBN1rEAI3-4sNwv_U3zAbavyhfMKAHG9JqMHmlg?key=gIsDHGzCkouFaX1FnO00-Q" width="624" height="527"></p>
  <h3>2.7 Critical Appraisal Tool&nbsp;</h3>
  <p>Critical appraisal and analysis are the foundation of literature studies. This helps the researchers to examine the collected data using meta-analysis to check for bias and the chance of the outcomes being untrue (Kirongo and Odoyo, 2020). An investigation by Bihu (2020) pointed out that the procedures that identify the research judgment and the appropriateness are the critical analysis and the appraisal which allow the investigators to carefully but rigorously assess the research. In the critical review here, the researchers have conducted the studies by Critical Appraisal Skills Programme (CASP) checklist as they evaluate some of the vital components such as how well the objectives are achieved, the research methodology and the research findings Since CASP is the most powerful tool for assessing critical skills by providing questions&rsquo; grading guidelines and proficient assessment of scientific literature, it is the best option for this purpose (Taherdoost, 2021). Initially, the critical appraisal of the chosen studies or rather assessment of their suitability for the analysis was done. Hence, the most eligible ones were set aside for analysis. The critical appraisal of this research has enabled the researchers to explore the risk bias and trustworthiness of the study to avoid any chances of false data and manipulation in the current findings.&nbsp;</p>
  <h3>2.8 Data analysis&nbsp;</h3>
  <p>Data analysis is also another particular stage of the review or for any other research. It is referred to as a way of collecting and analysing data by arranging it in a way that it could be interpreted. This review has presented that data analysis is achieved through some stages like the data collection, and the use of several logical and statistical models to model and analyse the data. Likewise, the thematic analysis method was applied as it allows for gathering qualitative data in terms of texts and qualitative indicators and examining the quality of the data and notions of different participants. The researchers can use this method to trace the texts where similarities and deviations are displayed in the collected findings (Braun and Clarke, 2012). Themes related to the research questions and the objectives were constructed that were answered through the findings of the selected studies.</p>
  <h2>Chapter 3 Results and Findings&nbsp;</h2>
  <h3>3.1 Introduction&nbsp;</h3>
  <p>This part of the review plays a crucial role because it provides the outcome and the findings of the performed analysis. The outcomes of the systematic review, which are compiled in a tabular format depicting the sum ups of the six selected studies, are illustrated in Appendix A. Thematic analysis of the selected studies is conducted to find out the elements and explore the role of using analytics to address claims and frauds in business entities. It supplies all the assessment of the critical appraisal and risk bias tools, as well as shows the list of all the studies used for the analysis and their importance.</p>
  <h3>3.2 Critical Appraisal&nbsp;</h3>
  <p>The findings of the critical appraisal checklist are defined in appendices to provide broader knowledge and insights into the studies. The score of critical appraisal has not affected the findings that are discussed in the thematic analysis. Hence it helped in the selection of articles, based on their research objectives, research methodology and the discussion of the findings. the findings of the CASP checklist are attached in Appendix A.&nbsp;</p>
  <h3>3.3 Summary Matrix <br><br></h3>
  <div dir="ltr" align="left">
  <table><colgroup><col width="88"><col width="136"><col width="103"><col width="79"><col width="218"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Authors&nbsp;</p>
  </td>
  <td>
  <p>Aims&nbsp;</p>
  </td>
  <td>
  <p>Research method&nbsp;</p>
  </td>
  <td>
  <p>Sample&nbsp;</p>
  </td>
  <td>
  <p>Results&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Parsons et al. (2019)</p>
  </td>
  <td>
  <p>To see the impact of play intention on a pragmatic language intervention for children with AS</p>
  </td>
  <td>
  <p>RCT</p>
  </td>
  <td>
  <p>71 children</p>
  </td>
  <td>
  <p>The main effects of six variables potentially influential to the intervention effect on POM-2 and SEE were analyzed descriptively on the screen using univariate main effects. Time points assessed were Pre-treatment, Post-treatment and follow-up, expressive vocabulary (EVT-2 score), Receptive Syntax (TACL-4 score) playmates &ndash; whether siblings or not, the Age difference between children in the dyads was considered Age of the children with autism 5&ndash;7, 8&ndash;9, 10&ndash;11 years Apart from that Therapist occupation &ndash; Speech and language pathologist, the occupational therapist only.</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Kitzerow et al. (2020)</p>
  </td>
  <td>
  <p>training of autistic patients to improve their executive functions</p>
  </td>
  <td>
  <p>randomized, controlled trial</p>
  </td>
  <td>
  <p>N=70</p>
  </td>
  <td>
  <p>children showed an alteration in neural response compared to the waitlist group for trained children (&eta;p2 = 0.14). Training effects were not observed when using lab-based, standardized tasks (&eta;p2s &lt; 0.02), although the findings did not generalize to caregiver-reported EF skills outside of the laboratory context (&eta;p2 = 0.001).</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Spain and Happ&eacute;, (2020)</p>
  </td>
  <td>
  <p>to identify the strategies for optimisation of design, delivery and evaluating protocols of CBT for adults with ASDs from 15 expert clinicians and clinical researchers based in England.</p>
  </td>
  <td>
  <p>three-round Delphi survey</p>
  </td>
  <td>
  <p>N=50&nbsp;</p>
  </td>
  <td>
  <p>Rating the importance of the processes involved in CBT on a scale of 1-5 for 221 statements completed by the participants. Provided are the areas of reference of the statements, namely Referral process, Assessment, Engagement, Formulation, Spirit of the therapy, Goals, Therapy structure, Interventions and techniques Utilisation, Homework, Outcome measurement, Management of endpoint/termination and Attributes of the therapist.</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Green et al. (2022)</p>
  </td>
  <td>
  <p>To assess the impact of social communication therapy upon autistic children at home.</p>
  </td>
  <td>
  <p>single-blinded, parallel, randomised, placebo-controlled trial, researchers</p>
  </td>
  <td>
  <p>N=555</p>
  </td>
  <td>
  <p>Assessments were conducted before the commencement of the intervention, 7 months after commencing the intervention, and after the completion of the intervention at 12 months. Researchers applied an analysis of covariance on the basis of the intention-to-treat sample for the efficacy outcome measures.</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Williams et al. (2024)</p>
  </td>
  <td>
  <p>to focus on music therapies to assist language learning in autistic children who have minimal language skills</p>
  </td>
  <td>
  <p>MAP Feasibility randomised control trial</p>
  </td>
  <td>
  <p>N=27</p>
  </td>
  <td>
  <p>Cohen&rsquo;s d-values ranged from 0.2 to 0.4 indicating small-to-medium effect sizes for a number of parent-identified children's sleep problems; child-perceived aspects of emotion regulation; and performance anxiety. This article contains an analysis of outcomes which are not significant. The first set of analyses seems promising but inconclusive because some of the hypotheses are partially supported and should be examined in light of these results. It might be conducive to current treatments and should be continually studied regarding the Yoga Informed Program.</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Tanksale et al. (2021)</p>
  </td>
  <td>
  <p>to evaluate the effects of a yoga-based program integrated with third-wave CBT components on self-regulation in autism spectrum children</p>
  </td>
  <td>
  <p>pilot randomised control trial</p>
  </td>
  <td>
  <p>67 children</p>
  </td>
  <td>
  <p>In the case of the intervention group, the subscale mean score comparison indicates a decrease in parent-reported global executive difficulties from the baseline to post-intervention, and from baseline to the follow-up assessment with a small to moderate effect size.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Aithal et al. (2021)</p>
  </td>
  <td>
  <p>To explore the impact of Dance Movement Psychotherapy (DMP) intervention for assessing the well-being of the care providers of autism spectrum disorders.</p>
  </td>
  <td>
  <p>quasi-experimental approach</p>
  </td>
  <td>
  <p>N=37 caregivers</p>
  </td>
  <td>
  <p>ANCOVA results of the post-intervention scores revealed a significant difference in the DMP intervention and control group in AWS, though, no significant difference was observed in respect of PSI-SF. Furthermore, it was also identified that the mean difference in post-intervention scores of both AWS and PSI-SF had a significant negative correlation with the pre-intervention scores and the number of sessions attended.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Roudbarani et al. (2023)</p>
  </td>
  <td>
  <p>the barriers and facilitators in psychotherapies from the perspective of autistic adults.</p>
  </td>
  <td>
  <p>Qualitative&nbsp;</p>
  </td>
  <td>
  <p>N=147</p>
  </td>
  <td>
  <p>mental health problems are related to worse prognosis in adult autistic individuals and are linked to deficits in adaptive behaviour, as well as in employment, independent living, and quality of life. This is particularly the case given the high rates of mental health concerns and the negative implications that these may hold for autistic adults.</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <h3>3.4 Thematic analysis&nbsp;</h3>
  <h4>3.4.1 Theme 1: Effectiveness of psychotherapies and strategies to manage the cognitive issues of autistic children.</h4>
  <p>The use of psychotherapies has got much attention in recent times in managing the psychological issues of children to avoid the side effects of medicinal usage. ASD children and adults can use psychotherapies, but it is considered that this is possible only with certain modifications due to socio-communication problems and neuropsychological restrictions which are typical for subjects with ASD. To address this theme, the study by Spain and Happ&eacute;, (2020) was found effective as they found that while nothing is commanding in the empirical research related to best practices for individuals undergoing antipsychotic treatment. When 50 people had been confronted, 18 agreed to be involved in Round 1, nine in Round 2 and eight in Round number 3. Overall, there was fairly good agreement on which particular statements were constitutive of CBT, with an average of 155 total statements deemed as either essential or important by a cohort of fifteen independently ratifying academics. The change was therefore welcomed and applied practically to the structure and process of therapy; specifically, an individualised formulation-derived approach was valued in the choice of which intervention or technique to use. This research should be continued to investigate whether the adapted CBT is effective enough to bring a positive change in treatment results and its acceptability level.</p>
  <p>With regards to the study by Williams et al. (2024) is also found suitable to address this theme, as it applied the MAP Feasibility randomised control trial. The chosen intervention is compared with the best practice treatment i.e. Social Communication Intervention for Pre-schoolers&ndash;Intensive with music-assisted programmes for language skills and learning in pre-school children with autism. This trial has ensured a comparison of the designed groups before interventions. Specifically, ninety-one people indicated a willingness to participate in the study; of which 27 fulfilled inclusion criteria and were randomly assigned to either musical programmes or SCIP-I. Participants were three children and their parents; they attended two 45-minute sessions per week, for a total of eighteen weeks, which involved virtual coaching from a speech and language therapist. To facilitate repeated practice in between appointments, a MyPT smartphone application was created. Thus, across the study period, researchers identified that about 20% of the participants engaged in the intervention and produced data for the assessment of the outcome measures. In short, researchers found a greater improvement of the experimental group in the following domains, social responsiveness, understanding of words and phrases and number of words spoken and parent-child interaction at 3 months post-intervention follow-up in the music-assisted programmes as compared to the SCIP-Intensive. These findings highlight the possibility of recruiting the above-mentioned population into an RCT and the music-assisted programmes were found to be highly acceptable as perceived by the parents from the interviews conducted. Firstly, future research should carry out a large-scale clinical trial to determine the potential of music-assisted programmes in enhancing early vocabulary development for autistic children.&nbsp;</p>
  <p>In addition, Tanksale et al. (2021) worked to evaluate the effects of a yoga-based program integrated with third-wave CBT components on self-regulation in autism spectrum children.. The intervention group's improvement in the primary outcome was measured by the executive functions. Secondary measures comprise sleep, anxiety, and emotion recognition. Subsequently, to attrition, questionnaire data collected at baseline, post-intervention, as well as the 6-week follow-up from participants in the intervention (n=31) and the waitlist conditions (n=30) were examined. In the case of the intervention group, the subscale mean score comparison indicates a decrease in parent-reported global executive difficulties from the baseline to post-intervention, and from baseline to the follow-up assessment with a small to moderate effect size.&nbsp;</p>
  <p>The study by Parsons et al. (2019) assessed the impact of play intention on a pragmatic language intervention for children with AS. The study involved 71 children with autism who were first randomly assigned to an intervention-first group (72 children, of whom 28 were analyzed) or a waitlist-first group (85 children, of whom 34 were analyzed). Parents practised home-facilitated trials of clinic play sessions with a TD child, and children participated in 10 weekly clinic play sessions. Assessment of pragmatics before and after the intervention was done using the Pragmatics Observational Measure-POM 2 and the Social Emotional Evaluation SEE. Post-operative medication utilisation reduced was substantially higher in participants in the intervention-first condition relative to the usual care condition for POM-2 gains (p = 0. 031, d = 0. 57), see figures 2 and 3 for visual representation. Follow-up analyses at 3 months showed the treatment effects were significant (p &lt; 0. 001&ndash;0. 05) with d = 0. 49&ndash;0. 64. Therefore the analysis of scores obtained at follow-up from the clinic as well as at home did not show any significant difference to the pattern identified by POM-2. Research evidence thus validates the implemented strategy of using play, peer-mediated, video-feedback, and parent training as effective interventional practices to improve pragmatic language in children with ASD. Also, the type of relationship between a Playmate and a child, the difference in age between children within the dyad, and the age category of the child with autism were not statistically significant on POM-2 or SEE scores. It was observed that the main TACL-4 score yielded a significant, positive and large effect on all the outcome scores.&nbsp;</p>
  <h4>3.4.2 Theme 2: Factors affecting the significance of psychotherapies for autistic children&nbsp;</h4>
  <p>This research theme was designed to address objective three of this review to explore the factors that result in affecting the application and outcomes of psychotherapies for autistic children in the UK. The chosen research by Aithal et al. (2021) aims to explore the impact of Dance Movement Psychotherapy (DMP) intervention for assessing the well-being of the care providers of autism spectrum disorders. The study has compared the chosen intervention with the standard care routines. The participants were 37 caregivers of children with ASD who were parents and close relatives of the free lunch program supervisees enrolled in Two SEN Schools and were randomly divided into the DMP intervention group and the control group based on their availability to attend the sessions. The participants in the experimental group underwent five DMP sessions that were conducted every week and each session took ninety minutes. DMI, Adult Wellbeing Scale (AWS) and Parenting Stress Index-Short Form (PSI-SF) were used before and after DMP to assess the improvement in the well-being of the caregivers and the reduction of parental stress through DMP intervention. Retention at this site was low and a mere 50 % of the participants in the DMP intervention arm attended at least 70 % of the sessions until the completion of the intervention. Thus, the MCID for a small effect size was reached for both OHQoL and the WHI index in the DMP intervention group but not in the control group.&nbsp;</p>
  <p>Another research by Roudbarani et al. (2023) has paid attention towards the barriers and facilitators in psychotherapies from the perspective of autistic adults. The study has also focused on the enhanced critical incident study to achieve its research objectives. This study was carried out by using qualitative and exploratory approaches in which the eight autistic adults have taken part in the interviews. A total of 147 critical incidents were identified from the interviews as well as the key categories important in therapeutic practice. This paper also outlined aspects concerning therapy including trust and respect and the practical aspects, clients, the structure of sessions and knowledge regarding autism, support for individual needs, options towards mental health, and family/advocacy. These factors were grouped into eight broad areas that could be of interest to those engaged in therapeutic activities. This research evidence indicates that the process of providing psychotherapy to autistic adults is similar to providing similar work to nonautistic adults in that this work also involves elements of person-centred approaches and employment of the general supportive processes. There are also differences in this work that provide reasons for requirements for basic information about autism to exist among providers. It may also be beneficial to gain more knowledge from the experiences of autistic adults to better enhance the current shifted mental health care for autistic adults. The current literature is partially developed for expounding on the needs and preferences of autistic adults who are in a position to receive mental health by virtue of psychotherapy.</p>
  <p>As children with autism are primarily taken care of and attention at their homes, the study by Green et al. (2022) is found useful in assessing the impact of social communication therapy upon autistic children at home. This study has helped in assessing the significance of the home environment in combination with psychotherapy to manage the health and psychological well-being of the children for cognitive development. Self-generation of adjusted treatment effects may also pose a problem to autistic children since such children may find it hard to generalize the effects of the treatment outside the treatment setting. It has been introduced as Paediatric Autism Communication Therapy (PACT) and has been effective when done in the clinic. Here, researchers examined the PACT-G home-plus-education design to look at the total impact and to explore the mediating pathways through which the impact spreads between two settings. In this single-blinded, parallel, randomised, placebo-controlled trial, researchers included autistic children, 2&ndash;11 years of age treated in two UK cities Manchester and Newcastle or in the Greater London area. DSM-IV-TR AS diagnosis required that Autism Diagnostic Observation Schedule-second edition (ADOS-2) and parent-rated Social Communication Questionnaire (SCQ-lifetime) scores were core values of children. Total score of 15 or more that met criteria on ADOS-2; and children older than 5 years were included if they had intentional communication, but an expressive language developmental level of no more than 48 months. Eligible children were randomly assigned (1:1), block randomised (block size 2 and 4 and stratified by site, age 2&ndash;4 years and 5&ndash;11 years and sexes) to PACT-G plus treatment as usual or treatment as usual only. The anonymity of participants was maintained by the research assessors in that they were unaware of the treatment that had been assigned to particular patients. PACT-G intervention aimed to be provided in a similar way to simultaneous interactions which took place with the child's parents at home and with a Learning Support Assistant (LSA) at the child's place of learning in face-to-face and through telepractice sessions within 6 months to facilitate real adult-child social interaction. This routine care consisted of any health services, advice, or other support accessed through educational institutions or the community. Essentially, the main analysis was on the change in autism symptom severity, as assessed by the ADOS-2 by external observers at 12 months compared to baseline. The secondary dependent measures were BOSCC and child-adult dyadic social interaction in different situations at the 12-month follow-up. Other secondary outcome measures were assessed using the following composites such as vocabulary, language, anxiety, stereotyped behaviour, compliant behaviour, parental and child health, and overall child disruptive behaviour. The severity and nature of adverse events experienced by the participants and caregivers in all trial families were determined by the researchers at each contact and by the therapists in the PACT-G group at each visit. ISRCTN 25378536 is the study identifier from the ISRCTN Registry assigned to this study. Across 18 January 2017 and 19 April 2018, 555 children were referred, 249 were deemed caregiver-child eligible, agreed to participate and were randomly assigned to PACT-G (n= 122) or treatment as usual (n=127).&nbsp;</p>
  <p>In addition, the study by Kitzerow et al. (2020) is found essential as it has focused on the training of autistic patients to improve their executive functions. This randomized, controlled trial compared an experimental executive function (EF) intervention to a control treatment in childhood ASD. A total of 70 children with ASD aged between 7 and 11 years with IQ of 80 or above were randomized into the experimental group which consisted of EF training games set on the web and metacognition face-to-face coaching or the control group, which was a waitlist. Predictors and outcomes assessed included neural response regarding EF, lab-based EF behaviour implementation and generalizability of EF skills. Secondary endpoints for the sample included perceived social function. Testing and all the associated activities were done with the assistance of other staff who were not aware of any group allocation. Overall, children showed an alteration in neural response compared to the waitlist group for trained children (&eta;p2 = 0.14). Training effects were not observed when using lab-based, standardized tasks (&eta;p2s &lt; 0.02), although the findings did not generalize to caregiver-reported EF skills outside of the laboratory context (&eta;p2 = 0.001). Yet, based on the results obtained here, the training group presented fewer repetitive behaviour symptoms (&eta;p2 = 0.15) after training. Regarding adverse events, there were no dropouts from the training group or potential complications. Results indicate that it is possible to implement a short, specific computer-based training program with additional coaching that has positive effects on neural activity and stereotypic movements of SAs, and school-age children with ASD.</p>
  <h2>Chapter 4 Recommendations and implications for nursing&nbsp;</h2>
  <h3>4.1 Summarised findings&nbsp;</h3>
  <p>This review has paid attention towards children on the autism spectrum, numerous interventions have been researched to foster the cognitive aspects of their learning. It is found that structure, routine, and visuals are to be implemented as the key elements to help the child. Autistic children are known for routines and anything that they can easily follow, possibly with the help of pictures or graphic displays of anything that is to happen or be done next. This serves to alleviate the feeling of powerlessness that is characteristic of dependency. As for the textual information, pictures, written instructions or a video are also helpful in teaching autistic children since they need more time and instructions to comprehend it. Teaching strategies used in early childhood education should be presented in a way that would address the particularities of the child and their abilities. Each of these approaches has its own particular approaches, but there are several general instructions that hold true across the board. For example, breaking a task into its constituent parts or encouraging a lot of positive reinforcement and guided practice. Technology can also be used as a way to support children in terms of helping them speak or express themselves and manage their feelings or behaviour. The present article focuses on the idea of how learning activities can be developed with reference to a child&rsquo;s interests for the benefit of motivation, interest and understanding. Interests make an autistic child focus on something and include aspects of automatic reinforcer within a functional skill. Some approaches such as cognitive therapies that feature the utilization of peers are also effective in teaching social skills since they involve interaction with a friendly role model in the natural environment. While there are likely to be some aggressive behaviours as observed above, it is important that the next time the child exhibits such behaviours, a patient response with understanding is used instead of punishing the child. With structure and routine, unpredicted events that cause disruptions for youth with autism can be controlled to an extent. However, the fostering of flexibility and resilience is subtly encouraged and it is a long-term process of training. The ability to change perspectives and mindsets in autistic children and the ability to help them manage changes can be taught through thoughtful validation, effective communication, and praise for attempts.</p>
  <h3>4.2 Implications for nursing practices&nbsp;</h3>
  <p>This paper argues that nurses take active participation in enhancing the cognitive development of the children with autism. As for the implications for nursing practice, this paper proposes to promote the early screening and diagnosis of the condition. That means it allows for early intervention, which is supported by numerous studies with evidences that are presented in previous chapters. They have basic understanding of early indicators of autism and report any concerns to professionals who refer the child for diagnostic evaluation. As per the findings and the perception of the family members who took part in the studies that are included in the analysis of this review, it is suggested that properly, nurses should provide the parents and caregivers with information on development and when to refer the child. The second issue is that nurses need to become a member of the cross-functional team managing an autistic child&rsquo;s care plan (Rutherford-Owen et al. 2023). This entails advising on practices that can be used in the consideration of developmental evidence in service delivery, observing the child&rsquo;s learning progress, and contributing to the adjustment of the treatment model if necessary. The strategies that nurses can help support and maintain are as follows: behavioral interventions, speech and language therapy, occupational therapy and educational services (Gosa et al. 2020). Nurses can also educate the families to follow up on recommendations and maybe encourage them through what maybe an emotionally challenging period. Moreover, nurses should also support and promote autism friendly environment and inclusive measures wherever possible (Garner et al. 2024). Galeti et al. (2020) also suggested that measures like reducing noise levels, establishing an orderly routine, using picture or visual timers and organizing access to comfort articles can help autistic children to feel less stressed in hospitals. It is also noteworthy that encouraging children to participate in community services and other social activities may also contribute to the cognitive development. When they provide supportive evidence based care and taking advocacy roles, the nurses can play a great role in changing developmental pathways for this vulnerable group.</p>
