RSS 1.0Welcome to ChesterRep - the University of Chester's Online Research Repository
ChesterRep is the University of Chester's institutional repository and an online platform designed to collate, store, and aid discoverability of the University’s research.
All University of Chester staff are expected to use the Current Research Information System, Symplectic Elements, to submit material to ChesterRep. Guidance on how to deposit and manage publications using Elements can be found here. You can also discover more about our editorial and open access policies here. Please note that you must be a member of the University to view these pages.
If you are a student at the University of Chester and want to submit work to ChesterRep, please contact researchsupport.lis@chester.ac.uk.
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An assessment of burden associated with problem joints in children and adults with moderate or severe haemophilia A: analysis of the CHESS-Paediatrics and CHESS II cross-sectional studiesBACKGROUND: Clinical research has offered many definitions and fragmented perspectives of joint morbidity in haemophilia. As joint damage, pain and mobility impairment can be present without clinical record of persistent bleeding, a person-centric joint morbidity characterisation remained a priority for the haemophilia community, giving rise to the ‘problem joint’ concept. As diagnosing and managing joint morbidity is critical, the aim of this study was to analyse the holistic burden of problem joints in people with moderate or severe haemophilia A (HA). Data from the ‘Cost of Haemophilia in Europe: a Socioeconomic Survey’ (CHESS) cross-sectional studies were used. CHESS-Paediatrics included male paediatric patients (≤ 17 years) with congenital moderate or severe haemophilia, while CHESS II included adult males (≥ 18 years) of any severity. Both studies sought to collect detailed information on the clinical, economic and humanistic burden of haemophilia. Demographics, clinical outcomes, treatment regimen, adherence, physical activity, healthcare resource use and number of problem joints were evaluated and described by HA severity and number of problem joints (none, 1, ≥ 2). RESULTS: In total, 1171 people with non-inhibitor moderate or severe HA from CHESS-Paediatrics (n = 703) and CHESS II (n = 468) were included in this analysis. Presence of problem joints was more prevalent among CHESS II participants (44%) than in CHESS-Paediatrics (14%). Around two-thirds (67%) of CHESS-Paediatrics and 39% of CHESS II participants received prophylactic factor VIII replacement therapy. The presence of chronic pain was greater in severe HA with ‘ ≥ 2’ problem joints in both cohorts. Clinical symptoms and bleed-related hospitalizations were more prevalent in the presence of problem joints regardless of HA severity in both cohorts. CONCLUSIONS: This analysis of the CHESS population studies has expanded on previous work by examining the relevance of the problem joint measure of haemophilic morbidity and its associated burden. Adverse clinical symptoms and increased bleed-related hospitalizations were observed in the presence of problem joints in both children/adolescents and adults across HA severities. Use of person-centric characterizations of joint morbidity may improve analysis of long-term outcomes and lead to improvements in future haemophilia care.
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Exploring the acceleration of sustainability transitions: The case of the transition to a low-carbon hydrogen network in North West EnglandClimate change attributable to anthropogenic emissions presents a major sustainability challenge. Low-carbon hydrogen could have an important role in decarbonisation by replacing the use of fossil fuels across various heavy-emitting sectors in the UK. The North West of England is well-positioned for the development of a low-carbon hydrogen network due to its existing infrastructure, assets and capabilities. The transition to low-carbon hydrogen can be thought of as a sustainability transition because it is goal oriented and encompasses niche innovations that exhibit a lower techno-economic performance than established technologies. While transitions typically occur over decades, the urgency of decarbonisation has led scholars to explore how they could be accelerated. Guided by the Multi-Level Perspective (MLP) approach to understanding sustainability transitions, this research explores how the transition to a low-carbon hydrogen network in England’s North West region could be accelerated. It does so by employing an explorative case study methodology, collecting primary data through semi-structured interviews and virtual workshop sessions. The data is analysed using two conceptual frameworks and further enriched by drawing upon conceptualisations from MLP literature. The first framework outlines examples of five acceleration mechanisms observed across hydrogen transition initiatives in North West England, highlighting the key activities and tensions with each. Findings indicate that embedding is less frequently observed than other mechanisms due to broader challenges associated with instrumentalising, such as design limitations of national funding schemes and a lack of frameworks to encourage private sector investment in low-carbon hydrogen technologies. The second framework explores the role of institutional and organisational drivers in promoting complementarity changes to accelerate the transition to low-carbon hydrogen, while also identifying potential transition bottlenecks. The findings suggest that institutional drivers aimed at improving the economics of low-carbon hydrogen innovations could be crucial for catalysing complementarity changes. Several high-significance bottlenecks that could prohibit the deployment of hydrogen innovations are identified, including persistent lock-in, bootstrapping, the weak spot bottleneck and public opposition. These bottlenecks are likely to arise during the experimentation phase of the transition, suggesting the need for their resolution in the short term. This research emphasises the importance of institutional support in accelerating sustainability transitions. Examples of institutional support identified for the case studied in this research included funding schemes that enable the actual demonstration of hydrogen innovations, education programmes that may enhance social acceptance of hydrogen innovations, and measures that address the unfavourable economics of low-carbon hydrogen such as supportive business models, carbon tax reforms, and end-user subsidies. Additionally, this research highlights the need for a co-ordinated approach when strategically planning the development and deployment of low-carbon innovations, both in the early phases and throughout the course of