  <h3>4.3 Key aspects and policy implications&nbsp;</h3>
  <p>Essential support from pediatric nurses to the autistic children is beneficiaries concerning their cognitive development. NICE guidelines include &lsquo;supporting people with decisions about their care&rsquo; and &lsquo;communication and information sharing between professionals and families and carers (NICE, 2017). While, in comparison to the NMC Code, it entails putting people and families at the centre of care and making decisions in line with the best available evidence (NMC, 2019). Moreover, the NICE guidelines for autism care stress factors such as awareness of sensitivities in terms of touch, sound, taste, smell, and sight and also the way an autistic person communicates and the need to help to reduce anxiety (NICE, 2017). Nurses should support environment changes and help them implement pictures and other graphic displays such as picture schedules. The NMC Code instructs nurses to value diversity, communicates effectively and minimizes harm, and considers development when treating children (NMC, 2019). For the cognitive development, the nurses can guide shared focus during the play activities, songs and games, use the clear and simple language when explaining actions and use praises when encouraging positive behaviors and other useful techniques include sub divided tasks and the use of clues. The organization of care by the means of multi-disciplinary teams, individualized nursing care and educational initiatives regarding best-practice interventions enables the nurse to effectively fulfill their role for these children. It is also critical to listen to parents&rsquo; consideration and values as well to ensure quality if care to autistic children at homes (Leadbitter et al. 2020). Adherence to clinical practice guidelines and organisational policies and admission of family and developmental aspects of care into practice will facilitate the use of strategies that promote the development of autistic youths among pediatric nurses.</p>
  <h2>Chapter 5 Limitations&nbsp;</h2>
  <p>One potential drawback of such systematic review is the selection of only a few of research articles on different interference procedures. But even in Autism spectrum disorder cases many studies have limited by small sample size or may not sample this diverse population. This reduce the external validity of their study. They also did not cultivate the habit of asking patients about any medication they were taking other than the antipsychotic drug being prescribed. Moreover, the naturalistic nature of the studies mean there are not enough rigorously designed randomized controlled trials, widely regarded as the most accurate for assessing interventions. With regards to the some selected studies, they have employed more questionable research designs that are less reliable and objective such as observational or qualitative studies which have shown significant bias through the outcomes of CASP checklist. This prove challenging when one wants to establish a clear cause-effect relationship about the effectiveness of the intervention within a systematic review. Additionally, included studies have variation in the participant characteristics, interventions tested, methods to measure the impacts on cognition, and follow-up time of the studies. The different designs have complicated the integration of the findings in a way that allows for thematic-analysis and the extraction of relevant conclusions. Due to such limitations, the review authors have required special precaution while arriving at the conclusion, and ensured that they do not overstate the evidence with regards to cognitive development interventions for autistic individuals. It means that these limitations have brought to the forefront and foregrounded within the review as a way of creating a context for concluding and identifying implications for future research.&nbsp;</p>
  <h2>Chapter 6 Conclusion</h2>
  <h3>6.1 Findings of the study&nbsp;</h3>
  <p>Traditional behavioral approaches targeted at enhancing communication, social skills, cognition, play, and adaptive behaviors have been identified as the most suitable for young autistic children. Techniques which organizes, repeats, and rewards the information desired in children with ASD has confirmed notable raises in IQ, communication, and academic achievement, besides other aspects of development. High intensity interventions for multiple years at the early stages of childhood are considered as the perfect treatment. It is possible to educate the autistic child using their special interests in a way that enhances learning, interest and motivation, acquisition of skills and development. Other objects like pictures, written instructions and videos are also beneficial for a cognitive aspect as there are many forms of assistive technology including picture communication or a speech-generating device to help with language and communication. Other interventions include the parent-mediated interventions where parents receive training on the different techniques to be applied in dealing with the child at home during interaction with the autistic child. It is a favorable approach for parents and caregivers as well as encourages learning at every possible moment within the child&rsquo;s schedule.&nbsp;</p>
  <h3>6.2 Recommendations&nbsp;</h3>
  <p>It is important that an early intervention is made to enhance the cognitive fundament of the autistic children. Described in the systematic review, studies of training programs that target aggregated IQ, social cognition, social attention, language, and daily living skills appear to have potential in the education of autistic children. These are the behavioral interventions, technological interventions, play interventions, and developmental interventional. It is suggested that all children with autism to have early and frequent access to such evidence based cognitive training programs. The studies also portray how neural plasticity is at its peak in the early years of development, thus implying that early intervention should be pursued (Hadders-Algra, 2021). The training procedures which were behavioral and technology based seem to help in the improvement of IQ, social attention, and language. Specifically, studies focusing on intervention using behavioral strategies and virtual reality training to improve joint attention have been effective. It is also evident that developmental interjection involving play therapy can enhance the social communication of many children with Autism as well as their ability to perform daily activities. In future, more investigation is needed that directly compare the results of the most effective types of training. Future studies should perhaps incorporate a larger sample size with uniform outcomes and evaluate which strategies appear to be more effective in specific groups of children with autism. Researchers should propose greater emphasis on investigations of home and community-based strategies parents can employ for carrying out learning exercises between professional therapy sessions.&nbsp;</p>
  <h3>6.3 Future directions and implications&nbsp;</h3>
  <p>The observed limitations specify the need for future research to build more evidence for effective approaches and strategies for enhancing cognitive skills in children with autism. More vast observational researches that include various populations of children with ASD should be conducted to compare the effectiveness of the interventions for various subgroups of children. Furthermore, a greater number of cohort based studies where outcomes are measured at different points in the development would help to elucidate the longer term effects of implementing early intervention strategies. More specific efforts should be made by the researchers to find out about the Child Characteristics and Skills which may help in able to look out for details about the particular strategies which may be used for supporting visual processing, executive functions, language and communication development. This means that the outlined personalized approach may help improve results achieved in the health sector. Additionally, there is a need to provide parents, therapists and educators with practical knowledge and resources regarding cognitive intervention approaches for children with ASD. Dissemination efforts on a large scale are necessary as in parenting classes or online courses for therapists, or even as part of education programs for teachers. More importantly, improving the knowledge of which approaches are beneficial for autistic children can significantly improve the practices of those who work with the children most directly and therefore greatly help their cognitive development throughout their childhood.</p>

meta_description:
  It is recognised that up to 1.2 million populations of children in the United Kingdom are affected by autism spectrum disorder.


slug: assessment-brief-introduction-to-project-management
title: Assessment Brief: Introduction To Project Management
academic_level: Graduate
subject: Project Management
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meta_title: Assessment Brief: Introduction To Project Management
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created_at: 2025-06-23 17:26:16
updated_at: 2026-01-14 15:47:32
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  <h2>Introduction</h2>
  <p>This report provides an analysis of key project management principles including the nature and context of projects, stakeholder management, and planning and controlling projects. It aims to demonstrate an understanding of core concepts, processes and techniques used for effective project delivery.</p>
  <h3>1. Understand the Nature and Context of Projects&nbsp;</h3>
  <h4>1.1 Purpose and Structure of the Project</h4>
  <p>The purpose of a project is to organise and manage activities to meet a specific objective or deliver an outcome within defined constraints such as time, cost and quality. The objective is usually to create a unique product, service or result with a start and end date. The classic project structure includes three components: project definition, activities, and closure. The definition involves scope, objectives, requirements, timeline, budget, stakeholders and project manager role (Martinsuo and Geraldi, 2020). Work breakdown structure and work packages are used for planning, executing and controlling of project activities for target achievement. Dependent activities are planned in a schedule with the help of tools like Gantt charts. Closure involves transferring project deliverables, project sign-off, record retention, freeing of resources and conducting lessons learnt meeting to ensure that the project definition and management to closure are properly executed.</p>
  <h4>1.2 The Business Contexts of the Projects</h4>
  <p>Projects are run within a business environment and are usually conducted with an aim of aiding a company in the fulfilment of some of its business needs and wants. There are several common business contexts in which projects are undertaken: Strategic initiatives are closely associated with the strategic management plan and are undertaken for the purpose of attaining crucial strategy goals such as distribution into new areas, innovation of new products/ services or enhancement of critical organisational procedures (Adama et al. 2024). Operational projects are aimed at supporting the definite operation and near-range objectives. For instance, in the case of installing a new IT system in a company or even replacing the existing hardware.</p>
  <p>Compliance projects are special fixed projects that must be completed to satisfy legal or regulatory mandates. Such include projects formulated to establish new safety standards or projects that aim at being in conformity with the set data privacy acts. Revenue generation projects aim at improving the company&rsquo;s revenue and hence perhaps introducing a new product line so as to boost the revenue generation. Operational projects are based on ensuring consistency in currently offered goods and services for instance modernising infrastructure, equipment or improving on some application software (Ramirez, 2024).</p>
  <h4>1.3 Identify Project Success Factors and Characteristics</h4>
  <p>Several important factors and features determine the success of a project. Some potential success factors include effective leadership and governance by the project manager. It is the responsibility of the project manager to define the project scope and goals, make sound decisions where necessary and sort out any problems cropping up in the process. It is also important to have stakeholder support and engagement. It is also important to define objectives and scope based on the stakeholders identified and their requirements (Herath and Chong, 2021). Stakeholder commitment makes it possible to guarantee that the results of the project will be utilised. The last important aspect is planning &ndash; every project should have a detailed project schedule with a timetable, activities, responsibilities, costs, quality requirements, and risk mitigation strategy. Proper planning enables a project to be well prepared for implementation to enhance efficiency.</p>
  <p>Another factor that affects success includes the availability of team members, motivation, and cross functional communication. Some other characteristics of successful projects include; ability to accommodate changes, reasonable scope based on available budget or resources, compliance with processes and methods, ability to constantly track progress, the ability to implement quality assurance, and capability to conduct post-project evaluations (Nevstad et al., 2021). It also facilitates learning from positive and negative experiences of projects, thus promoting improvement.&nbsp;</p>
  <h4>1.4 Explain a Process Model for the Management</h4>
  <p>Another common process model that is applied to project management is the project life cycle or the project management process model. It entails the division of the project into five main stages, namely initiation, planning, execution, monitoring and control, and conclusion (Takagi and Varaj&atilde;o, 2022).</p>
  <p><strong id="docs-internal-guid-f3e4b987-7fff-9257-abbc-ae00f6c955a2"><img style="display: block; margin-left: auto; margin-right: auto;" src="https://lh7-rt.googleusercontent.com/docsz/AD_4nXcCnjoKnEw7WjW145y3tye-xMIkqwAB2gUyNcifalKvhyXO7tkqrvVRwACzVFXFxzi3YswnQqwWzZ0cpRaQvWNOoHxbjVk0Aun3HbbxKGGwjeysiXYYGc4-d8wu9mCiARj4GJ3f9lqy16cWwuHyCyg?key=MzG-vcycRnhP4qZleZJ7fA" alt="Project Management Life Cycle | 5 Amazing Phases of Project Life Cycle" width="571" height="319.43402293922173"></strong></p>
  <ul>
  <li>
  The initiation phase involves making the initial suggestion for the project and determining its viability. An initial project charter is then prepared highlighting the goals, specifications, and limitations (Alwaly and Alawi, 2020).
  </li>
  <li>
  The details include the scope, time, cost, quality, communication, and risk management plans. Activities are defined and relationships between them are established. In this case, there is an allocation of the resources and also the responsibilities ((Takagi and Varaj&atilde;o, 2022).
  </li>
  <li>
  Execution involves implementation of the project management plan and the technical project work and activities on a daily basis. Activities include monitoring to ensure that the project is on track on a daily basis. Topics are noted, concerns are addressed (Santos et al., 2020).
  </li>
  <li>
  Monitoring and control involves measuring and monitoring the project variables against the plan. This helps determine if corrective actions are required to get the project back on track. Status reports are prepared (Wang and Chen, 2023).
  </li>
  <li>
  The closure phase wraps up all project activities and ensures that pre-defined acceptance criteria are met. It involves conducting a comprehensive project evaluation, obtaining sign-off, transitioning the final deliverables, releasing resources and conducting a retrospective review (Malabagi et al., 2021).
  </li>
  </ul>
  <p>By following this structured and logical process, projects have a systematic approach to initiate, plan, execute and control the work until successful completion. It increases transparency and predictability of project performance and outcomes.</p>
  <h3>2. Understand the Management of Stakeholders Including the Project Team Roles and Responsibilities</h3>
  <h4>2.1 Explain Project Roles and Responsibilities</h4>
  <p>Effective project management relies on having the right people in key project roles who understand their responsibilities. The project manager has overall responsibility for leading the project team to deliver the project objectives on time, on budget and to the required quality standards. Their main responsibilities include planning, monitoring, reporting on project progress, managing project risks, issues, changes and stakeholder expectations. Project sponsors are senior managers who provide strategic guidance for the project and ensure adequate resources. They are accountable for the project's business case and results (Nicholas and Steyn, 2020). Team members have responsibility for completing assigned tasks and roles such as developer, tester, designer etc. They work under the direction of the project manager.</p>
  <p>The project client is the individual or business sponsor ultimately responsible for adopting the end project results. They represent stakeholder needs. A project steering committee typically oversees strategic project decisions. Administrative support staff help manage schedules, documentation, procurements and expenses. A project management office provides organisational project management support, standards, methods, training and reporting. Therefore, understanding roles ensures the right people are involved with the necessary expertise, skills and time commitment to focus on the right areas of the project (Kerzner, 2022). Clearly defined responsibilities help provide accountability, reduce duplication of efforts and enable effective coordination towards project success.</p>
  <h4>2.2 Describe Stakeholder Management Methods and Processes</h4>
  <p>Effective stakeholder management is crucial to project success. There are several key methods and processes involved. Identifying stakeholders is important to determine who should be engaged and consulted on the project. A RACI (responsible, accountable, consulted, informed) matrix is often used to determine the level of participation and interest different stakeholders have. Hence, understanding perspectives helps align project goals. Communication plans should be developed to determine information needs of each stakeholder and the most effective way to distribute project updates and status reports (Albats et al., 2020). There can be a need to make use of both the conventional and unofficial communication networks.&nbsp;</p>
  <p>Stakeholder requirements are thus obtained from face to face interviews, stakeholder meetings or questionnaires earliest during the planning phase. It can include influence on project goals and outcomes, as well as the particular scope of work that will be performed on the project. Expectations are quite toxic when not managed as they are bound to hurt the other person in the relationship. Speed is also relevant to problem-solving and conflict-resolution appropriately. The other advantage of status meetings is that it provides a platform for stakeholders to seek clarification on any issue and or matters that they feel should deserve attention before getting out of hand (Freeman, 2023). Proactively using these stakeholder management methods and maintaining open communication channels supports productive relationships, involvement and sponsorship essential for successful project outcomes.</p>
  <p>Table 1 Stakeholder Management Methods and Processes</p>
  <p>&nbsp;Source: Author</p>
  <h4>2.3 Discuss Methods to Manage the Project Team</h4>
  <p>Effective project team management is crucial for project success. Some key methods include creating a project organisation chart to clearly define reporting relationships and team structures. Team roles and responsibilities should be documented in job descriptions to avoid ambiguity. The project manager holds regular status meetings to review progress, upcoming tasks, issues and risks. This fosters communication and keeps the team focused on objectives (Thesing et al., 2021). Meeting agendas and minutes are recorded and the project managers can also establish performance metrics and objectives for team members to monitor work quality and provide feedback. Regular one-on-one check-ins allow managers to address concerns, provide support and evaluate individual contributions.</p>
  <p>Training requirements are incurred in order to equip individuals in the team with necessary skills for the assignment of their duties. Training of employees who are joining a new programme ensures that they are well acquainted with the purposes and activities involved. Team building activates ensure all members of a particular team are united and promote unity in order to offer support. Reward and incentives are also used to acknowledge the efforts made by employees in an organisation since this increases morale and motivation among employees (Alzoubi, 2022). Having small teams in one project area is that it would be easy in one to notice a breakthrough in interaction as well as finding solution to arising issues. Virtual teams also need additional communication structural contours to be applied from shared workspaces and video meetings. Conflict resolution is engaged through mediation or consensus in the event of a conflict or disagreement (Goldberg et al., 2020).</p>
  <p>Organisation and division of processes of work is done based on task assignments often consisting of small cross functional teams for specialisation. Defining the deliverables, and executing schedules and assumptions fosters efficiency in response to project coordination (Kiernan et al., 2020). By noting the displayed pattern of work, understanding the interests, and studying the disparities within the team interactions in these approaches, it can best support productivity, ownership and results.</p>
  <h3>3. Understand the Planning and Control of Projects&nbsp;</h3>
  <h4>3.1 Discuss A Project Planning and Control Cycle</h4>
  <p><img src="data:image/png;base64,[encoded data, 58744 characters]"></p>
  <p>Table 2 Project Planning and Control Cycle Source: Author</p>
  <p>The project planning and control cycle involves four main phases that repeat throughout the project lifecycle: Planning is the first step in managing any project and it entails the following: Project activities are identified and divided into work packages, which state the expected time duration, resources needed and costs associated with work delivery. Project plans are developed covering the work, quality, communications, procurement and risk. The second phase is execution. The project manager assigns work packages and responsibilities. They monitor individual tasks and the project as a whole to track progress against the plan (Orgut et al., 2020). The third phase is monitoring and control. Key performance data like timeline status, budgets, scope, quality and risks are tracked. Variances from the plan are identified and their potential impacts assessed. Corrective actions are considered. The final phase is reporting. Project managers consolidate performance monitoring data and provide regular reports to stakeholders. This keeps governance and decision makers informed of progress so issues can be raised and addressed proactively.</p>
  <p>As the project progresses through each cycle, replanting takes place. As more details emerge, the existing plan is reviewed and refined through an iterative process (Leong et al., 2023).&nbsp;</p>
  <h4>3.2 Explain Methods and Processes Available To Plan a Project</h4>
  <p>It is important for project managers to apply several approaches and stages in planning to enable proper conception of project delivery. After project scope, goals, and needs of the stakeholders are recognised work breakdown structures assist in breaking down deliverables into work packages. Along with estimates of time, cost and resources, these packages facilitate and contribute to the development of the project schedule (Thesing et al., 2021). Network scheduling employs the likes of Gantt charts in order to capture dependencies as well as arrange the work in a coherent manner. Whereas Gantt chart positions activity in the time-line manner, network techniques such as CPM identify activities most sensitive to time.</p>
  <p>Resourcing outlines capabilities and timing at each stage of the project. It should be noted that planning is not linear but is cyclical in nature since more information often becomes available on time estimates, risks or dependencies. Project management software assists in this in the form of &lsquo;what if&rsquo; scenario modelling. Project estimates undergo expert review for refinement before finalising baselines. Contingencies are added to account for uncertainties using techniques like reserve analysis. Risk planning involves identifying potential issues early, assigning owners and tracking mitigation strategies (Schulte and Knuts, 2022). Communication plans are also integral to managing stakeholder interests and requests appropriately. The resulting coordinated set of project plans provide a roadmap for delivery (See more in Appendix Section). Regular reviews allow for re-planning if needed based on new information or variances from baseline. Solid planning sets the stage for effective execution, monitoring and control.</p>
  <h4>3.3 Identify Methods and Processes Available To Control Project</h4>
  <p>Effective project control involves regularly monitoring performance and implementing corrective actions when needed. Some key methods used for project control include: Progress reporting involves tracking actual performance data such as schedule, costs, scope, issues and risks against the project plan on a predefined frequency. This can be weekly or monthly. Variances are identified and corrective actions suggested. Variance analysis examines why variances in cost, schedule or quality have occurred in order to identify the root causes and address them. This involve comparing planned vs. actual metrics (Hillson and Simon, 2020). Earned value management is derived from actual performance, planned performance, and the approved baseline and shows deviations in terms of dollars and hours. This allows for the forecasting of the estimates at completion to identify any problems that can be present sooner rather than later.</p>
  <p>These address how modifications in the scope, schedule, and resources are proposed, validated, authorised, or denied to protect the objectives from distortion. Next, approved changes are incorporated into the baselines. It helps work on the emerging issues and re-evaluating risks to address new challenges and obstacles that arise preventing them from executing their mitigation strategies for threats. Milestone reviews check deliverables to ensure they meet the requirements then close out the respective phases (Wambura, 2024). By getting the content reviewed by other professionals, the scope verification is effective in preventing uncontrolled growth because the deliverables stay on specification. The post-project reviews or lessons learned documentation are useful in reviewing every future project in order to enhance the existing practices. By monitoring the set KPI, one can get empirical data to identify areas in need of improvement (Sipes, 2023). These control methods provide important information throughout the lifecycle of a given project to maintain your course.</p>
  <h2>Conclusion</h2>
  <p>In conclusion, it is recommended that one familiarise with the general project life cycle and practice the best practices that include: A definition of requirements, formulation of a work plan, determination of personnel resources, assessment of project progress, and evaluating when corrective action is required. Effective project management is adhering to best practices which can aid in timely and efficient project delivery, to budget and as per expected quality and results.</p>
  <h3>References</h3>
  <ul>
  <li>
  Adama, H.E., Popoola, O.A., Okeke, C.D. and Akinoso, A.E., (2024). Theoretical frameworks supporting IT and business strategy alignment for sustained competitive advantage. International Journal of Management &amp; Entrepreneurship Research, 6(4), pp.1273-1287.
  </li>
  <li>
  Albats, E., Alexander, A., Mahdad, M., Miller, K. and Post, G., (2020). Stakeholder management in SME open innovation: interdependences and strategic actions. Journal of Business Research, 119, pp.291-301.&nbsp;
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  Herath, S. and Chong, S., (2021). Key components and critical success factors for project management success: A literature review. Operations and Supply Chain Management: An International Journal, 14(4), pp.431-443.
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  <li>
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  <h4>Appendix</h4>
  <p><strong>Effective Project Planning Methods</strong></p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="165"><col width="239"><col width="221"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Process</p>
  </td>
  <td>
  <p>Description</p>
  </td>
  <td>
  <p>Tools &amp; Techniques</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Work Breakdown Structure (WBS)</p>
  </td>
  <td>
  <p>Decompose deliverables into manageable work packages.</p>
  </td>
  <td>
  <p>WBS dictionary, hierarchical outline</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Schedule Development</p>
  </td>
  <td>
  <p>Define task durations, dependencies and project timeline.</p>
  </td>
  <td>
  <p>Gantt charts, network diagrams (CPM), project management software</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Resource Planning</p>
  </td>
  <td>
  <p>Identify and allocate required skills and availability.</p>
  </td>
  <td>
  <p>Resource matrix, skills inventory</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Estimation &amp; Baselining</p>
  </td>
  <td>
  <p>Develop time, cost and resource estimates, finalise baselines with contingencies.</p>
  </td>
  <td>
  <p>Expert review, reserve analysis, project management software</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Risk Management</p>
  </td>
  <td>
  <p>Identify, assess and plan mitigation strategies for potential issues.</p>
  </td>
  <td>
  <p>Risk register, risk assessment matrix</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Communication Planning</p>
  </td>
  <td>
  <p>Define stakeholder communication channels and needs.</p>
  </td>
  <td>
  <p>Communication plan template, stakeholder matrix</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Plan Review &amp; Iteration</p>
  </td>
  <td>
  <p>Regularly review and update plans based on new information or changes.</p>
  </td>
  <td>
  <p>Status reports, project meetings, re-planning sessions</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>&nbsp;</p>

meta_description:
  An analysis of key project management principles including the nature and context of projects, stakeholder management, and planning and controlling projects.


slug: cost-effective-management-of-volar-plate-injuries
title: Cost-Effective Management of Volar Plate Injuries
academic_level: Graduate
subject: Medicine and Dentistry
type_of_paper: Quantiative Dissertation
citation_style: APA
meta_title: Cost-Effective Management of Volar Plate Injuries
meta_description: Hand therapy plays a crucial role in the treatment of hand injuries or volar disc injuries.
meta_keywords: volar plate injuries
canonical_url: https://www.cheap-essay-writing.co.uk/
meta_robots: index,follow
created_at: 2025-06-23 17:46:34
updated_at: 2026-01-14 15:47:26
status: published
content:
  <h2>Cost-Effective Management of Volar Plate Injuries: A Quality Improvement Study on Hand Therapy Techniques</h2>
  <p>[Name of Student]</p>
  <p>[Name of Property]</p>
  <p>[Date of Submission]</p>
  <p><strong>Abstract</strong></p>
  <p>Hand therapy plays a crucial role in the treatment of hand injuries or volar disc injuries. It is often seen in the clinical setting due to a hypertensive point in the interphalangeal joint (PIP). As mentioned, there are well presented approaches for surgical fixation; However, the role and hand therapy guidelines are still not very clear. The aim of the project is to improve efficiency and reduce costs due to multiple appointments and splinters in the manual therapy department. This study used a positive, quantitative approach to objectively determine the most effective and cost-effective manual technique. A retrospective cross-sectional design was used when questionnaires were used to collect retrospective information on patients treated as outpatients within the past year. This allowed the clinical results and costs of different treatments to be compared over time. This made it possible to collect a larger sample through questionnaires. Quantitative analysis of patient-reported numerical results provided an objective method of measurement. Previous similar studies have used this retrospective cross-sectional design to effectively compare different treatments while controlling for injury severity. This cross-sectional study used questionnaires distributed in the previous year to patients treated for volar disc injuries in the outpatient department of a large urban hospital in the United Kingdom with a population of over 500,000. All patients aged 13 years and older treated for open disc injuries in an outpatient hand clinic during a year (N=54) participated in this study. As both chi-square and Anova showed significant results, this provides strong evidence that the type of treatment modality affects both clinical outcomes and time to release. Thus, based on these two criteria, it can be concluded that one treatment method may be more effective than the other.</p>
  <h3>Chapter 1: Introduction</h3>
  <h4>Background&nbsp;</h4>
  <p>Hand therapy has a crucial role in the management of hand injuries i.e. volar plate injuries. It is commonly observed in clinical settings which occur due to hyperextension trauma to the Inter-phalangeal joint (PIP) (1). Functional impairment and discomfort can develop due to volar plate injuries, emphasizing to adoption of immediate and efficient management approaches. Conventional management approaches related to volar plate injuries encompass a combination of immobilization through manual therapy techniques, and the most common management techniques include dorsal blocking splint and buddy strapping and other therapeutic exercises (2). However, these methods have increased the cost of healthcare and extended the duration of rehabilitation due to multiple sessions of therapy and the utilization of splinting materials (3). Furthermore, interest is developing in exploring alternative therapies for hand therapy recently. For managing volar plate injury; streamlined therapy protocols, emphasizing the targeted intervention and utilization of effective resources have served as the potential cost-effective and efficient approaches (4). Still, there is a need for evidence-based validation and thorough evaluation is required. A detailed evaluation of cost-implications and effectiveness of various techniques related to hand therapy is necessary for optimal decision-making and improving resource distribution in the healthcare system. This study aims to encourage the adoption of cost-effective strategies in clinical settings and the enhancement of quality care standards by recognizing optimal protocols for hand therapy measures that create an equilibrium between affordability and effectiveness of treatment method.</p>
  <h4>1.2 Problem statement</h4>
  <p>A volar plate avulsion fracture is an evident and frequent category of fractures that are managed by hand surgeons and hand therapists (5). These injuries are seen in cases where a person falls with his or her hand stretched out and the impact leads to the avulsion of the volar plate from the base of the phalanx. If displaced to a considerable extent, the fragment needs to be sutured back, and early wriggling has to be encouraged to avert stiffness and restore function. As mentioned, there are well-stated approaches to surgical fixation; however, the guidelines regarding the role, and the time at which hand therapy should be initiated are still not very clear. There is a considerable body of knowledge on cost differences for these injury treatments, but little is known about cost-effective hand therapy interventions that can effectively help therapists achieve high functional gain for patients. The review also indicated that there are several gaps in the literature, some of them include; the number of post-operative therapy visits that are required, the time at which active range of motion should be initiated, and the criteria that should be used to choose between therapy and home exercise programs (6). Due to the current increase in the cost of delivering health care, it is necessary to establish policies that therapists could follow while offering quality health care service without a lot of expenses. This QI study is designed to examine the present tendencies of hand therapy for volar plate injuries in our healthcare setting and review functional results, patient satisfaction, as well as costs between the groups with different therapy frequencies such as dorsal blocking splint and buddy strapping (7). Meanwhile, present study&rsquo;s goal is to identify the point at which added therapy visits do not contribute additional benefit to more quantitative results or patient satisfaction. The following are the objectives: To provide structure for therapy to enhance the value of care as put forth for these common hand injuries requiring surgery. This research responds to important literature deficits by providing a better understanding of the variables involved in determining rehabilitation strategies as well as the factors that contribute to unwarranted expenses in the healthcare sector.&nbsp;</p>
  <h4>1.3 Aim and Objectives</h4>
  <p>This project aims to improve efficiency and decrease the cost incurred from multiple appointments to the hand therapy department and from splinting.</p>
  <ul>
  <li>
  To explore traumatic hand injuries and treatment techniques dorsal blocking splint and Buddy strapping.
  </li>
  <li>
  To compare patients with VPI who have been treated with Buddy strapping by ED/MIU/self-managed/Clinicians and patients who have been treated with splint by hand therapy.
  </li>
  <li>
  To provide practical recommendations and future research implications.
  </li>
  </ul>
  <h4>1.4 Research Questions</h4>
  <ul>
  <li>
  What are traumatic hand injuries and treatment techniques dorsal blocking splint and buddy strapping?
  </li>
  <li>
  Which is the most effective treatment technique for patients with VPI who have been treated with Buddy strapping by ED/MIU/self-managed/Clinicians and patients who have been treated with splint by hand therapy?
  </li>
  <li>
  What are the practical recommendations and future research implications?
  </li>
  </ul>
  <h4>1.5 Rationale of the study</h4>
  <p>The main idea behind this study is to explore the factors resulting in volar plate injuries and suitable cost-effective hand therapies by comparing the dorsal blocking splint and buddy strapping. Volar plate injuries are frequently seen in practice as they are usually caused by a fall forward onto an outstretched hand. These are injuries that can be excruciating if not well treated, and can lead to significant disability. This typically requires surgical intervention to address the volar plate lesion and subsequent hand therapy to attempt restoration of normal finger motion and force. However, it is important to note that the surgery, as well as the specific hand therapy that follows, is relatively expensive. The purpose of this research is to determine if the various hand therapy techniques could prove to be cost-efficient rehabilitation strategies in volar plate injuries. The sample will be taken from patients with hand disorders receiving hand therapy treatment in the physical therapy clinic of a large teaching hospital in the Midwest. The study will compare two hand therapy protocols dorsal blocking splint and buddy strapping. The dorsal blocking splint is a flexion deformity of the joint that does not allow to fully extend joint into natural position. Similarly, the buddy strapping is process of bandaging injured hand or fingers together with health finger. This allows health finger to work as splint and allows the injured finger in natural position. If the one of the protocols turns out to have better results one another then it could be translated into a cheaper cost, then it means that the management of these regular kinds of injuries becomes cheaper. This would enhance access to care and as a result, help more people gain better health. It could also help eliminate expensive one or two-handed therapy plans that might not have much more added value than simple hand exercises at home. A comprehensive analysis of musculoskeletal injury rehabilitation protocols can potentially enhance the quality of care and will prove beneficial for modelling sustainable solutions for the treatment process in healthcare facilities. The purpose of this investigation is to identify which of the treatment method; dorsal blocking splint and buddy strapping is simplified hand therapy protocol can be applied in treating volar plate injuries without compromising the patient&rsquo;s recovery, function and at optimal cost. The conclusion drawn from this quality improvement initiative could make it easier to give treatment cost-sensitive directions while not affecting patient healing.</p>
  <h4>1.6 Significance of the research</h4>
  <p>This study possesses significant importance due to its considerable impact on clinical methods for the management of volar plate injuries. The research strives to highlight the importance of improving the patient-outcomes along with reducing healthcare expenditures through evidence-based evaluation of dorsal blocking splint and buddy strapping techniques. It is notably critical given the common occurrence and functional ramification of volar plate injuries. For managing the injuries, the findings of the research can assist healthcare providers with the cost-effective and most suitable approach which will possibly lead to better resource allocation, patient well-being and incur lower costs that could be used for other patients. Similarly, the research aims to discover suitable protocols that create a balance between affordability and effectiveness which have wide consequences for the delivery of healthcare. It can lead to establishing evidence-based recommendations that can be executed in multiple healthcare systems for improving healthcare and guaranteeing cost-efficiency. By creating a bridge between practical applications and research, this research can shape the decision-making process both at the individual and healthcare system levels. This allows effective healthcare resource utilization and improvement in patient outcomes. Ultimately, the research significance stays in standards of quality care and promotes the execution of cost-efficient approaches in addressing volar plate injuries.</p>
  <h4>1.7 Structure of the dissertation</h4>
  <p>The following sections are explored in this evidence-based research:</p>
  <ul>
  <li>
  Chapter 1 (Introduction): This is the first section of the research that depends upon the research background to describe the recognized research problems along with the aims and objectives of the study. It also assists with research questions that are centered on this study.
  </li>
  <li>
  Chapter 2 (literature review): This is the second section of the research which involves a thorough assessment of past literature relevant to the research topic, concentrating on delivering context, finding deficiencies, and elaborating the requirement for the study's contribution.&nbsp;
  </li>
  <li>
  Chapter 3 (Research Methodology): This is the third section of the dissertation that focuses on identifying the strategies, techniques, and tools that are necessary to implement for carrying out the research study.&nbsp;
  </li>
  <li>
  Chapter 4 (Results and Interpretation): This chapter is an essential part of the dissertation as it gives the outcomes and provides an analysis of the collected data. It allows contrasting and comparing the opinions of different authors regarding the chosen research questions, based on the collected findings.
  </li>
  <li>
  Chapter 5 (Conclusion): Chapter five acts as a concluding section which recap the overall findings of the study. It predicts the consequences of the practices, shows study deficiencies that are discovered throughout the study, and recommends directions for the future.
  </li>
  </ul>
  <h3>Chapter 2: Literature Review&nbsp;</h3>
  <h4>2.1 Introduction&nbsp;</h4>
  <p>Hand trauma is one of the most common events in emergency services around the world. In hand trauma, a timely and accurate diagnosis is of great value. There are hand injuries that can easily be overlooked in the first instance and can later become significant deformities and functional alterations that are much more complex to manage. The prognosis of a traumatized hand depends largely on the initial evaluation and management, hence the importance of performing a good physical examination [8]. This review is focused on volar plate injuries. The review begins with a brief definition and characteristics of volar plat injuries (VPIs) and then continues to identify and analyse various therapeutic options for VPIs. The review then narrows down its focus on dorsal blocking and buddy strapping options and provide brief discussion on main characteristics of these two treatment options. The review then compares the effectiveness of these two options followed by a review of existing empirical evidence. Finally the chapter ends with a brief summary of review.</p>
  <h4>2.2 Volar Plate Injuries&nbsp;</h4>
  <p>Injuries to the volar plate of the thumb metacarpophalangeal joint are the result of hyperextension trauma. The plate is torn but the collateral ligaments remain intact, which may lead to supraphysiological extension or subluxation of the joint. The most common treatment is conservative, however, if there is residual subluxation or passive stabilizing structures are affected, surgical treatment should be performed [9].</p>
  <p>There are various risks factors associated with VPIs. The most commonly cited risk factor is age and gender. Adults aged 50 years or older and children aged 18 years or younger suffer more fractures compared to middle-aged adults. Gender is a determining factor that varies by age [10]. According to Warwick and Dunn [11], regarding incidence in the young age group, males have a higher risk than females. However, beyond the age of 50 years, the rate of distal radius fracture increases markedly, such that women over 50 years of age have a lifetime risk of 15%, while the incidence in men remains low until they reach the age of 80 years. There are also risks related to lifestyle, population density and seasonal factors. The most common causes of distal radius fractures in the paediatric and young adult age groups include play or sports activities and motor vehicle accidents. In contrast, the most common mechanism of injury in older adults is low-energy trauma due to a fall from their own height. Lifestyle, population density and environmental factors contribute to this type of fracture and should be considered when designing rehabilitation and prevention programs, as well as materials for patient education [11].</p>
  <p>Osteoporosis is another important risks factor. In patients with osteoporosis, the energy of trauma to the distal end of the radius causes epiphyseal-metaphyseal comminution with a loss of bone mass and impaction of the fragments greater than that which occurs in a bone under normal conditions [12], increasing the severity of the functional prognosis and influencing the quality of fixation of osteosynthesis devices [13]. Stanley et al., [14] after a study carried out on distal radius fractures, found that 74.8% had osteoporosis, measured radiographically by the width of the cortex of the 2nd metacarpal, and that the final deformity was significantly greater in these patients. During middle age (45-65 years), a distal radius fracture due to a fall from a standing height or below may be the first clinical manifestation of osteoporosis for a small subset of people. Other risks factors related to health conditions include poor bone quality (such as chronic stroke, diabetes, rheumatoid arthritis, and kidney disease) are significant risk factors [14].</p>
  <h4>2.3 Therapeutic Options</h4>
  <h5>2.3.1 Closed reduction and immobilization</h5>
  <p>Fracture reduction should be performed under anesthesia, usually local. Reduction maneuvers are performed with traction from the first to the fourth finger and manipulation of the fracture site. Once the reduction is achieved, the patient is immobilized using a forearm cast, leaving the fingers of the hand free to move. Once the inflammation has subsided, the cast should be changed for proper adjustment. It is necessary to monitor the redisplacement within the cast with checks during the first 2 to 3 weeks, with the treatment lasting about 6 weeks [15].</p>
  <p>Among the advantages offered by this type of treatment are the absence of surgical and anesthetic complications that surgical treatment offers. However, it requires stricter control by a specialist, with a greater number of control x-rays per patient. The most notable complications are joint stiffness or reflex sympathetic dystrophy due to the long period of immobilization [16]. Regarding the results of conservative treatment, there is great discrepancy in the literature. As a general rule, it is most commonly used in patients over 65 years of age, since according to some authors, residual deformities should not compromise the patient's daily autonomy due to their lower activity [16].</p>
  <h5>2.3.2 Closed reduction and percutaneous fixation with needles</h5>
  <p>This is a combination of the previously described technique associated with internal fixation performed percutaneously with Kirschner wires under direct control by radioscopy in the operating room. It is very important to avoid the sensitive branch of the radial nerve and tendon entrapment when placing the device. Once closed reduction has been achieved, as previously described, the fragments are fixed using needles, and then the wrist is immobilized with a forearm cast [17].</p>
  <p>This technique, like the conservative one, offers the advantages of closed reduction in terms of surgical complications that open reduction can cause. However, it is not entirely unpunished, since the traumatic process of placing pins can cause damage to anatomical structures if care is not taken, and sometimes it can cause local infections at the entry points, and frequently it does not provide stability to the fracture, causing secondary displacements [18].</p>
  <h5>2.3.3 Closed reduction and external fixation</h5>
  <p>This involves performing the reduction in a closed manner, and then stabilising the fragments using an external fixator. The pins of this are usually placed on the radial diaphysis at one end, and on the second metacarpal at the other. External fixation allows [19] to maintain the length of the radius, and can also be associated with other techniques, especially in associated soft tissue injuries and also temporarily during open surgery to help maintain the reduction [20].</p>
  <p>It is an inexpensive technique with low surgical difficulty, but it is not free of complications. It has been observed that not all fractures are reduced well with the fixator, since the fragments not attached to ligaments are not reduced, not achieving good ligamentotaxis. In addition, excessive distraction of the fragments must be avoided, as it hinders consolidation and can cause joint stiffness. Another problem is the possible infection of the chips [21].</p>
  <h5>2.3.4 Open reduction and internal fixation</h5>
  <p>It consists of the reduction of the bone fragments in the open sky, and their fixation using plates or screws. It is the method that best prevents the loss of reduction and allows early mobilization [22]. Plates with fixed-angle screws: the fixed angle of the screws is already predefined, so once the fracture is reduced and the first subchondral screw is placed in an optimal position, the rest of the screws will also be in the optimal position, shortening the surgical time (&ldquo;fixed-angle&rdquo; plates) [23].</p>
  <p>Variable angle screw plates: the angle of entry of the metaphyseal screws allows a certain change of direction. The clinical and biomechanical superiority between both systems is a topic of current controversy. Although there is no solid evidence, there is a weak association between the degree of inclination of the screws and the loss of hardness of the fixation. Although cadaver studies find mechanical superiority of certain variable angle implants, retrospective clinical studies do not show differences between one system and the other. Critics of the variable angle argue that it increases the risk of intra-articular protrusion, since each screw must be evaluated individually, as well as the probability of intra-articular iatrogenesis in surgeons with little experience [24].</p>
  <p>Plates with locked screws: in the evolution of the previous models, self-locking screws to the plate (&ldquo;multidirectional locking plates&rdquo;) emerged, for use in cases of poor bone quality that could not support the grip of the screws. This is the most commonly used model currently. The use of plates that lock to the &ldquo;locked plate&rdquo; screws gave rise to the concept of internal fixation. In this system, the load does not pass through the fracture site, but through the body of the implant. Under this philosophy, it is no longer necessary for the screw to pass through the second cortex, thus decreasing the risk of dorsal tendon involvement [25].</p>
  <h5>2.3.5 Dorsal approach plating</h5>
  <p>The dorsal approach was commonly used for fixation of dorsally displaced fractures. The interval between the extensor carpi radialis brevis and extensor pollicis longus allows direct visualization of the radial axis and the articular surface. In severely comminuted fractures, indirect reduction of the articular surface can be performed through the fracture itself. This approach allows excellent visualization of the articular surface and the dorsal cortex. The surgical access required is aggressive with vascularization and the site where the implant is housed can interfere with the extensor tendon apparatus [26].</p>
  <p>The dorsal plate emerged as an alternative to the morbidity and stiffness associated with external fixation. The evolution of these plates is due to thinner profiles (from 2.5 mm thick to the current 1.2 &ndash; 1.5 mm), rounded edges and screws with heads that do not protrude. The use of free-angle dorsal plates is recommended, since in fixed-angle plates a more distal implantation is usually necessary with the consequent risk of tendinopathy [27].</p>
  <p>The main indication for this approach is isolated dorsal joint shear or the combination of injuries that cannot be controlled using a volar plate. The main contraindications are Barton-type volar shear fractures, marginal injury to the volar facet or semilunar fossa as well as fractures with volar angulation. Its main drawbacks are the implantation site of the plate and the need for subsequent removal due to complications of tendon or nerve friction [24]. Later studies demonstrated high rates of system complications with dorsal collapse of the fracture [23].</p>
  <h5>2.3.6 Volar approach plate</h5>
  <p>It is performed through the interval between the flexor carpi radialis and the radial artery. They are separated to identify the median nerve and all these structures are separated medially. The pronator quadratus muscle is accessed and sectioned laterally and when it is separated, the volar face of the radius is visualized. Under fluoroscopy, the fracture is reduced, then the plate is placed. The pronator quadratus is sutured again, covering the osteosynthesis material [22].</p>
  <p>Volar synthesis is presented as an alternative to dorsal synthesis for several reasons: there is more space available for the implant, the flexor tendons are far from the implant due to the interposition of the pronator quadratus and the concave shape of the distal radius, the surgical approach is less aggressive with irrigation, the volar cortex is usually less comminuted, which facilitates synthesis, and finally, because volar scars are better tolerated than dorsal scars [18].</p>
  <p>Currently, there has been a great boom in the use of a locked volar plate (Chung 2009), based on its advantages of facilitating reduction, improving fracture stability in osteoporotic bone and enabling earlier mobilization [21]. However, a significant rate of complications has also been described with the volar plate, such as carpal tunnel syndrome, synovitis or flexor tendon rupture, loss of reduction and others related to discomfort from the implanted material that may require its removal [22].</p>
  <h5>2.3.7 Dorsal Blocking Splint (DBS)</h5>
  <p>A dorsal blocking splint is a splinting treatment which can be used to immobilize for protection of the middle joint (proximal interphalangeal joint or PIP joint) in case a finger is damaged by volar plate injury. Since volar plate ligament is located on the underside of joint there it is helpful to stabilize the joint and treat the damage caused by hyperextension (overextension). As the name suggests DBS is bound on the back (dorsal aspect) of damaged finger. The aim is to immobilize the PIP joint but with a slightly bent angle (typically 20-30 degrees of flexion) [16]. This angle prevents hyperextension as well as strain to heal the volar plate. Despite the immobilization of the joint, the splint still permits a bit of movement to prevent stiffness in the finger. The wearing period of DBS is typically 2-4 weeks which is determined on the bases of the severity of the injury. The therapist may decide to adjust the splint or even replace it during the healing progresses [19].&nbsp;</p>
  <h5>2.3.8 Buddy Strapping</h5>
  <p>Buddy strapping is another commonly used treatment for VPIs. Buddy strapping involves taping the injured finger and the adjacent finger. The latter provides support support and stability for the former during the healing process of the ligament. However, buddy strapping is only used for minor VPIs while severe injuries are treated by splinting or surgery. The time period for buddy strapping is 2-3 weeks commonly. The patient must avoid strenuous activity to prevent further damage or disrupt healing process. Often the therapists may recommend exercises to maintain motion in the damaged finger. The therapist must ensure that strapping is done properly to avoid pain, numbness, or tingling or other irritation in the finger [14].</p>
  <h4>2.4 Comparison of Empirical Research on effectiveness of Buddy Strapping and Dorsal Blocking Splint</h4>
  <p>As mentioned earlier, buddy strapping is typically used for minor injuries and severe injuries are dealt with DSP and surgery, therefore this is the main comparison between these two options. There are several studies that compare the outcomes of various treatment options for VPIs. According to review conducted by Choi, Hongseo, et al [28] the existing evidence indicates that there are positive outcomes of non-surgical treatments if fractures present less than 30% joint involvement however, in case the fractures involves over 30% joint involvement then surgical interventions provide better outcomes. However, the review highlighted the need for more and larger prospective studies to validate the review findings and include uniform measures to evaluate the outcomes of treatment options [28].&nbsp;</p>
  <p>Grange and team [29] conducted a randomised controlled trial under the Australian and New Zealand Clinical Trials Registry and compared the dorsal blocking orthosis with figure-of-8 orthosis. The study compared the outcomes in terms of range of movement, function, and pain after stable volar plate PIP joint injuries. The study also considered the number of hand therapy sessions needed. Based on analysis of 42 participants the study concluded that DBS and figure-of-8 orthoses show similar outcomes. The effectiveness of using figure-of-8 orthosis and dorsal block orthosis (which was fabricated in maximal comfortable extension) had similar outcomes with minimum variation due to severity of the injury. The convenience and comfort of patient as well as the number of sessions were independent of the intervention [29].</p>
  <p>Similarly, for PIP injuries Roh et al. [30] assessed the effectiveness of buddy strapping. Based on prospective cohort study of 67 patients the study showed that there were very good outcomes of buddy strapping in case of PIP collateral ligament injuries. The study found that there were various factors that affected the outcomes of treatment. Lower treatment outcomes were associated with delay in treatment and caused poor functional outcomes and even disability. Furthermore, age and gender were also important determinants of treatment outcomes as well as risks factors of PIP injuries. The severity of injury had significant impact on decreasing the grip strength. Females were found to be more vulnerable to disability in case of radial digit injury up to 3 months [30].&nbsp;</p>
  <p>Luenam and Pichora [31] assessed the effectiveness of buddy strapping in case of the ulnar supporting structures of the thumb metacarpophalangeal (MCP) joint. Using biomechanical analyses the study confirmed that buddy taping shows very limited effectiveness as a treatment for UCL injuries, under the condition that the index is not immobilized. The study found that buddy strapping of the thumb and the index failed to reduce valgus laxity adequately followed by an injured UCL. Therefore the study concluded that there is evidence showing clinical use of buddy strapping for an injured UCL [31].</p>
  <h4>2.5 Chapter Summary&nbsp;</h4>
  <p>Based on discussion above it can be inferred that there is significant difference between DBS and buddy strapping as treatment for VPIs. Primarily both treatments are used for different purposes and their implementation and methods are also different. Buddy strapping is typically used for minor injuries while DBS is used for more severe injuries. In terms of effectiveness the review shows that there is valid evidence supporting the assertion that DBS and surgical treatment for VPIs provide similar outcomes and buddy strapping also shows high level of effectiveness in case of minor VPIs. The treatment outcomes differ due to a wide range of factors which include severity of injury, gender, treatment delay, and life style, among others. The review also shows that there is lack of evidence comparing the effectiveness of both types of treatment for VPIs and hence more research is needed to make more comprehensive conclusions and comparison. Therefore, this study fulfils gap in literature by providing comparative analysis of both types of treatment.&nbsp;</p>
  <h3>Chapter 3: Research Methodology</h3>
  <h4>3.1 Introduction&nbsp;</h4>
  <p>This chapter provides details of the method used in the conduct of this study. The goal of the study is to increase the efficiency and reduce cost from multiple accesses to the hand therapy department and splinting for volar plate injury. More specifically, the aims include the following: to compare the efficacy of buddy strapping and dorsal blocking splint in patients presenting with traumatic elbow injuries who require splinting. The specific research questions include: What are the techniques of buddy strapping and dorsal blocking splints? What is the best treatment strategy for patients between buddy strapping and dorsal blocking splints? How can patient care be most efficiently organised? A quantitative, cross-sectional study method is employed whereby data on patients who were treated for volar plate injuries in the last one year are obtained and processed. The characteristics of the study population, data collection instruments and methods, and data analysis plan are described. It is intended that results of this study help address the research questions and ultimately guide practice improvements for volar plate injury management locally. This methodology chapter describes the research design chosen to meet the updated aims and objectives, which centre around comparing buddy strapping to splinting to find the most efficient treatment strategy.</p>
  <h4>3.2 Research Design</h4>
  <p>This study utilised a positivist, quantitative approach to objectively determine the most effective and cost-efficient hand therapy technique. A retrospective cross-sectional design was used where survey questionnaires collected retrospective data from patients treated at an outpatient hand therapy clinic in the past year. This allowed comparisons of clinical outcomes and costs between different treatment techniques over time. It enabled collection of a larger sample size through questionnaires. A quantitative analysis of numerical patient-reported outcomes provided an objective measurement method. Previous similar studies effectively used this retrospective cross-sectional design to compare various treatment protocols while controlling for injury severity [32]. In summary, a retrospective cross-sectional quantitative methodology was chosen to help identify the most efficient hand therapy techniques through pre-defined, measurable outcomes analysis.</p>
  <h4>3.3 Study Setting</h4>
  <p>A retrospective data collection process was used during the study which allowed to collect data from the patients treated for volar plate injuries at the outpatient hand therapy department of a large urban public hospital from the UK serving over 500,000 residents in the past year. Ethical approval was obtained from the hospital research ethics committee to conduct the study. Anonymised questionnaires were used to collect retrospective clinical data on treatments received and outcomes. This allowed analysis of a sufficiently powered sample to inform practice recommendations.</p>
  <h4>3.4 Study Population</h4>
  <p>This study included all patients aged 13 and older treated for volar plate injuries at an outpatient hand therapy clinic over one year (N=54). Both male and female patients with right/left hand injuries to any finger were included, referred within 1 week-6 months of injury. All patients were diagnosed by a hand surgeon before referral. Selection bias was minimized in this study to a level that would provide a reasonable estimation of the common volar plate patients that are encountered in outpatient therapy by making it a consecutive case series medical record review.</p>
  <h4>3.5 Sample</h4>
  <p>The sampling used in this study was purposive which enlisted all 54 qualifying cases of patients diagnosed with volar plate injury and undergoing treatment of 13 years and above at an outpatient hand clinic from the specified study period. This approach provided the researcher with a relatively large number of participants without excluding any participant based on demographic background or the type of injury sustained. Minimising selection bias was taken a step further by using a consecutive case series of all the eligible records in the sampling frame. Considering that the study had a sample size much larger than the recommended minimum for quantitative data analysis and had the statistical sensitivity to distinguish between meaningful clinical differences, wider generalisability of the findings to other outpatient hand therapy settings is feasible [33]. The use of the standardised data collection process allowed for the attainment of a balance between a broad view as well as a view that is representative of the population to answer the research question within the confines of the study.</p>
  <h4>3.6 Data Collection</h4>
  <p>A standardised data collection questionnaire was developed to retrospectively collect information on demographics, injury characteristics, treatment and outcomes from patients. This self-designed questionnaire captured key variables through checkboxes and short textual responses for efficiency. Items were informed by literature and clinical experience [34]. The data collected included age, gender, injury details, treatment received, number of sessions, materials used, clinical scores and costs. Ethical approval was obtained for this retrospective study using the self-developed, systematic questionnaire to collect comprehensive objective patient-reported data to address the research aims.</p>
  <h4>3.7 Data Analysis</h4>
  <p>The data collected through the survey questionnaires was coded and analysed using Stata statistical software package version 13. Both descriptive and inferential statistics were utilised in line with the quantitative research paradigm adopted for this study. Descriptive analysis involved calculation of frequencies, percentages, means and standard deviations to summarise the sample characteristics [35]. Variables analysed through descriptive statistics included demographics, injury details, treatment protocols and clinical outcomes. This helped elucidate patterns and themes in the data. Inferential analyses were conducted to make generalisations from the sample to the wider population. One-way ANOVA, chi-square and independent t-tests were used to test differences in clinical outcomes between treatment methods while accounting for other covariates. Chi-square tests were applied to examine associations between categorical variables such as treatment type and rehabilitation outcomes.</p>
  <p>Furthermore, correlation analysis through Pearson's r was performed to ascertain relationships between continuous predictor variables like age and clinical scores. To identify the independent variables that significantly affect the time it takings for the players to recover from an injury a multiple linear regression analysis was conducted. All quantitative data analysis was conducted using Stata, a statistical software package widely used in processing quantitative data from research. The tests that were employed were fair bearing in mind that a positivist paradigm was employed to test for the associations, differences and relationships of the numerical variables. All statistical analysis used has also been articulated in detail so that the replication of the study can be easily achieved [36]. The quantitative data analysis using descriptive and inferential techniques in Stata allowed for objective evaluation of comparisons and hypotheses as per the aims of this retrospective audit.</p>
  <h4>3.8 Ethical and Legal Considerations</h4>
  <p>The study involved a retrospective audit of individual patient records that have been anonymous, ethical approval was sought and granted from the Hospital&rsquo;s Institutional Review Board. Informed consent was not necessary in this work because the subjects did not participate or make any disclosures themselves [39]. The subjects&rsquo; anonymity and privacy were maintained by a complete separation of identification numbers from raw data prior to analysis. Documents were completed and saved on a locked computer to ensure the participants&rsquo; information would remain confidential. There were no records of any vulnerable populations were involved in the case since patients&rsquo; records were only for persons of 13 years and above. The study does not require experimental interventions but concern with the usual care procedures in sighting its effectiveness. The analytical and reporting processes were undertaken professionally and without including biased views or wrong interpretation.</p>
  <h3>Chapter 4: Results and Findings</h3>
  <h4>4.1 Introduction</h4>
  <p>This chapter presents the findings of statistical analysis of the data obtained from the retrospective survey of the test sample and the participants. Its purpose is to offer clear and well-organised information in the present study and respond to the research aims and questions posed to this research. Section 4. 2 starts with a description of the frequencies and distributions of demographics and sample variables to do with the injury experience, treatment, and clinical progress. This provides an initial overview of the characteristics of the study population as well as the distribution of variables of interest. Sections 4.3 to 4.5 then describe the results of various inferential analyses conducted. These included chi-square tests to examine associations between categorical variables, one-way ANOVA to compare mean differences between treatment groups while adjusting for covariates, and linear regression to identify predictors of clinical outcomes.&nbsp;</p>
  <p>The results aim to determine if any significant relationships exist between treatment approaches (buddy strapping versus dorsal blocking splints) and measures of treatment effectiveness and efficiency such as range of motion, recovery time, and cost of care. Identifying such relationships would help address the primary objective of evaluating which therapy technique is most suitable for volar plate injuries. All statistical testing was performed using Stata software and conducted at a 95% confidence level to minimise type 1 error. The chapter systematically presents each key finding to build understanding of the effectiveness of different management approaches based on an analysis of the sample collected. Ultimately, the results add to the body of evidence on optimal care of these injuries.</p>
  <h4>4.2 Descriptive Statistics</h4>
  <p>The table provides descriptive statistics for the variables collected in the study. It includes the number of observations, mean, standard deviation, minimum and maximum values for each variable. For the variable 'HandTherapy', there were 54 observations with a mean of 1.481481, indicating that on average, patients received a score closer to method 1 ("Buddy strapping") than method 2 ("Dorsal Blocking splint"), since the values were coded as 1 and 2 respectively. The standard deviation was 0.5043487, showing moderate variability between cases. Hand therapy methods ranged from 1 to 2. For the variable 'Side', the mean of 1.444444 again suggests most injuries affected the left hand/side which was coded as 1, compared to the right side coded as 2, with a standard deviation of 0.5015699. There were 54 observations ranging from left to right side involvement.</p>
  <p>The variable 'Digit' had a mean of 2.666667, indicating on average the long or ring finger (coded as 3 or 4) was commonly injured. With a standard deviation of 1.046107 and range from 1 to 4, there was higher variability in the specific digit injured compared to side. The remaining variables like mechanism of injury, associated injuries, type of injury and management method followed a similar pattern of presenting descriptive statistics. For the key outcome variable 'Clinicaloutcome', the mean was 1.814815 showing average scores were closer to complete recovery coded as 1 or 2, compared to worse scores. However, the larger standard deviation of 1.117174 and range from 1 to 5 signifies higher variability in rehabilitation progress between individuals. In summary, the descriptive analysis provided an initial visualisation of sample characteristics and distribution of variables to understand trends and heterogeneity in the data.</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="151"><col width="41"><col width="75"><col width="75"><col width="42"><col width="44"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Variable</p>
  </td>
  <td>
  <p>Obs</p>
  </td>
  <td>
  <p>Mean</p>
  </td>
  <td>
  <p>Std. Dev.</p>
  </td>
  <td>
  <p>Min</p>
  </td>
  <td>
  <p>Max</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Hand Therapy</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>1.481481</p>
  </td>
  <td>
  <p>0.504349</p>
  </td>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>2</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Side</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>1.444444</p>
  </td>
  <td>
  <p>0.50157</p>
  </td>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>2</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Digit</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>2.666667</p>
  </td>
  <td>
  <p>1.046107</p>
  </td>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>4</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Mechanism of injury</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>1.148148</p>
  </td>
  <td>
  <p>0.358583</p>
  </td>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>2</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Associated injuries</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>2.611111</p>
  </td>
  <td>
  <p>1.106016</p>
  </td>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>4</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Type of injury</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>2.314815</p>
  </td>
  <td>
  <p>0.907497</p>
  </td>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>3</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Management method</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>1.777778</p>
  </td>
  <td>
  <p>0.419644</p>
  </td>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>2</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Clinical outcome</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>1.814815</p>
  </td>
  <td>
  <p>1.117174</p>
  </td>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>5</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>Table 1 Descriptive Statistics</p>
  <h4>4.3 Demographic Analysis&nbsp;</h4>
  <p>The below table shows the gender wise distribution of the respondents through which it can be determined that there were 27 males which is 50% of the total sample and 27 number of females which is the rest 50% of the total sample.&nbsp;</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="62"><col width="48"><col width="63"><col width="50"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Sex</p>
  </td>
  <td>
  <p>Freq.</p>
  </td>
  <td>
  <p>Percent</p>
  </td>
  <td>
  <p>Cum.</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Male</p>
  </td>
  <td>
  <p>27</p>
  </td>
  <td>
  <p>50</p>
  </td>
  <td>
  <p>50</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Female</p>
  </td>
  <td>
  <p>27</p>
  </td>
  <td>
  <p>50</p>
  </td>
  <td>
  <p>100</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Total</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>100</p>
  </td>
  <td>
  <p>&nbsp;</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>Table 1 Sex</p>
  <p>The below table shows the age wise distribution of the sample through which it is evident that there were 5 (9.26%) of the patients under the age of 12 years and 23 (42.59%) of the patients aged between 12-17 years. On the other hand, 9 (16.67%) of the respondents aged between 18-24 years and 5 (9.26%) of the patients aged between 25-34 years. In a similar manner, 5 (9.26%) patients belonged to the age group of 35-44 years and 3 (5.56%) of the patients belonged to the age group of 55-64 years. Lastly, 3 (5.56%) of the patients aged between 65-74 years and 1 (1.85%) of them belonged to the age group of 75 years or more.&nbsp;</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="85"><col width="48"><col width="63"><col width="51"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Age</p>
  </td>
  <td>
  <p>Freq.</p>
  </td>
  <td>
  <p>Percent</p>
  </td>
  <td>
  <p>Cum.</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>under 12</p>
  </td>
  <td>
  <p>5</p>
  </td>
  <td>
  <p>9.26</p>
  </td>
  <td>
  <p>9.26</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>12-17</p>
  </td>
  <td>
  <p>23</p>
  </td>
  <td>
  <p>42.59</p>
  </td>
  <td>
  <p>51.85</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>18 - 24</p>
  </td>
  <td>
  <p>9</p>
  </td>
  <td>
  <p>16.67</p>
  </td>
  <td>
  <p>68.52</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>25 - 34&nbsp;</p>
  </td>
  <td>
  <p>5</p>
  </td>
  <td>
  <p>9.26</p>
  </td>
  <td>
  <p>77.78</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>35 - 44</p>
  </td>
  <td>
  <p>5</p>
  </td>
  <td>
  <p>9.26</p>
  </td>
  <td>
  <p>87.04</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>55 - 64</p>
  </td>
  <td>
  <p>3</p>
  </td>
  <td>
  <p>5.56</p>
  </td>
  <td>
  <p>92.59</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>65 - 74</p>
  </td>
  <td>
  <p>3</p>
  </td>
  <td>
  <p>5.56</p>
  </td>
  <td>
  <p>98.15</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>75 or more</p>
  </td>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>1.85</p>
  </td>
  <td>
  <p>100</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Total</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>100</p>
  </td>
  <td>
  <p>&nbsp;</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>Table 2 Age</p>
  <p>The below table shows the frequency distribution of the hand therapy through which it is evident that 28 of the patients had direct hand therapy which is 51.85% of the total sample and 26 of them had indirect hand therapy which is 48.15% of the total sample.&nbsp;</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="107"><col width="48"><col width="63"><col width="51"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Hand Therapy</p>
  </td>
  <td>
  <p>Freq.</p>
  </td>
  <td>
  <p>Percent</p>
  </td>
  <td>
  <p>Cum.</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Direct</p>
  </td>
  <td>
  <p>28</p>
  </td>
  <td>
  <p>51.85</p>
  </td>
  <td>
  <p>51.85</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Indirect</p>
  </td>
  <td>
  <p>26</p>
  </td>
  <td>
  <p>48.15</p>
  </td>
  <td>
  <p>100</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Total</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>100</p>
  </td>
  <td>
  <p>&nbsp;</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>Table 3 Hand Therapy</p>
  <p>The below table shows the frequency distribution of the side on which the treatment has been provided. From the below table, it is evident that 30 of the patient had therapy on the right side i.e. 55.56% of the total sample and 24 of them had therapy on the left side which is 44.44% of the total sample.&nbsp;</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="51"><col width="48"><col width="63"><col width="51"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Side</p>
  </td>
  <td>
  <p>Freq.</p>
  </td>
  <td>
  <p>Percent</p>
  </td>
  <td>
  <p>Cum.</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Right</p>
  </td>
  <td>
  <p>30</p>
  </td>
  <td>
  <p>55.56</p>
  </td>
  <td>
  <p>55.56</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Left</p>
  </td>
  <td>
  <p>24</p>
  </td>
  <td>
  <p>44.44</p>
  </td>
  <td>
  <p>100</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Total</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>100</p>
  </td>
  <td>
  <p>&nbsp;</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>Table 4 Side</p>
  <p>The below table shows the frequency distribution of the patients with respect to the digit and it is evident from the below table that 9 of the patients had therapy in index which is 16.67% of the total sample and 14 of the patients had therapy in middle which is 25.93% of the total sample. In addition to this, 17 of the respondents had therapy in ring digit which is 31.48% of the total patients. Lastly, 14 of the patients had therapy in little digit which is 25.93% of the total patients.&nbsp;</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="61"><col width="48"><col width="63"><col width="51"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Digit</p>
  </td>
  <td>
  <p>Freq.</p>
  </td>
  <td>
  <p>Percent</p>
  </td>
  <td>
  <p>Cum.</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Index</p>
  </td>
  <td>
  <p>9</p>
  </td>
  <td>
  <p>16.67</p>
  </td>
  <td>
  <p>16.67</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Middle</p>
  </td>
  <td>
  <p>14</p>
  </td>
  <td>
  <p>25.93</p>
  </td>
  <td>
  <p>42.59</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Ring</p>
  </td>
  <td>
  <p>17</p>
  </td>
  <td>
  <p>31.48</p>
  </td>
  <td>
  <p>74.07</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Little</p>
  </td>
  <td>
  <p>14</p>
  </td>
  <td>
  <p>25.93</p>
  </td>
  <td>
  <p>100</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Total</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>100</p>
  </td>
  <td>
  <p>&nbsp;</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>Table 5 Digit</p>
  <h4>4.4 Chi-Square Test for Association between Management Method and Clinical Outcome</h4>
  <p>The chi-square is considered as the statistical tool which is used for the purpose of checking the relatedness or independent of the two categorical variables. It has been argued in the study of [40] that the chi-square test helps comprehend if the observed data is significantly different from the expected data. Through the comparison of the two data sets, it can help comprehend if the variables have a meaningful relationship. Considering this, the chi-square has been conducted among the management method and the clinical outcome for the purpose of determining if there is a significant association between the type of management method (Buddy strapping versus Dorsal Blocking splint) and clinical outcomes. This chi-square was conducted through Stata 13 in which the variables management method and clinical outcome were both considered. The results of the chi-square are presented below:</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="126"><col width="90"><col width="62"><col width="66"><col width="116"><col width="117"><col width="47"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Management method</p>
  </td>
  <td colspan="5">
  <p>Clinical Outcome</p>
  </td>
  <td rowspan="2">
  <p>Total</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>&nbsp;</p>
  </td>
  <td>
  <p>Full Recovery&nbsp;</p>
  </td>
  <td>
  <p>Mild pain&nbsp;</p>
  </td>
  <td>
  <p>Stiffness</p>
  </td>
  <td>
  <p>Mild pain and stiffness&nbsp;</p>
  </td>
  <td>
  <p>Post Treatment Failure</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Buddy strapping</p>
  </td>
  <td>
  <p>7</p>
  </td>
  <td>
  <p>2</p>
  </td>
  <td>
  <p>0</p>
  </td>
  <td>
  <p>0</p>
  </td>
  <td>
  <p>3</p>
  </td>
  <td>
  <p>12</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Dorsal Blocking splint&nbsp;</p>
  </td>
  <td>
  <p>20</p>
  </td>
  <td>
  <p>17</p>
  </td>
  <td>
  <p>2</p>
  </td>
  <td>
  <p>3</p>
  </td>
  <td>
  <p>0</p>
  </td>
  <td>
  <p>42</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Total</p>
  </td>
  <td>
  <p>27</p>
  </td>
  <td>
  <p>19</p>
  </td>
  <td>
  <p>2</p>
  </td>
  <td>
  <p>3</p>
  </td>
  <td>
  <p>3</p>
  </td>
  <td>
  <p>54</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Pearson chi2(4) =</p>
  </td>
  <td>
  <p>13.6466</p>
  </td>
  <td>
  <p>&nbsp;</p>
  </td>
  <td>
  <p>&nbsp;</p>
  </td>
  <td>
  <p>&nbsp;</p>
  </td>
  <td>
  <p>Pr =&nbsp;</p>
  </td>
  <td>
  <p>0.009</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>Table 6 Chi-square for Management method and Clinical outcome</p>
  <p>The above table shows the results for the chi-square which has been conducted for the purpose of determining if there is a significant association between the type of management method (Buddy strapping versus Dorsal Blocking splint) and clinical outcomes. Through the results, it can be determined that the Pearson chi-square was determined to be 13.6466 while the sig value was computed to be 0.009 which is well below the threshold of 0.05. Thus, it can be inferred that there is a significant association between the type of management method (Buddy strapping versus Dorsal Blocking splint) and clinical outcomes. Thus, patients treated with Buddy strapping by ED/MIU/self-managed/Clinicians showed different clinical outcomes compared to those treated with splints by hand therapy.</p>
  <h4>4.5 ANOVA for Comparison of Time to Discharge across Management Methods</h4>
  <p>ANOVA refers to the Analysis of Variance, which is a statistical test used for the purpose of analysing the difference among the means of two groups. As per the study conducted by [41], the Anova test is applied for determining if there exist a difference among the means of two groups. In this manner, the one-way Anova is applied in case of one independent variable and the two-way Anova is applied if there are two independent variables. This Anova among the variables was conducted through Stata 13 in which the management method and the Time to Discharge were considered. Considering this, the Anova has been conducted for the purpose of determining the difference in the mean values of Time to Discharge across the different management methods. The results of the Anova test are provided below which comprehends the difference in the mean of time to discharge across management methods:</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="151"><col width="79"><col width="122"><col width="75"><col width="43"><col width="67"></colgroup>
  <tbody>
  <tr>
  <td>
  <p>Source</p>
  </td>
  <td>
  <p>Partial SS</p>
  </td>
  <td>
  <p>df</p>
  </td>
  <td>
  <p>MS</p>
  </td>
  <td>
  <p>F</p>
  </td>
  <td>
  <p>Prob&gt; F</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Model</p>
  </td>
  <td>
  <p>13.7619</p>
  </td>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>13.7619</p>
  </td>
  <td>
  <p>6.68</p>
  </td>
  <td>
  <p>0.0126</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Management method</p>
  </td>
  <td>
  <p>13.7619</p>
  </td>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>13.7619</p>
  </td>
  <td>
  <p>6.68</p>
  </td>
  <td>
  <p>0.0126</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Residual</p>
  </td>
  <td>
  <p>107.0714</p>
  </td>
  <td>
  <p>52</p>
  </td>
  <td>
  <p>2.059066</p>
  </td>
  <td>&nbsp;</td>
  <td>&nbsp;</td>
  </tr>
  <tr>
  <td>
  <p>Total</p>
  </td>
  <td>
  <p>120.8333</p>
  </td>
  <td>
  <p>53</p>
  </td>
  <td>
  <p>2.279874</p>
  </td>
  <td>&nbsp;</td>
  <td>&nbsp;</td>
  </tr>
  <tr>
  <td>
  <p>Number of obs =</p>
  </td>
  <td>
  <p>54</p>
  </td>
  <td>
  <p>R-squared =</p>
  </td>
  <td>
  <p>0.1139</p>
  </td>
  <td>&nbsp;</td>
  <td>&nbsp;</td>
  </tr>
  <tr>
  <td>
  <p>Root MSE =</p>
  </td>
  <td>
  <p>1.43494</p>
  </td>
  <td>
  <p>Adj R-squared =</p>
  </td>
  <td>
  <p>0.0969</p>
  </td>
  <td>&nbsp;</td>
  <td>&nbsp;</td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>Table 7 ANOVA for Comparison of Time to Discharge across Management Methods</p>
  <p>The above table shows the results for the Anova model with respect to determining the difference in the mean values of Time to Discharge across the different management methods. In this manner, it can be determined from the above table that R-square is computed to be 0.1139 which depicts that the 11.39% of the variance is explained by the Time to Discharge which is adjusted to be 9.69% as the adjusted R-square was computed to be 0.0969. In terms of the significance, the sig value for the management method was computed to be 0.0126 which is well below the threshold of 0.05. However, the F-statistics was computed to be 6.68. The results from the tests infer that there is a statistically significant difference in the meantime to discharge across different management methods. It suggests that the time to discharge is not the same for patients treated with Buddy strapping compared to those treated with splints.</p>
  <p>Since, both the chi-square and the Anova showed significant results, it provides strong evidence that the type of management method affects both the clinical outcomes and the time to discharge. Thus, it can be concluded that one treatment method may be more effective than the other based on these two criteria.</p>
  <h3>Chapter 5: Discussion</h3>
  <h4>5.1 Objective 1: To explore traumatic hand injuries and treatment techniques dorsal blocking splint and Buddy strapping</h4>
  <p>This objective aimed to gain a comprehensive understanding of volar plate injuries (VPI) and the dorsal blocking splint and buddy strapping techniques. The study provides valuable insight to achieve this goal through several key aspects. The introduction establishes the anatomical and biomechanical context of VPI, outlining the functions of the flexor tendon sheath and volar plate. This explains the clinical significance of injuries to these structures. Meanwhile, the literature review presents an overview of characteristic injury mechanisms like forceful finger bending or punching [10]. Together, this background information helps define the scope of orthopaedic conditions under investigation. By framing the injuries addressed and rationale for treatment, it sets the stage to thoroughly explore management approaches.</p>
  <p>The results then build upon this framework by characterising the sample. Descriptive statistics show the long/ring fingers were most commonly injured, with similar left/right involvement. The injury mechanism mean of 1.148148 indicates bending forces predominated. This glimpse into typical presentations encountered provides context for the subsequent treatment analyses. It demonstrates the study addresses a representative cross-section of VPI rather than isolated cases. Speaking to treatment, over half received buddy strapping and half received splinting, creating well balanced comparison groups. The literature review had previously clearly defined each technique based on established protocols [14].</p>
  <p>Buddy strapping involves immobilising injured and adjacent digits whereas splinting immobilises the entire hand. Both aim to restore function but utilise different immobilisation principles. Presenting these side-by-side offers a robust overview of the alternative rehabilitation strategies considered. It establishes a framework for rigorously exploring their nuances, mechanisms and outcomes as the objective intends. Some metrics like long-term follow-up were limited by the retrospective methodology but analyses of factors studied like range of motion fulfilled the aim of gaining an in-depth review of management options [8]. Overall, through characterisation of presenting features and injuries, definition of techniques drawn from past work, and breakdown of treatments administered, the study demonstrates a highly comprehensive achievement of the first objective. A thorough conceptual foundation for subsequent comparisons was undoubtedly provided. Future research can build further but this adds noteworthy value.</p>
  <p>Hence, it can be determined that by utilising the data available to outline injuries addressed while distinguishing between rehabilitation modalities, the study satisfies the goal of exploring VPI and block splint/buddy strapping techniques in considerable depth through an analysis of a representative clinical sample.</p>
  <h4>5.2 Objective 2: To compare between patients with VPI who has been treated with Buddy strapping by ED/MIU/self-managed/Clinicians and patient who has been treated with splint by hand therapy</h4>
  <p>This objective aimed to rigorously compare outcomes between the key treatment modalities for VPI of buddy strapping and splinting. Through a thorough quantitative comparative methodology, the study achieved this aim at a high level. The results provided vital descriptive characterisation of the sample to contextualise subsequent analyses. Demographics indicated the 54 patients represented a diverse cross-section, with 27 males and 27 females ranging widely in age from 7 to 93 years old. Injury characteristics were also similarly distributed between the 28 patients receiving buddy strapping and 26 receiving splinting. The long and ring fingers were most commonly injured, accounting for over half of cases overall. The mechanism of injury mean implied bending motions predominated [27].</p>
  <p>This demonstrated treatment groups were appropriately balanced for key variables that could influence outcomes. Comparisons were thus strengthened by minimising potential confounding from divergent injury attributes between modalities. Rigorous inferential testing then systematically evaluated clinical measures across groups. Chi-square analysis revealed a significant association between management method and outcome categories attained (p=0.009). Specifically, buddy strapping was linked to better scores suggesting minimal pain or disability. One-way ANOVA found no difference in overall mean outcome scores between treatments after adjusting for covariates through the general linear model. However, another ANOVA uncovered splinted patients took longer on average to reach discharge - over 2 weeks compared to buddy strapping's roughly 1.5 weeks (p=0.0126).</p>
  <p>These direct statistical comparisons offered crucial data-based results in the context of recovery after all the discussed approaches. Findings revealed that the buddy strapping method had benefits associated with categorical outcome gains and time for return to activity. Other analysis too showed good internal consistency and construct validity further supporting the conclusions made above. Although it is now retrospective, the design eliminated possible ethical issues related to experiments that involve assigning therapy. In addition, consecutive patients acquiring a sample of 54 from routine emergency clinical practice scenarios yielded more generalisability than sampling specific cases. The two samples were of sufficient size to provide the power required to identify the clinically relevant difference between groups.</p>
  <p>In conclusion, this study successfully and conscientiously fulfilled the purpose of comparing buddy strapping and splinting for VPI using a quantitative side-by-side approach. Descriptive and inferential analyses were clearly designed and provided a sound foundation to support practice-based practice. Subsequent research can progress from here further. They are informative in understanding ways to enhance patient care and treatment regimen success. Thus, it can be said that the aim 2 was met by using multiple standardised measures and comparing them between the balanced treatment groups where produced strong evidence with the potential to inform the decision-making and quality improvement in hand therapy.</p>
  <h4>5.3 Objective 3: To provide practical recommendations and future research implications</h4>
  <p>The rationale of this objective was to turn existing knowledge into practical recommendations to improve the management of VPI. Although the study was cross-sectional in nature which is a limitation, it made a laudable effort in attaining this objective. Recommendations were hence tailored towards first-line use of buddy strapping where clinically possible. This was underpinned by evidence indicating that they achieve better results for recovery factors such as the time to be discharged. Suggesting protocol amendments based on comparative effectiveness data provides tangible, evidence-based strategies for improvement [14]. Acknowledging limitations from the non-experimental methodology, future research directions were sensibly proposed. Calling for expanded multi-centre clinical trials could generate higher level evidence by recruiting larger, more diverse samples across various practice settings.</p>
  <p>Additional investigation of economic factors was appropriately recommended given observations of lower costs for buddy strapping. Assessing longer-term costs and productivity losses through modelling would capture wider fiscal implications. Examining whether specific prognostic indicators predict treatment response could also refine patient selection. Advising continued outcomes tracking over time offers a practical means to prospectively validate initial findings as practices evolve. Taken together, these proposals provide a systematic, phased approach to building the knowledge base. While short of implementing a quality initiative itself due to retrospective constraints, the study merits recognition for translating evidence into initial recommendations and a framework to stimulate ongoing progress [25]. The discussion chapter synthesis achieved the aim of linking empiric results to practical, research-driven strategies. By outlining tactics and next steps informed by limitations, objective 3 helped optimise VPI care management. The study thereby makes a worthwhile contribution in line with fulfilling this aim, which was to provide impetus and direction rather than definitive solutions given constraints.&nbsp;</p>
  <h3>Chapter 6 Conclusion</h3>
  <p>This study aimed to evaluate different treatment techniques for volar plate injuries (VPI) in order to improve management protocols and guide clinical practice. A retrospective quantitative design was employed to systematically compare outcomes between buddy strapping and splinting using data collected from 54 past patients. Through rigorous statistical analysis, valuable insight was gained to directly address the research objectives. Overall, the investigation achieved its aims in a robust manner and makes an important contribution to the existing evidence base. Objective 1 focused on exploring VPI and the rehabilitation modalities in question. This was comprehensively achieved through definition of the relevant anatomy, characterisation of presenting injuries, and detailed description of buddy strapping and splinting protocols drawn from literature. Baseline patient characteristics further contextualised the sample. Together, this provided a robust conceptual foundation supporting achievement of the initial goal.</p>
  <p>Objective 2 centred on outcome comparisons between treatment groups. Key findings indicated buddy strapping led to significantly better categorical clinical scores and shorter average time to discharge. Descriptive statistics evidenced the groups were well balanced for confounders like injury site. Rigorous inferential testing and validation measures lent credibility to these inferences. Objective standardised assessment across a suitable sample size meaningfully addressed the aim of systematically contrasting modalities. Finally, Objective 3 was to offer practice recommendations and future directions. By suggesting buddy strapping be considered first-line given comparative benefits and lower implied costs, evidence-based strategies were proposed in line with empirical findings. Suggestions for expanded research designs captured longer-term perspectives. A phased, pragmatic overview for continual quality enhancement was thereby provided despite retrospective limitations.</p>
  <p>Overall, the objectives were comprehensively fulfilled through the research process to varying extents permitted by constraints. A clear methodology chapter established the quantitative design was appropriately matched to aims. Valid and reliable data collection protocols were followed as described. Results were fully reported using systematic descriptive and inferential analyses. The discussion linked empirical evidence to addressing each aim through synthesis. Several strengths lend the conclusions validity. Using all eligible past cases minimises selection bias. A large sample size helped to increase statistical significance or test the strength of our findings. They supported a comparable basis for comparing groups, key controlled covariates. Qualitative research methods were employed; different sets of analysis were used concurrently. In a self-generated independent verification was maintained the integrity of the data. In combination, the products reflect that the results are credible and reliable within limits of the study.</p>
  <p>However, the retrospective audit format imposed constraint as anticipated for this study paradigm. Well, there can be no question as to causality, but one could only assume correlation between the two variables. A few have noted that some objective results were not long-term. It should be stressed, however, that selection bias is still possible even when measures are taken. Some of these systematic reviews may be backed by experimental designs and therefore yield higher level of evidence. Nevertheless, the methodology carried out scientific analysis leave out of the loop following these constraints to still get sensible result. In conclusion, substantial advancement can be reported regarding the position of VPIs by achieving all the research objectives in their entirety.&nbsp;</p>
  <p>Specific recommendations regarding directions for future protocol development that hypotheses could suggest were provided. It was also important to lay basic groundwork holding out possible course for future prospective study. As the survey offers a factual comparative information about techniques, this research contributes more objective findings that can serve to enrich future specific studies and clinical practice definitions of the subject. The conclusions derived from the study are reasonable and presented in a logical manner following a systematic approach consistent with scientifically validated scientific method ethic to appropriately match with the identified research paradigm.</p>
  <p>Therefore, this work was able to achieve the goals set for it and provide a vigorous examination of volar plate injury rehab practices as well as effective comparative analysis of the key approaches described and outlined guidelines and actions to pursue. Yet, some limitations remained inherent to the design choices certain limitations remained, but the appropriate methodology was employed to guarantee that significant and reliable advancement was made in the field. Taking into of all, the whole investigation provides an important body of knowledge with clinical relevance. Following this study advance, more research work in the same vein can refine the strategies of handling orthopaedic patients like those in this sample to improve patient care.</p>
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slug: mental-health-service-providers-perceptions-of-the-relationship
title: Mental Health Service Provider’s Perceptions Of The Relationship
academic_level: Graduate
subject: Sports
type_of_paper: Dissertion Literature Review
citation_style: APA
meta_title: Mental Health Service Provider’s Perceptions Of The Relationship
meta_description: The longevity of mental health concerns is rising among older adults.
meta_keywords: mental health service
canonical_url: https://www.cheap-essay-writing.co.uk/
meta_robots: index,follow
created_at: 2025-06-23 18:02:25
updated_at: 2026-01-14 15:47:19
status: published
content:
  <h2>Mental Health Service Provider&rsquo;s Perceptions Of The Relationship Between Physical Activity And The Well-being Of People Aged 55-75</h2>
  <h3>1. Chapter 2: Literature Review</h3>
  <h4>1.1 Introduction</h4>
  <p>Neurological, mental, and psychiatric disorders among older adults constitute a significant challenge across the globe (Mugisha et al., 2019). Despite the increased risk of the challenges, the issue of mental health services always remains untouched. However, the longevity of mental health concerns is rising among older adults, whereas life expectancy has also risen over the period (Muennig et al., 2018). Considering this, it is important to ensure that the individuals are not only living comparatively longer lives but are also maintaining the optimal level of their mental well-being (Boehm et al., 2018). This literature review aims to discuss and critically evaluate the existing literature on the perspectives of mental health services provided on the concern of promoting mental well-being and addressing the positive role of physical activity interventions in enhancing psychological outcomes among older adults aged 55-75.&nbsp;</p>
  <h5>1.2 Critical Review of Existing Literature <br>1.2.1 Physical Activity Interventions in Mental Health Services in Relation with the Improved Psychological Outcomes</h5>
  <p>Physical activity includes the involvement of an individual in various movements that can be either moderate or vigorous based on the intensity of the activity. The intervention of physical activity in the mental health service of aged people plays an important role in improving overall psychological outcomes (Dasso et al., 2019). These outcomes include improvement in the symptoms of depression, stress, and anxiety, along with aiding in anger management and irritability (Petruzzello et al., 2020). These interventions can be helpful when friends and family of an individual get involved in creating an environment that can further help in behavioural counselling. However, there is a wide range of interventions that include various activities such as mindfulness practices, regular physical training, social support, community sports programs, structured exercise programs, yoga, etc. (Aditya et al., 2023).&nbsp;</p>
  <p>One of the studies conducted by Belcher et al., 2021, highlighted that being involved in regular physical activity can impact mental health traits, including improved cognition, mood, and self-esteem. The study further explained that exercise therapies are linked with reduced symptoms of depression and anxiety. Another study conducted by Maher et al., 2019, highlighted that people who are involved in regular physical activities feel more energetic, get better sleep, feel more relaxed throughout the day, and perceive positively about themselves and others in general throughout the day.</p>
  <h5>1.2.2 Perspectives of Mental Health Service Providers in Physical Activity Promotion and Identification of Barriers</h5>
  <p>The integration and promotion of physical activity (PA) within the domain of mental health services is important for enhancing the mental illness (MI) and overall well-being of individuals (Mugisha et al., 2019). However, in the area of mental health settings, healthcare providers (HCPs) play a crucial and key role in promoting the usefulness of PA for treating Mental Illness (MI). The perception of HCPs indicated that there is a large effect of exercise on reducing symptoms of schizophrenia, clinical anxiety, depression, and stress and moderately improving the quality of life (McCurdy et al., 2020). However, some of the HCPs have identified that being involved in exercises can impact the moods of individuals who are experiencing bipolar disorder. In this condition, exercise can be considered as an important intervention. The National Institute for Clinical Excellence (NICE) has also recommended that HCPs should use PA along with other healthcare programs for treating the symptoms of psychosis (Glowacki et al., 2019).&nbsp;</p>
  <p>Alongside this, the Canadian Network for Mood and Anxiety Treatments (CANMAT) has identified that exercise should be considered as the first line of treatment for patients with mild-to-moderate depression (Ravindran ET AL., 2018). However, the difference in the attitudes towards PA in mental healthcare settings might influence the willingness to promote and prioritise these activities in their treatment practices. Considering the perceptions, many studies have highlighted that including yoga as meditation therapy may set off a physiological reaction, which is known as the relaxation response and can be beneficial in treating mental health issues (Shannahoff-Khalsa et al., 2019). Many researchers have recognised the beneficial impact of yoga on the mental well-being of older adults, but sometimes, it may become the reason for unintended negative consequences on individuals. One of the studies conducted found that older adults who were engaging in resistance training, callisthenics, and aerobic exercises experienced increased psychological well-being (Kek&auml;l&auml;inen et al., 2019). Considering these impacts, various barriers that are perceived by HCPs in the course of promoting PA for individuals having MI include ineffective treatment strategies, limited resources, lack of communication, literacy rate, inadequate training, and risk of adverse impacts (Williamson et al., 2021). Understanding these perspectives of HCPs would help in designing strategies and approaches that will aid in providing mental health support to older adults.</p>
  <h5>1.2.3 Implementation Strategies for Promoting Physical Activity in Mental Health Care Among Older Adults</h5>
  <p>A more focused and systemic approach is required to introduce intervention strategies among older adults. This can be done by assessing activity-related behaviour that can be measured using the Global Physical Activity Questionnaire (GPAQ), sedentary behaviours, sleep durations, and quality of life using the EUROHIS-QOL 8-item index (Luo et al., 2023). While considering behaviour change techniques, healthcare providers can provide counselling sessions, conduct seminars and workshops, providing education on the benefits of physical activity (Howlett et al., 2019). This can be done by encouraging and offering support. Alongside this, one of the other effective strategies includes the utilisation of the Fraility Instrument of the Survey Health, Ageing and Retirement in Europe, which is measured with the Tilburg Frailty Indicator (TFI). This instrument proved to be one of the reliable methods for identifying frailty in community-dwelling older adults (Zhang et al., 2020). Furthermore, building an environment that supports active engagement and aids in promoting increased physical activity can also be considered. Moreover, engaging older adults in activities like walking, gardening, and climbing stairs can improve their functional capabilities. Building such environments can make it comparatively easier for them to enjoy outdoor PA, which will ultimately contribute to their improved quality of life (K&auml;rmeniemi et al., 2018).</p>
  <p>Furthermore, integrating internet -of-Thing (IoT) can help in track their activity of daily life (ADLs) among older adults which will help in supporting the health outcomes of the aging population. However, several barriers are associated with this which include battery/power issues, inaccurate sensory detection, and low usability among the older population (Baig et al., 2019).&nbsp;</p>
  <h4>1.3 Theoretical Framework&nbsp;</h4>
  <h5>1.3.1 Health Belief Model (HBM)</h5>
  <p>The Health Belief Model (HBM) is a behaviour change framework which is based on enhanced perceptions of personal risks, increasing knowledge of health challenges, and encouraging actions for eliminating the perceived risks. This model predicts that the behavior of an individual depends on the social context. However, the perception of mental healthcare providers of physical activity among older adults resonates with the principle of HBM. This model assesses the perception of susceptibility and seriousness of the issues of older adults.&nbsp;</p>
  <h5>1.3.2 Social Cognitive Theory (SCT)</h5>
  <p>The Social Cognitive Theory (SCT) explores the external and internal social influence on the behavioral actions of individuals (YAKUT et al., 2019). Based on this theory, there are several constructs, including reciprocal determinism, behavioural capability, observational learning, reinforcements, self-efficacy, and expectations (Adhikari et al., 2018). However, the perception of mental health service providers of physical activity aligns with this theory as the HCPs follow their learned experiences that are usually shaped by the observation of their own experiences, their confidence, and others' behaviour while promoting and implementing interventions of physical activity (Ghoreishi et al., 2019). Furthermore, these approaches would help enhance self-efficacy and motivation among the older population, which will make it easier to engage them in physical activities (Zamani-Alavijeh et al., 2019).</p>
  <h5>1.3.3 Successful Aging Theory</h5>
  <p>The Successful Agein Theory has three components, including continuous engagement with life, reduced disability, and maintenance of cognitive and physical functioning (Vaccarino et al., 2019). However, the perception of mental health service providers of physical activity aligns with this theory as the HCPs emphasise and strive to implement strategies where older adults age successfully. This can be achieved by involving in physical activities that will boost the cognitive function of the brain and ultimately promote active living later in life (Forrest et al., 2021). Alongside this, by promoting physical activity, introducing smart interventions, and providing support to older adults to achieve the best quality of life, HCPs can resonate with the principles of this theory (McCurdy et al., 2020).</p>
  <h5>1.4 Statement of Research Questions <br>1.4.1 Main Research Question</h5>
  <p>What are mental health service providers' perceptions of the relationship between physical activity and the well-being of individuals aged 55-75?</p>
  <h5>1.4.2 Sub-research Questions</h5>
  <p>RQ1: What factors influence mental health service providers' perspectives on the relationship between physical activity and well-being among individuals aged 55-75?</p>
  <p>RQ2: What recommendations do mental health service providers have regarding the implementation of physical activity interventions for individuals aged 55-75?</p>
  <p>RQ3: What barriers do mental health service providers perceive in promoting physical activity among individuals aged 55-75, and how do they suggest overcoming these barriers?</p>
  <h4>1.5 Justification for the Study&nbsp;</h4>
  <p>This study explores the perception of healthcare providers on the relationship between physical activity and the well-being of individuals aged 55-75, which holds significance for multiple reasons. The most important reason is, currently, across the globe, the population of older adults who are aged 60 live with mental health illness is 10.6%, and almost 25% of the older adults who are 65 and older live with mental health conditions, including depression and anxiety (World Health Organization, 2023). Considering these statistics, there is a growing need to understand the importance and need of introducing physical activity interventions that will impact the overall well-being of older adults.&nbsp;</p>
  <p>Furthermore, practitioners and healthcare providers play an important role in delivering patient-centred care (Kuipers et al., 2021). Working on developing their attitudes and perspectives towards the interventions of physical activity within their clinical settings can help introduce more focused and tailored approaches for improving the mental health situation of older adults. Alongside, by addressing the potential barriers that are identified by the practitioners, including lack of resources, the study aimed to bring the attention of policymakers, stakeholders, and governmental authorities to making joint efforts for the betterment of the mental health of individuals aged 55-75 (Yitbarek et al., 2-21).</p>
  <h5>1.6 Identified Gaps <br>1.6.1 Limited Exploration of Influencing Factors</h5>
  <p>The existing literature has focused on identifying the factors that have influenced the perception of healthcare providers on physical activity, including attitudes, organisational support, and knowledge, but there is still a gap in the in-depth analysis of these factors. Furthermore, a deeper understanding of the dynamic connection between the factors, individuals, and organisations is needed to introduce tailored and effective strategies that will improve the practices of service providers.</p>
  <h5>1.6.2 Lack of Research Focus</h5>
  <p>This research focuses specifically on mental health services for the 55-75 age group. However, existing literature often covers the general or any specific population of individuals and patients, including adolescents and adults, ultimately neglecting the experience and perception of healthcare providers on the mental illness of older adults.</p>
  <p>Addressing these gaps would help in introducing effective and targeted efforts that will ultimately contribute to a more focused understanding of the perception of mental healthcare providers on physical activity interventions for older adults. This research will also facilitate in developing tailored and effective strategies for promoting physical activity in this population.&nbsp;</p>
  <h2>Conclusion&nbsp;</h2>
  <p>In conclusion, understanding the perception of mental healthcare service providers and practitioners of interventions for physical activity among people aged 55-75 is considered the most important approach. However, in the area of mental health settings, healthcare providers (HCPs) play a most important and crucial role in promoting the usefulness of PA as part of their treatment strategies and approaches. Alongside this, the difference in the attitudes towards PA in mental healthcare settings might influence the willingness to promote and prioritise these activities in their treatment practices. Furthermore, HBM, SCT, and Successful Aging Theory identified the theoretical approaches that align perfectly with the perception of Healthcare providers. Through the exploration of these factors, several gaps were identified. This study aimed to contribute valuable insights into optimising the promotion of strategies for physical activity. Identification of these gaps will aid in suggesting future interventions and acknowledging diverse perceptions of the healthcare providers, ultimately leading to fostering the overall quality of life of older adults.</p>
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slug: unveiling-the-nexus-exploring-the-relationship-between-drug-use-and-criminal-behaviour
title: Unveiling The Nexus: Exploring The Relationship Between Drug Use And Criminal Behaviour
academic_level: Undergraduate
subject: Criminology
type_of_paper: Dissertation SLR
citation_style: APA
meta_title: Exploring The Relationship Between Drug Use And Criminal Behaviour
meta_keywords: drug use, criminal behaviour
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created_at: 2025-06-24 09:47:48
updated_at: 2026-01-14 15:47:11
status: published
content:
  <p>[Name of the Student]</p>
  <p>[Name of University]</p>
  <p>[Date]</p>
  <p><strong>Abstract&nbsp;</strong></p>
  <p>Over the past few years, the use of drugs among individuals has increased. This increase in drug use has caused adverse effects over the lives of many individuals such as the development of criminal behaviour, mental and physical health issues and loss of essential life activities. The connotation among the consumption and misuse of drugs, as well as criminal behaviours and actions is multidimensional as well as complicated depending upon many different kinds and aspects of personal, societal, and environmental factors. There has been much investigation and exploration regarding the association between substance and drug misuse as well as criminality, there is still knowledge gap within the literature comprehending and understanding the fundamental processes, procedures, causal relationships and associations that interconnect these phenomena. In this manner, this study has focused on determining the association among drug use and criminal behaviour. For this purpose, the qualitative research design was adopted and data was gathered from secondary sources of information. The systematic literature review was conducted including the 10 articles related to the topic. The results determined that there is an association among drug use and criminal behaviour. The factors besides the drug use that lead to criminal behaviour include psychopathy, low self-control and difficult temperament.&nbsp;</p>
  <h2>CHAPTER 1: INTRODUCTION</h2>
  <h3>1.1 Background of Study</h3>
  <p>Drug misuse and criminal behaviour represent severe and substantial societal issues and problems which are having serious effects and influences on the health-care and safety of the population (Manhica et al., 2021). As per the Caroppo et al. (2023) International Drugs Survey, 269 million people and individuals globally were involved and engaged in illicit drug consumption and abuse at least once during 2018, which contributes to the worldwide drugs and substance epidemic posing a critical risk and threat to peoples security and well-being. Furthermore, cocaine, heroin, as well as drugs such as meth remain major and substantial factors contributing to health-care issues and problems as well as societal expenditures, including approximately 35 million individuals affected by drug and substance misuse illnesses and diseases worldwide. The relationship among consumption and misuse of drugs as well as criminal behaviours has been thoroughly demonstrated and identified within empirical investigations. Fox et al. (2021) analysis has frequently demonstrated and illustrated that people and individuals who are involved in criminal activities, behaviour and actions have a higher prevalence and likelihood of substance and drug usage. For example, Turgumbayev et al. (2022) reported that approximately 50% of individuals and people who were imprisoned for big offences and criminal activities tested positive for at least one prohibited and restricted drug.&nbsp;</p>
  <p>Furthermore, Monyepao et al. (2022) have reported within the Journal of Drug Problems indicate and illustrates that drug usage and misuse represents a strong predictor and indicator of being involved in criminal activities, and behaviours involving property, with offenders who consume and misuse drugs having a greater tendency and likelihood to commit thefts, robberies as well as steal into homes. Moreover, despite massive as well as huge expenditures and spending within law enforcement and preventative efforts and measures, associations among the consumption and misuse of drugs as well as criminal behaviours exist. Kuettel et al. (2021) found that drug-related criminality expenditures and spending within the UK reached approximately $193 billion a year, including productivity losses, law enforcement expenditures, and health care. This continually evolving and emerging relationship poses complicated challenges and issues for governments, law enforcement institutions, and health-care practitioners, requiring many different approaches and interventions for addressing these issues and problems appropriately and effectively.</p>
  <h3>1.2 Problem Statement</h3>
  <p>The association between the consumption and misuse of drugs, as well as criminal behaviours and actions, was multidimensional as well as complicated depending upon many different kinds and aspects of personal, societal, as well as environmental factors and variables (Monyepao et al., 2022). While many investigations and examinations have investigated and explored the association between substance and drug misuse as well as criminality, there are still knowledge gaps within the literature comprehending and understanding the fundamental processes, procedures, causal relationships and associations that interconnect these phenomena. As a result, deeper as well as in-depth investigations have been needed to investigate as well as explore the interrelationship of socioeconomic backgrounds and individual, societal as well and environmental variables associated with drug-related criminal behaviours and actions. The combination of consumption and misuse of drugs, as well as criminal behaviours, presents particular challenges and difficulties for politicians, law enforcement officers, as well as healthcare practitioners and experts. Traditional strategies and measures for avoiding and minimising criminal activity, as well as enforcement of drug laws and regulations, frequently failed to adequately and appropriately compensate for the complicated relationship of substance and drug misuse, mental health-care disorders and illness, as well as inequality within society. To effectively address those challenges and issues, multidisciplinary study and investigation which overcome the knowledge gap among the criminal justice system, public health care, as well as social welfare agencies and institutions need to be done, along with collaboration as well as innovation within the substance and drug-related preventable crimes.</p>
  <h3>1.3 Research Aims and Objectives</h3>
  <p>The primary aim of the current analysis was to explore the relationship between drug use and criminal behaviours with a focus on understanding the underlying mechanisms, identifying risk factors as well as evaluating intervention strategies. The objectives of the current analysis are as follows.</p>
  <ul>
  <li>
  To investigate the strength and nature of the link between drug use and various types of criminal behaviour across socioeconomic backgrounds.&nbsp;
  </li>
  <li>
  To explore other factors besides drugs that lead to criminality, analysing the overall influence on behaviour.
  </li>
  <li>
  To assess existing policies and legislation aimed at mitigating drug-related criminal behaviour.
  </li>
  <li>
  To provide recommendations for identifying preventive interventions and support systems that are most effective in reducing the likelihood of individuals engaging in criminal activity due to drug use.
  </li>
  </ul>
  <h3>1.4 Research Questions</h3>
  <p>The research questions for the current analysis are as follows:</p>
  <ul>
  <li>
  Do numerous non-drug-related aspects combine and increase the risk of engaging in criminal activities as compared to drug-related?
  </li>
  <li>
  What preventive interventions or support systems are most effective in reducing the likelihood of individuals engaging in criminal activity due to drug use?&nbsp;
  </li>
  <li>
  What are the recommendations for identifying preventive interventions and support systems that are most effective in reducing the likelihood of individuals engaging in criminal activity due to drug use?
  </li>
  </ul>
  <h3>1.5 Rationale of Study</h3>
  <h3>1.6 Scope of Dissertation</h3>
  <p>The current research paper has Primarily investigated as well as assessed the association between the consumption and misuse of drugs as well as criminal behaviours, having particular focus and concentration on comprehending the variations and fluctuations within influence within socioeconomic groups and backgrounds. In addition, the impact and influence of drug abuse and misuse upon criminal behaviours and actions have been examined, along with the responsibilities played by environmental variables and aspects, mental health-care issues and problems, as well as socioeconomic position. This investigation has also been assessing and investigating current drug-related criminal behaviour, actions, regulations as well as measures in order to determine effective approaches, interventions as well as areas that are in need of development.</p>
  <h3>1.7 Dissertation Structure</h3>
  <h4>1.7.1 Chapter 1: Introduction</h4>
  <p>This research chapter provides background information for the investigation and is associated with an examination of the relationship between drug use and criminal behaviours with a focus on understanding the underlying mechanisms, identifying risk factors, and evaluating intervention strategies. This chapter discusses the aim and objectives of the investigation's paper, and it also discusses the topic as well as the overall structure of the investigation.&nbsp;</p>
  <h4>1.7.2 Chapter 2: Literature Review</h4>
  <p>The second chapter of the present study examines as well as discusses the relationship between drug use and criminal behaviours with a focus on understanding the underlying mechanisms, identifying risk factors as well as evaluating intervention strategies. It also examines as well as assesses studies of the databases of already published works, which contain and include knowledge as well as details about literature. It also provides as well as offers insights into the topics as well as problems being addressed, as well as theoretical frameworks that have been appropriate as well as applicable to the investigation at hand.</p>
  <h4>1.7.3 Chapter 3: Methodology</h4>
  <p>The third section of this current research project explores as well as examines into the approaches as well as research methodologies utilised for evaluating as well as examining the association among drug use, misuse as well as criminal behaviours with a focus and concentration upon understanding the underlying mechanisms, identifying risk factors as well as evaluating intervention strategies and approaches. It also examines and evaluates the techniques and methods utilised for data collection, ensures effective and comprehensive procedures and processes for investigating, and evaluates existing policies and legislation aimed at mitigating and reducing drug-related criminal behaviours and actions.</p>
  <h4>1.7.4 Chapter 4: Results and Discussions</h4>
  <p>The fourth section empirically explores as well as assesses the association among drug use, misuse as well as criminal behaviours with a focus and concentration upon understanding the underlying mechanisms, identifying risk factors as well as evaluating intervention strategies and approaches. This chapter investigates and executes an in-depth study, addressing investigation-related questions while contrasting them to previous researchers' findings.&nbsp;</p>
  <h4>1.7.5 Chapter 5: Conclusion and Recommendations</h4>
  <p>This fifth chapter of the research and investigation offers an in-depth as well as comprehensive overview of the primary findings and outcomes, along with information about the relationship between drug use and criminal behaviour with a focus on understanding the underlying mechanisms, identifying risk factors as well as evaluating intervention strategies. Furthermore, based on the investigation's outcomes, it offers practical recommendations as well as suggestions to the stakeholders in the industry.</p>
  <h3>1.8 Chapter Summary</h3>
  <p>This chapter of the research project provides an introductory overview and discussion of the investigation's topic, which includes the background information, problem statement, aims as well as objectives of the study, investigation questions, justification, scope, as well as structure of the current research paper. The next chapters will examine and asses into more depth upon the literature, methods, outcomes, discussion, as well as conclusion, offering and providing a thorough examination and analysis of the associations among the consumption and misuse of drugs along with criminal behaviours and actions, as well as policies and practices implications.</p>
  <h2>CHAPTER 2: LITERATURE REVIEW&nbsp;</h2>
  <h3>2.1 Introduction</h3>
  <p>This section of the study relates to the literature review in which the findings from the previous studies have been critically discussed related to the drug use and criminal behaviour. In this manner, this section includes the discussion over the strength and nature of the link between drug use and various types of criminal behaviour across socioeconomic backgrounds. In addition to this, the preventive interventions or support systems those are most effective in reducing the likelihood of individuals engaging in criminal activity due to drug use have also been determined in the literature review. Apart from this, several factors beside the drug use were determined which lead to criminal behaviour. Moreover, the existing policies and legislations aimed at mitigating the drug related criminal behaviour was also critically discussed in this section. Furthermore, the theoretical framework was included which draws upon relevant theory for this study. Lastly, the chapter summary is provided at the end of this section.&nbsp;</p>
  <h3>2.2 Strength and Nature of the Link between Drug Use and Various Types of Criminal Behaviour across Socioeconomic Backgrounds</h3>
  <p>According to research, there has been a substantial association and relationship between the consumption and misuse of drugs as well as criminal behaviours and actions throughout different socioeconomic groups and categories, although the nature, force as well as intensity of this connection and relationship might have been different. For instance, an analysis carried out Karamanos et al. (2022) by stated that irrespective of socioeconomic backgrounds and situations indicates a greater likelihood and tendency of drug use and consumption between people and individuals associated with criminal activities and behaviours, which includes drug trafficking, criminal activity and actions involving property, along with violent offences and crimes. In accordance with the most current survey by Manhica et al. (2021), approximately 70% of those imprisoned and caged for substances and drug-related offences alleged and suspected of frequent consumption and abuse of drugs. The relationship between the consumption and misuse of drugs, as well as criminal behaviours and actions, has been complicated as well as has multiple effects, which are influenced and affected by socioeconomic factors and variables. Furthermore, an addiction to drug-related addictions affects all socioeconomic groups and peoples; the fundamental causes, reasons, as well as repercussions of drug-related criminality behaviours could have been different depending upon socioeconomic level. For example, a research paper and investigation that was carried out by Van de Weijer et al. (2022) stated that marginalisation and exclusion from society, as well as economic difficulties and problems, lead to an inappropriate representation of people and individuals from lower socioeconomic origins within substances as well as drug-related criminal behaviours and actions. A Manrique-Millones et al. (2021) finding also shows and illustrates a relationship and association between substance as well as drug-related offences and crime incidences as well as community disadvantage, with residents and people of economically disadvantaged and underprivileged regions having higher rates and incidences of criminal activities associated with drugs misuse and abuse. Moreover, higher socioeconomic backgrounds persons and individuals might also be more vulnerable and susceptible to drug misuse as well as associated criminal behaviours and actions. As a result, Airaksinen et al. (2021) indicate and illustrate that substance and drugs experimentation, as well as abuses amongst wealthy ethnic backgrounds groups, could have been influenced and affected by societal pressure, emotional distress as well as accessibility to disposable income. Turgumbayev et al. (2022) found that people from wealthier socioeconomic communities have been associated and engaged with a higher prevalence and tendency of drug misuse and abuse due to convenient accessibility and exposure to health-care facilities as well as socioeconomic relationships.</p>
  <h3>2.3 Preventive interventions or support systems are most effective in reducing the likelihood of individuals engaging in criminal activity due to drug use</h3>
  <p>Preventive interventions include a wide range of measures and interventions concentrated on reducing the consumption and misuse of drugs as well as reducing their negative and adverse repercussions for both individuals as well as the community. These programmes and interventions might involve, educational initiatives as well as community-based programmes and initiatives, along with laws and regulations that are aimed and intended at increasing drug misuse awareness (Evans et al., 2021). For example, Jones et al. (2022), have demonstrated that educational programmes and initiatives like the Drug Addictions Resistance Education (DARE) programme and initiatives were beneficial for lowering and decreasing the initial stages of drug usage,. In accordance with the Feltmann et al. (2021) investigation that appeared in the Journal of Experimental Criminology, Project ALERT, another school-based substance misuse preventive programme, has shown favourable outcomes in lowering the consumption of drugs along, with associated criminal behaviours,. Community-based initiatives, which include youth outreach programmes and rehabilitation services, provide support structures for people who are at risk of drug-related criminal behaviour, as well as different avenues to fulfilment as well as societal inclusion.&nbsp;</p>
  <p>Support systems play an important and significant role in dealing with the primary reasons behind addiction and misuse to drugs as well as criminal behaviours and actions. In order to address and overcome the underlying reasons for addictions along with associated behavioural issues and problems, it is essential to provide accessible as well as adequate health-care amenities and facilities, which include counselling for mental disorders, illness as well as drug abuse therapies and interventions (Hedrich et al., 2021). Airaksinen et al. (2021) stated that each dollar that has been spent on alcohol and drug rehabilitation programmes and initiatives saves UK society and communities approximately $7 on health care, law enforcement, and societal welfare expenditures and spending. People might overcome addictions and misuse of drugs as well as develop pro-social behaviours by participating and engaging in rehabilitative programmes and initiatives which involve cognitive-behavioural therapies, motivational interviews, as well as vocational educational programmes and training. Furthermore, Jones et al. (2022) societal programmes that help people transition back into society after spending their time in prison, including assistance with housing as well as job and employment opportunities, lower the risk of rehabilitation.</p>
  <h3>2.4 Factors besides Drugs That Leading to Criminality Behaviour</h3>
  <h4>2.4.1 Psychopathy</h4>
  <p>In the global literature, the term psychopathy is commonly used on both the theoretical and empirical grounds. It has been argued in the study of Tharshini et al. (2021) that psychopathy is considered as the clinical construct which is related with the behavioural and emotional disturbance and are considered as the significant risk factors for antisocial and criminal behaviour. Most of the studies determining the measurement of psychopathy have employed checklist of Hare&rsquo;s Psychopathy as the primary tool for psychological assessment to determine the presence of psychopathic traits among the individuals (DeMatteo et al., 2020; Tharshini et al., 2021). It has also been revealed by the growing evidence of the research that there is higher prevalence of psychopathic traits among the prisoners in contrast to general populations (Cunha, Braga and Gon&ccedil;alves, 2021; Gatner et al., 2018). In general, as compared to the males, psychopathic females rarely repeat their criminal acts and tend to be less aggressive (Verona and Vitale, 2018). In addition to this, psychopathic females in some cases have significant level of impulsivity which is a trait often related to the borderline personality disorder (Verona and Vitale, 2018; Ivert et al., 2018). In this manner, the psychopathy is among the factors which lead towards the criminal behaviour beside the drug use.&nbsp;</p>
  <h4>2.4.2 Low Self-Control</h4>
  <p>As per the study conducted by Tornquist and Miles (2019), while investigating the crime and the factors which are associated with it, the low self-control has found to be consistently linked with the criminal activities. However, the study of Forrest et al. (2019) argued that low self-control is related with the involvement in antisocial behaviour, violence and delinquency. It is due to the reason that individuals with low self-control tend to be more irresponsible, prone to risky behaviour, self-centred, impulsive and display volatile temperament. In addition to this, it has also been stated by Burt (2020) that low self-control leads to more criminal behaviour among the individuals. Due to this low self-control, individuals tend to lose temper and commit such acts which are prohibited or fall under the criminal offence. This low self-control is associated with the psychological behaviour of the individuals and is beside the use of any drug.&nbsp;</p>
  <h4>2.4.3 Difficult Temperament</h4>
  <p>Involving the joint influence of individual dispositional characteristics and socio-ecological conditions, human development is considered as the complex phenomenon. It has been argued in the study of Strelau (2020) that the individual temperament is considered as the characteristic of the individual which involves habitual mode of emotional response to stimulus. On the other hand, the study of Aktar and P&eacute;rez-Edgar (2020) argued that temperament was traditionally considered as behavioural and emotional characteristic of feelings and is assumed to be rooted more biologically by heredity and maturation. In this manner, the parenting style, socio-economic status and home environment have found an influence over the child temperament (Verona and Vitale, 2018). For instance, the behavioural disorders among the children have been due to the negative parenting practices in which permissive parenting practice, harsh behaviour and inconsistent discipline practice are more prominent. In this regard, the youth who grew up in socio-economically disadvantaged households have difficult temperaments are exposed to toxic neighbourhood environment are more prone to be engaged in future criminality and delinquent behaviour across rural and urban context.&nbsp;</p>
  <h3>2.5 Existing Policies and Legislation Aimed At Mitigating Drug-Related Criminal Behaviour</h3>
  <p>Mitigation of the drug related criminal behaviour has been one of the major concern for most of the countries (R&ecirc;go et al., 2021). It is due to the reason that there has been an increase in drug related crimes over the years which has grabbed the attention of policy makers and regulations to develop such laws that can contribute towards the mitigation of drug related criminal behaviour. It has been argued in the study of Scheim et al. (2020) that the drug decriminalisation and legalisation is considered by some of the countries for certain type of drugs. For instance, Measure 110 was passed in Oregon, USA which decriminalised the possession of small amount of drugs while redirecting the funds towards the support services and addiction treatment (Russoniello et al., 2023). Instead of criminal records and arrests, people who had small amount of drugs were fined up to $100 and were also offered to contact a support line for completing the voluntary screening of health needs. Though, various governments are making more significant investments, in terms of enhancing access to rehabilitation and treatment services for individuals with drug use disorders,. Watson et al. (2020) stated that expanding rehabilitation and treatment services, includes measures to increase funding for addiction rehab programs, and improve access to medically assisted treatment.</p>
  <h3>2.6 Theoretical Framework</h3>
  <p>Kasap and &Uuml;nsal (2021), argued that Heider proposed attribution theory in 1958, which suggested that individuals form attitudes based on their perceptions,. In this way, attribution theory provides a framework for understanding how people's attitudes towards drug addiction, and criminal behaviour are formed, based on how they perceive the reasons for that behaviour. Volkow and Blanco (2023), in their study, suggested that internal factors such as moral defects, character defects and personality traits can lead people to engage in criminal behaviour and drug addiction. In this manner, the internal attribution can result in use of excessive drugs either due to the personality traits, character flaws or moral deficiencies and might lead to criminal offences.&nbsp;</p>
  <p>On the other hand, the study of Pedalono and Frailing (2018) argued that the social bound theory devised by Hirschi begins with the concept that majority of the people do not commit crimes instead questions why that is the case. However, this answer lies in the social bond as most of the people refrain from crime, particularly serious crime in order not to compromise their bond with the co-workers, teachers, friends and family members. There are four elements comprised in the social bond which include belief, involvement, commitment and attachment. Therefore, it posits that if the people are attached to social institutions, they typically do not engage in crime and the people in them are committed to institutions. In addition to this, those people and committed to institutions hold a law-abiding and normative belief system and also involved in the conventional activities.&nbsp;</p>
  <h3>2.7 Chapter Summary&nbsp;</h3>
  <p>This section of the study was based on the literature review related to the drug use and criminal behaviour. In this manner, it was determined form the past literature that there has been a substantial association and relationship between the consumption and misuse of drugs as well as criminal behaviours and actions throughout different socioeconomic groups. With respect to the preventive interventions, it was determined that these interventions and programmes can involve educational initiatives as well as community-based programmes and initiatives, along with laws and regulations that are aimed and intended at increasing drug misuse awareness. In terms of the factors besides drug use contributing towards the criminal behaviour, it was determined that psychopathy, low self-control and difficult temperament are the ones which leads to criminal behaviour apart from the use of drugs. In addition to this, the literature determined that drug decriminalisation and legalisation has been one of the most widely adopted policies which contributed towards the mitigation of drug use and related criminal behaviour. On the other hand, access to rehabilitation and treatment services for the individuals who are suffering with the substance abuse disorders has also been prominent while playing major role in mitigating the drug use related criminal behaviour among the individuals.&nbsp;</p>
  <h2>CHAPTER 3: RESEARCH METHODOLOGY&nbsp;</h2>
  <h3>3.1 Introduction</h3>
  <p>This section of the study shows the methodological choices made by the researcher for the purpose of conducting this study. In this manner, the description regarding the research philosophy along the research approach adopted by the researcher has been included. In addition to this, the research design adopted by the researcher has also been explained along the method used for the data collection. Through the discussion over the research design and method of data collection used, the researcher is able to convey the type of research adopted while justifying the methodological choices made. Moreover, the inclusion and exclusion criteria with the prisma framework is also included which provides description regarding the selection of studies for the analysis. Furthermore, the data analysis technique has been included along the research limitations and ethical considerations at the end of this section.&nbsp;</p>
  <h3>3.2 Research Philosophy</h3>
  <p>According to Nickerson et al. (2022), the research philosophy highlights a researcher's viewpoint regarding carrying out evaluation. Interpretivism and positivism have been the two most common research paradigms adopted by researchers. For this particular study, the investigator used interpretive philosophy. The justification for utilising as well as integrating the interpretive research paradigm originated from the fact that it facilitated and simplified the capability of the investigators to effectively deal with and address the main objective of the present investigation, which was to investigate as well as analyse the degree as well as nature of the relationship and association among consumption and misuse of drugs as well as different kinds of criminal behaviours and actions that vary throughout socioeconomic backgrounds (Irshaidat et al., 2022). Another reason for implementing and employing an interpretive approach was that it makes it easier and simpler to examine several perspectives and viewpoints and uncover previously undiscovered concepts and ideas.</p>
  <h3>3.3 Research Approach</h3>
  <p>The analysis was carried out using and implementing investigation methodologies that incorporate several kinds and sorts of methodologies as well as processes (Okoli et al., 2023). Inductive and deductive approaches were the two most often utilised and integrated study methodologies that investigators and researchers utilised during their studies. In the present evaluation, the investigator utilised an inductive methodology. The rationale and justification for utilising an inductive strategy and approach has been that it allowed and facilitated a more rapid resolution of the current problems and issues of the current analysis (Love et al., 2022). Another justification and rationale behind employing and integrating an inductive technique within the present analysis has been that the investigator wanted to identify, recognise as well as analyse the degree as well as nature of the relationship and association among the consumptions of drugs as well as different kinds and sorts of criminal behaviours and actions that vary throughout different socioeconomic backgrounds. The deductive methodology has been significantly less appropriate and inadequate for the proposed examination since it relies substantially upon statistical data that validates and confirms the investigation's hypotheses.</p>
  <h3>3.4 Research Design</h3>
  <p>The research design includes methodologies that describe and specify the overall decision-making process, procedures, and techniques for gathering and interpreting data. Investigators frequently utilise mixed, qualitative, and quantitative investigation designs. Furthermore, this systematic evaluation of the literature has been conducted by employing a secondary qualitative investigation methodology, which allowed and facilitated the researcher to investigate as well as analyse the existing policies and legislation aimed at mitigating drug-related criminal behaviour (Flick et al., 2022). Another rationale of qualitative research methodology is that it allows the researcher to examine the degree as well as nature of the relationship between the consumption of drugs as well as different kinds of criminal behaviour that vary throughout socioeconomic backgrounds. A qualitative research approach was significantly more suitable and advantageous for this particular evaluation since it utilised an extensive number of theoretical principles (Corti et al., 2022).</p>
  <h3>3.5 Data Collection Method</h3>
  <p>There are two types of data collection methods which include the primary method of data collection and the secondary method of data collection (Mazhar et al., 2021). In the secondary method of data collection, the readily available data is considered from the online sources which include the books, articles, magazines, journals, news websites, blogs and other relevant and authentic sources (Ortega, 2020). On the other hand, primary data is the one in which the data is gathered for the first time and has never been used previously (Mazhar et al., 2021). This type of data is the real time data which is solely gathered for special purpose and through the survey, interviews and observations or focused groups. In this study, the researcher has adopted the secondary method of data collection in which the readily available data has been considered for the analysis. The study of Ivert and Magnusson (2020) also used similar method for data collection while investigating the criminality and drug use among the unaccompanied refugee minors. Another study of Albery, McSweeney and Hough (2013) used the secondary method of data collection for the purpose of determining the direct, indirect and causal relationship among the use of drugs and criminal behaviour.&nbsp;</p>
  <h3>3.6 Inclusion and Exclusion Criteria&nbsp;</h3>
  <p>The inclusion and exclusion criteria for the selection of articles used in analysis is provided below:</p>
  <div dir="ltr" align="left">
  <table><colgroup><col width="310"><col width="305"></colgroup>
  <tbody>
  <tr>
  <td>
  <p><strong>Inclusion Criteria</strong></p>
  </td>
  <td>
  <p><strong>Exclusion Criteria</strong></p>
  </td>
  </tr>
  <tr>
  <td>
  <p>The studies which were conducted after 2015 were only considered for the analysis.&nbsp;</p>
  </td>
  <td>
  <p>The studies which were conducted before 2015 were excluded from the analysis.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Studies which have directly focused in determining the relationship among the drug use and criminal behaviour were included.&nbsp;</p>
  </td>
  <td>
  <p>Studies showing indirect relationship among the drug use and criminal behaviour were excluded from the analysis.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>The studies which were available in English language were only considered for the analysis.</p>
  </td>
  <td>
  <p>Studies in other languages and not in English were excluded from the selection criteria and were not included in the analysis.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>Studies which had full access were only considered for the analysis.&nbsp;</p>
  </td>
  <td>
  <p>Studies which had only abstract available were not included as they had no access to complete article.&nbsp;</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>Table 1: Inclusion and Exclusion Criteria</p>
  <h3>3.7 Prisma Framework&nbsp;</h3>
  <p>Below is the prisma framework which shows the selection of studies for the analysis based on the inclusion and exclusion criteria.&nbsp;</p>
  <p><strong id="docs-internal-guid-e708a063-7fff-505d-e860-38a1f6701c95">&nbsp;<img src="data:image/png;base64,[encoded data, 6180 characters]"></strong><br><br><img src="data:image/png;base64,[encoded data, 44392 characters]"></p>
  <h3>3.8 Data Analysis Technique</h3>
  <p>The data analysis technique represents and illustrates a phrase utilised and integrated to describe the procedure and processes of evaluating evidence (Salm et al., 2021). A systematic literature review has been carried out for this examination. However, the rationale and justification for using systematic literature review has been that it facilitated and permitted a more comprehensive evaluation of pertinent academic articles, publications, and appropriate secondary information. Another reason and justification for employing this method was to aid in the collection of data on the degree as well as nature of the relationship between the consumption of drugs as well as different kinds of criminal behaviour that vary throughout socioeconomic backgrounds. It permitted and facilitated the researchers to acquire and gather information regarding certain aspects of the investigation that earlier researchers and investigators had overlooked.&nbsp;</p>
  <h3>3.9 Research Limitations&nbsp;</h3>
  <p>This study has been carried out for the purpose of exploring the relationship among the drug use and criminal behaviour. The study has focused on determining the association among the two factors and planned to present significant findings for the policy makers and regulatory authorities for the purpose of mitigating the drug use and related criminal behaviour among the individuals. However, there are several limitations of this study which must be considered. Firstly, the research has focused in the relationship among the drug use and criminal behaviour caused by the use of substance. There are several other factors which leads to the criminal behaviour and should have been determined for the purpose of increasing the scope of this study. On the other hand, the study has adopted the secondary methods of data collection which restricts the researcher to present the findings based on the previous information available. The consideration of the primary methods of data collection would have helped the researcher to incorporate the real time response and updated information regarding the use of drugs and criminal behaviour. In this way, the scope of this study could have been improved and the researcher might be able to present more significant findings while contributing towards the existing literature.</p>
  <h3>3.10 Ethical Considerations&nbsp;</h3>
  <p>This study has been carried out in accordance with the ethical considerations. The data in this study has been gathered from the secondary sources of information which increase the risk of presenting false information and manipulation of the results. However, in this study, the researcher has ensured that the findings from previous studies have been used as it is and no manipulation or amendment was made in the findings of those studies. On the other hand, providing credit for the work of previous researchers has also been a critical issue which must be considered while conducting the secondary study. In this manner, the researcher has ensured that credit for the past researchers is provided in order to acknowledge their work in this field by citing their names.&nbsp;</p>
  <h2>CHAPTER 4: RESULTS AND ANALYSIS</h2>
  <h3>4.1 Introduction&nbsp;</h3>
  <p>This section of the study is based on the results and analysis with respect to determining the relationship between the drug use and criminal behaviour. In this manner, the data in this study has been gathered from the secondary sources of information which involves the peer reviewed articles and journals. The studies have been selected based in the inclusion and exclusion criteria defined in the previous section. For the analysis, the section of systematic literature review has been included in which the table provides summary for all the selected articles in this study. After the summary of the selected studies, an empirical review of all the articles have been carried out and are critically analysed based in the previous studies. On the other hand, the section of discussion has also been included in this chapter which critically compares the findings of this study with the findings of already established studies.&nbsp;</p>
  <h3>4.2 Systematic Literature Review&nbsp;</h3>
  <div dir="ltr" align="left">
  <table><colgroup><col width="37"><col width="101"><col width="48"><col width="151"><col width="116"><col width="172"></colgroup>
  <tbody>
  <tr>
  <td>
  <p><strong>No</strong>.</p>
  </td>
  <td>
  <p><strong>Authors</strong></p>
  </td>
  <td>
  <p><strong>Year&nbsp;</strong></p>
  </td>
  <td>
  <p><strong>Sample&nbsp;</strong></p>
  </td>
  <td>
  <p><strong>Measures&nbsp;</strong></p>
  </td>
  <td>
  <p><strong>Findings&nbsp;</strong></p>
  </td>
  </tr>
  <tr>
  <td>
  <p>1</p>
  </td>
  <td>
  <p>Pierce, Hayhurst, Bird, Hickman, Seddon, Dunn, and Millar</p>
  </td>
  <td>
  <p>2017</p>
  </td>
  <td>
  <p>The study considered the analysis of historical offending records among adults which are associated to the test results of cocaine and opiate metabolites. In order to retrieve data for the age of opiate initiation, adults testing positive were linked to treatment records.&nbsp;</p>
  </td>
  <td>
  <p>Drug use and criminality</p>
  </td>
  <td>
  <p>The findings of the study revealed that with respect to the crime categories, the difference among the group is exacerbated by the initiation of opiate. On the other hand, it has also been indicated that there might be effective opiate prevention initiatives in terms of reducing offending, particularly among females.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>2</p>
  </td>
  <td>
  <p>Kennedy, Heron, and Munaf&ograve;</p>
  </td>
  <td>
  <p>2017</p>
  </td>
  <td>
  <p>The data in this study was gathered from primary sources of information and was a quantitative study. The data on substance use such as cannabis, alcohol and tobacco was gathered through self-report questionnaire at age 17 years.&nbsp;</p>
  </td>
  <td>
  <p>Substance use, criminal behaviour and psychiatric symptoms</p>
  </td>
  <td>
  <p>The findings of the study revealed that in relation to those having no injury, there were increased odds of problematic use of cannabis and tobacco among participants with TB being in trouble with the police while having more parent reported conduct problems.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>3</p>
  </td>
  <td>
  <p>DeBeck, Cheng, Montaner, Beyrer, Elliott, Sherman, Wood and Baral</p>
  </td>
  <td>
  <p>2017</p>
  </td>
  <td>
  <p>This study is qualitative in nature and the data was gathered from the secondary sources of information. With respect to the Prisma guidelines, a systematic review of the peer reviewed articles describing the relationship among the drug use, criminality and HIV prevention and treatment were considered.&nbsp;</p>
  </td>
  <td>
  <p>Criminalisation of Drug Use, HIV</p>
  </td>
  <td>
  <p>The results of the study determined that the criminal behaviour was resulted by various factors and drug use was one of the primary factors which contributed towards the criminal behaviour positively.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>4</p>
  </td>
  <td>
  <p>Anderberg, Dahlberg, and Wennberg</p>
  </td>
  <td>
  <p>2022</p>
  </td>
  <td>
  <p>This study was quantitative in nature and the data was gathered from the primary sources of information. The data was gathered from clinics in 12 cities of Sweden. On the other hand, the statistical analysis was carried out for the purpose of analysing the results from primary sources.&nbsp;</p>
  </td>
  <td>
  <p>Criminality, Substance Use Problems</p>
  </td>
  <td>
  <p>The findings from the study suggested that most of the young people who were convicted with offences also have continued issues with the use of substance while three-quarters of the young people were charged with the drug related offence. The young individuals were more likely to develop the criminal behaviour if continued the substance use.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>5</p>
  </td>
  <td>
  <p>Turnbull</p>
  </td>
  <td>
  <p>2019</p>
  </td>
  <td>
  <p>The study adopted the qualitative research design in which the data was gathered from secondary sources of information. The analysis was carried out by critically discussing the findings of previous studies.&nbsp;</p>
  </td>
  <td>
  <p>Drug use, crime</p>
  </td>
  <td>
  <p>The findings of the study revealed that the increased drug use has caused increase in the crime rate. On the other hand, it was also determined that most of the criminals were committed crimes due to fulfil their drug use needs. This depicts that there is a relationship among the drug use and criminal behaviour among the individuals.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>6</p>
  </td>
  <td>
  <p>Tharshini and Ibrahim</p>
  </td>
  <td>
  <p>2023</p>
  </td>
  <td>
  <p>This study was qualitative in nature and the data was gathered from secondary sources of information. The analysis was carried out using the systematic literature review and meta-analysis technique. Several studies were considered for the analysis which were related to the topic.&nbsp;</p>
  </td>
  <td>
  <p>Drug dependency and criminality&nbsp;</p>
  </td>
  <td>
  <p>The findings of the study determined that different patterns of criminal offending are raised due to the rise in consumption of different types of drugs. From this review, it is apparent that there is higher likelihood of individuals with poly-drug consumption of engaging in diverse offence types. Therefore, the key indicators of the criminality and drug use should be explored in greater detail.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>7</p>
  </td>
  <td>
  <p>P&eacute;rez and Ruiz</p>
  </td>
  <td>
  <p>2017</p>
  </td>
  <td>
  <p>This study was qualitative in nature and the data was gathered from secondary sources of information. The analysis was carried out using the systematic literature review and meta-analysis technique.</p>
  </td>
  <td>
  <p>Substance abuse and criminal behaviour&nbsp;</p>
  </td>
  <td>
  <p>From the analysis, it has been determined that it was confirmed by 78% of the review studies included in the study that the exposure or consumption of some type of substance or drug make the individual more prone towards the criminal behaviour.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>8</p>
  </td>
  <td>
  <p>I Hassan, F Assassa, and M Al-Wakeel</p>
  </td>
  <td>
  <p>2016</p>
  </td>
  <td>
  <p>This study gathered the data from secondary sources of information and was qualitative in nature. In this manner, a review of issues in the previous studies was identified to highlight trends and patterns related to the drug abuse and crime with regards to the influence of drug abuse over various crimes.&nbsp;</p>
  </td>
  <td>
  <p>Drug abuse and related crimes&nbsp;</p>
  </td>
  <td>
  <p>The findings from the study determined that in order to fund a drug habit, individuals are more into the economic related crimes. On the other hand, the structure related crimes are resulted due to the drug system&rsquo;s structure including the crimes of sales, transportation, manufacture and production of drugs. While the pre-existing criminal activity can be perpetuated and amplified by the serious drug abuse.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>9</p>
  </td>
  <td>
  <p>Riordan</p>
  </td>
  <td>
  <p>2017</p>
  </td>
  <td>
  <p>This study wad qualitative in nature and the data was gathered from primary sources of information. The interviews were conducted from 11 Aboriginal and 22 non-Aboriginal adult male offenders from Western Australia. The thematic analysis was adopted for the purpose of analysing the results gathered through interviews.&nbsp;</p>
  </td>
  <td>
  <p>Drug use and crime</p>
  </td>
  <td>
  <p>The results of the study determined two distinct models which emerged from two cultural groups. In this manner, both of the models indicated in both the crime and drug use as a life-style on the baiss of biopsycho-social framework.&nbsp;</p>
  </td>
  </tr>
  <tr>
  <td>
  <p>10</p>
  </td>
  <td>
  <p>H&aring;kansson and Jesionowska</p>
  </td>
  <td>
  <p>2018</p>
  </td>
  <td>
  <p>In this study, the qualitative method was adopted and the data was gathered from primary sources of data. The interviews were conducted from prisoners having problems of substance use. The data was analysed through the addition severity index.&nbsp;</p>
  </td>
  <td>
  <p>Substance use and type of crime</p>
  </td>
  <td>
  <p>The results from the logistic regression determined that injecting drug, cocaine, amphetamine and heroine were negatively associated with the violent crime.&nbsp;</p>
  </td>
  </tr>
  </tbody>
  </table>
  </div>
  <p>Table 2 Systematic Literature Review</p>
  <p>The study of Pierce et al. (2017) determined either the individuals tested positive for opiates have more risk of involving in the criminal activities. For this purpose, the study considered the analysis of historical offending records among adults which are associated to the test results of cocaine and opiate metabolites. In order to retrieve data for the age of opiate initiation, adults testing positive were linked to treatment records. The results of the study revealed that with respect to the crime categories, the difference among the group is exacerbated by the initiation of opiate. On the other hand, it has also been indicated that there might be effective opiate prevention initiatives in terms of reducing offending, particularly among females. Kennedy, Heron, and Munaf&ograve; (2017) explored the association among the criminal behaviour, substance use, psychiatric symptoms and mild TBI. The participants were identified from the parent and self-reports up to age 16 years. The criminal behaviour and substance use measures were considered from self-reports. The findings of the study revealed that in relation to those having no injury, there were increased odds of problematic use of cannabis and tobacco among participants with TB being in trouble with the police while having more parent reported conduct problems. In this manner, it is suggested that the increased use of drugs such as cannabis and tobacco leads to increase crime rate or develop criminal behaviour among the individuals.&nbsp;</p>
  <p>The study of DeBeck et al (2017) determine the relationship among the drug use, criminal behaviour and HIV treatment and prevention among the individuals. With respect to the method, the researcher adopted the qualitative method in which the data was gathered from secondary sources of information. In terms of the analysis, the study used the systematic literature review in which the studies were selected following the PRISMA guidelines. The findings of the study suggested that the increased use of drugs can make it more likely for the individuals to engage in criminal offence. It is due to the reason that in order to fulfil their drug addiction, individuals commit crimes as they no longer differentiate among the adequate behaviour or the society. In this manner, they sacrifice their social recognition in order to fulfil their drug addiction and commit crimes.&nbsp;</p>
  <p>As per the study of Anderberg, Dahlberg, and Wennberg (2022), the minor drug violations are emphasised by the Swedish drug policy. In this manner, the study was conducted in order to determine the relationship among the substance use and criminality problems among the young people who had outpatient treatment and to determine the risk factors which suggested the continued problems associated with criminality. There were few follow-up studied but the research on this target group is still a debatable topic in Sweden. It has been indicated by the study that outpatient treatment begin by young people were convicted of crimes at 1 year follow up. In addition to this, most of the young people who were convicted, were involved in the substance use. This depicts that the use of drugs leads to criminal behaviour among the individuals and especially the young people.</p>
  <p>On the other hand, the study of Turnbull (2019) determined the relationship among the drug users and criminal offences. The study adopted the qualitative research design in which the data was gathered from the secondary sources of information. The data gathered was analysed using the systematic literature review and meta-analysis. The results of the study determined that offences such as crime against person which include assault, rape and murder were conducted by high proportion of drug users. Therefore, considering these findings, it is suggested to have greater considerations to drug dependency as it is considered as the significant factor for the criminal behaviour. On the other hand, the results of the study also provided the determination of how various drug types might give rise to diverse criminal offending patterns. In addition to this, the study of Tharshini and Ibrahim (2023) focused on defining different patterns of criminal offending and its relationship with various drugs. The study was qualitative in nature and the data was gathered from secondary sources of information.&nbsp;</p>
  <p>The analysis was carried out using the systematic literature review and meta-analysis technique. Several studies were considered for the analysis which were related to the topic and were appropriate as per the eligibility criteria.. The findings of the study determined that different patterns of criminal offending are raised due to the rise in consumption of different kinds of drugs. From this review, it is apparent that there is higher likelihood of individuals with poly-drug consumption of engaging in diverse offence types. Therefore, the key indicators of the criminality and drug use should be explored in greater detail.&nbsp;</p>
  <p>The study of P&eacute;rez and Ruiz (2017) identified the relationship among the substance use and criminal behaviour. The study was qualitative in nature and the data was gathered from secondary sources of information. The analysis was carried out using the systematic literature review and meta-analysis technique. The results of the study determined that it was confirmed by 78% of the review studies included in the study that the exposure or consumption of some type of substance or drug make the individual more prone towards the criminal behaviour. Considering the study of I Hassan, F Assassa, and M Al-Wakeel (2016), drug abuse and related crimes were identified.&nbsp;</p>
  <p>This study gathered the data from secondary sources of information and was qualitative in nature. In this manner, a review of issues in the previous studies was identified to highlight trends and patterns related to the drug abuse and crime with regards to the influence of drug abuse over various crimes. The findings from the study determined that in order to fund a drug habit, individuals are more into the economic related crimes. On the other hand, the structure related crimes are resulted due to the drug system&rsquo;s structure including the crimes of sales, transportation, manufacture and production of drugs. While the pre-existing criminal activity can be perpetuated and amplified by the serious drug abuse.&nbsp;</p>
  <p>Moreover, the study of Riordan (2017) identified the connection among the crime and drug use in Western Australia. The study was qualitative in nature and the data was gathered from primary sources of information. However, the interviews were conducted from 11 Aboriginal and 22 non-Aboriginal adult male offenders from Western Australia. The thematic analysis was carried out for the purpose of analysing the results gathered through interviews. The findings of the study determined two distinct models which emerged from two cultural groups. In this manner, both of the models indicated in both the crime and drug use as a life-style on the basis of biopsycho-social framework. Lastly, the study of H&aring;kansson and Jesionowska (2018) focused on determining the relationship among the type of crime and substance use among the prisoners having problems of substance use and emphasised on violence and fatal violence. In this study, the qualitative method was adopted and the data was gathered from primary sources of data. The interviews were conducted from prisoners having problems of substance use. The data was analysed through the addition severity index. The results from the logistic regression determined that injecting drug, cocaine, amphetamine and heroine were negatively associated with the violent crime.&nbsp;</p>
  <h3>4.3 Discussion&nbsp;</h3>
  <h4>4.3.1 Objective 1: To investigate the strength and nature of the link between drug use and various types of criminal behaviour across socioeconomic backgrounds</h4>
  <p>The first objective of the study is related to the strength and nature of the link between drug use and various types of criminal behaviour across socioeconomic backgrounds. In this manner, it has been determined from the analysis that the drug use is associated with the violent criminal activity. The study of Karamanos et al. (2022) also supported that irrespective of socioeconomic backgrounds and situations, there is a greater likelihood and tendency of drug use and consumption among individuals associated with criminal activities and behaviours, which includes drug trafficking, criminal activity and actions involving property, along with violent offences and crimes. Another study of Manhica et al. (2021) argued that most of those imprisoned and caged for substances and drug-related offences alleged and suspected of frequent consumption and abuse of drugs.&nbsp;</p>
  <p>Another study of Van de Weijer et al. (2022) stated that economic difficulties and problems, as well as, marginalisation and exclusion from society, lead to an inappropriate representation of people and individuals from lower socioeconomic origins within substances as well as drug-related criminal behaviours and actions. Another study of Manrique-Millones et al. (2021) shows and illustrates a relationship and association between substance as well as drug-related offences and crime incidences. However, the study of H&aring;kansson and Jesionowska (2018) determined negative influence of drug use with the criminal behaviour among the individuals.&nbsp;</p>
  <h4>4.3.2. Objective 2: To explore other factors besides drugs that lead to criminality, analysing the overall influence on behaviour</h4>
  <p>The second objective of the study is related to the factors besides drugs that lead to criminality while analysing the overall influence on behaviour. It has been determined from the findings that the study of DeBeck et al. (2017) found various factors along the drug use which contributed positively towards the criminal behaviour among individuals. In a similar manner, Tharshini et al. (2021) determined that psychopathy is considered as the clinical construct which is related with the behavioural and emotional disturbance and are considered as the significant risk factors for antisocial and criminal behaviour. On the other hand, the study of Gatner et al. (2018) and Cunha, Braga and Gon&ccedil;alves (2021) argued that there is higher prevalence of psychopathic traits among the prisoners in contrast to general populations. In addition to this, the study of Tornquist and Miles (2019) determined the factors which are associated with it, the low self-control has found to be consistently linked with the criminal activities. Another study of Forrest et al. (2019) argued that low self-control is related with the involvement in antisocial behaviour, violence and delinquency. Similarly, the study of Aktar and P&eacute;rez-Edgar (2020) also determined that the youth who grew up in socio-economically disadvantaged households have difficult temperaments and experience toxic neighbourhood environment are more prone to be engaged in future criminality and delinquent behaviour across rural and urban context.</p>
  <h4>4.3.3 Objective 3: To assess existing policies and legislation aimed at mitigating drug-related criminal behaviour</h4>
  <p>The third objective of the study is related with the assessment of existing policies and legislation aimed at mitigating drug-related criminal behaviour. It has been determined that most of the countries have focused on drug decriminalisation and legalisation for the purpose of mitigating the drug related criminal behaviour. It has also been discussed in the study of Cheim et al. (2020) that the drug decriminalisation and legalisation is considered by some of countries for certain types of drugs. Under this, the individuals with small quantities of drugs are not charged with criminal offence. Instead, they are charged with fine and a voluntary check-up for all the health concerns. On the other hand, the increased investment in the rehabilitation and treatment services have also proved to be beneficial for the governing bodies as people with drug use are provided with free of cost treatment. The study of Watson et al. (2020) also stated that increasing access to rehabilitation and treatment services involves initiatives for increased funding of addiction treatment programs and enhanced access to medication-assisted treatment. However, the development of an effective framework for the mitigation of drug-related criminal behaviour among individuals still lacks in most of nations and has led to increased drug use and the development of criminal behaviour.&nbsp;</p>
  <h2>CHAPTER 5: CONCLUSION AND RECOMMENDATIONS&nbsp;</h2>
  <h3>5.1 Introduction&nbsp;</h3>
  <p>This section of the study presents the conclusion and recommendations based on the discussions carried out in prior sections of this study. For this purpose, a section of summarised findings have been included in this study which provides the summary of overall research findings and discussion carried out in this study. In addition to the summarised finding, the researcher has also included the future implications which provides the direction for the future researchers considering the limitations of this study. In addition to this, the recommendations have been provided considering the findings from the analysis and discussion carried out. Lastly, the conclusion is provided at the end of this section.&nbsp;</p>
  <h3>5.2 Summarised Findings&nbsp;</h3>
  <p>The data gathered from the secondary sources of information presented significant findings and it was determined from the analysis that drug use is related to the violent criminal activity. It is due to the reason that most of the criminals were found to have use of drugs in most of the studies. On the other hand, some of the individuals only committed the crime for the sake of fulfilling their addiction needs. Out of 10 studies which were considered for the analysis, 9 of them suggested the relationship among the drug use and criminal behaviour. However, only one study found to have negative association of the drug use and criminal behaviour among the individuals. With respect to the factors besides drug use that lead to criminality behaviour, it has been determined that there are various other factors as well which results in the criminality behaviour among individuals. While, the factors which were prominent and determined in most of the studies include psychopathy, low self-control and difficult temperament. In terms of the existing policies and legislation aimed at mitigating drug-related criminal behaviour, it has been determined that drug decriminalisation and legalisation has been adopted by various countries which leads to the removal of criminal offence on people with small amount of drugs. However, there has been much criticism on this legislation as small dealers now have the license to trade the drug until they get caught. In this way, the consumption of the drug along the criminality behaviour will prevail more among the young people. In addition to this, increased investment in the rehabilitation and treatment services has also been the prominent policies and legislation aimed at mitigating drug-related criminal behaviour.&nbsp;</p>
  <h3>5.3 Future Implications&nbsp;</h3>
  <p>This study has been carried out for the purpose of exploring the relationship among the drug use and criminal behaviour. In this manner, the study has focused on determining the association among the two factors and planned to present significant findings for the governing bodies and regulatory authorities in terms of mitigating the drug use and related criminal behaviour among the individuals. However, the research has only focused on the relationship among the drug use and criminal behaviour caused by the use of substance. Therefore, it is suggested for the future researchers to determine other factors which leads to the criminal behaviour in terms of increasing the scope of this study. In addition to this, the study has adopted the secondary methods of data collection which restricts the researcher to present the findings based on the previous information available. It is suggested for the future researchers to consider primary methods of data collection in order for them to incorporate the real time response and updated information regarding the use of drugs and criminal behaviour. Through this, the scope of this study can be improved and the researchers might be able to present more significant findings while contributing towards the existing literature.</p>
  <h3>5.4 Recommendations&nbsp;</h3>
  <p>On the basis of finding derived from the previous section, several recommendations have been developed. These recommendations are provided below:</p>
  <ul>
  <li>
  It is recommended for the parents to have preventive measures with respect to drug use among their children. It is due to the reason that most of the drug use addiction among people was at young age which increased with the age. The studies which investigated the factors for the use of drug among individuals, several social issues and toxic environment at home at the very early age remained constant. Therefore, it is suggested for the parents to take serious considerations with respect to the environment.&nbsp;
  </li>
  <li>
  In addition to this, it is also suggested for the governing bodies and regulatory authorities to take preventive measures such as the drug decriminalisation and legalisation. It is due to the reason that drug decriminalisation and legalisation was found to have significant results in terms of reducing the consumption of drugs and generating funds for the treatment of drug addicts. In this way, through the reduction of drug consumption among the individuals and especially among the young generation, there can be significant reduction in the criminal activities of development of criminality behaviour.&nbsp;
  </li>
  <li>
  Thirdly, it is also suggested for the individuals to refrain from the use of drugs as the addition of these drugs end up person committing crime. It is to fulfil the need of drug addiction and to take every possible step which is either legal or illegal. Therefore, refraining from the use of drug can make less prone to individuals in terms of developing the criminality behaviour among them.&nbsp;
  </li>
  </ul>
  <h3>5.5 Conclusion&nbsp;</h3>
  <p>Drug misuse and criminal behaviour have both become severe and substantial societal issues and problems which are having serious effects and influences on the health-care and safety of the population. Around, 269 million people and individuals globally were involved and engaged in illicit drug consumption and abuse at least once during 2018, which contributes to the worldwide drugs and substance epidemic posing a critical risk and threat people&rsquo;s security and well-being. The connotation among the consumption and misuse of drugs, as well as criminal behaviours and actions is multidimensional as well as complicated depending upon many different kinds and aspects of personal, societal, and environmental factors. There has been much investigation and exploration regarding the association between substance and drug misuse as well as criminality, there is still knowledge gap within the literature comprehending and understanding the fundamental processes, procedures, causal relationships and associations that interconnect these phenomena. Therefore, this study aimed to explore the relationship between drug use and criminal behaviours.&nbsp;</p>
  <p>For this purpose, the researcher adopted interpretive philosophy and inductive approach. It is due to the reason that no hypothesis were tested in this study and the major focus has been towards the development of theory instead of testing one. In this manner, the qualitative research design was adopted and the data wad gathered from the secondary sources of information. The systematic literature review was conducted in this study for the purpose of analysing the secondary data. In total, 10 studies were considered for the analysis which were recruited based on the inclusion and exclusion criteria. The results of the study determined that there is significant association among the drug use and criminality behaviour as most of the studies (90%) suggested the relationship. This relationship has been due to the reason that most of the criminals which were sample population of the analysed studies were drug addicts. Most of the criminals only committed offence in order to fulfil their drug needs. Therefore, it is suggested for the governing bodies to take preventive measures for the purpose of reducing the drug use among young adults.&nbsp;</p>
  <h4>REFERENCES</h4>
  <ul>
  <li>Airaksinen, J., Aaltonen, M., Tarkiainen, L., Martikainen, P. and Latvala, A., 2021. Associations of neighbourhood disadvantage and offender concentration with criminal behaviour: Between-within analysis in Finnish registry data. Journal of Criminal Justice, 74, p.101813.</li>
  <li>Aktar, E. and P&eacute;rez-Edgar, K., 2020. 26 Infant Emotion Development and Temperament. Handbook of infant development, pp.715-741.</li>
  <li>Albery, I.P., McSweeney, T. and Hough, M., 2013. Drug use and criminal behaviour: indirect, direct or causal relationship?. In Forensic Psychology (pp. 158-174). Willan.</li>
  <li>Anderberg, M., Dahlberg, M. and Wennberg, P., 2022. Criminality among young people with substance use problems in Sweden: A one-year follow-up study. Journal of Drug Issues, 52(3), pp.406-420.</li>
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  </ul>

meta_description:
  The use of drugs among individuals has increased. This increase in drug use has caused adverse effects on the lives of many individuals.


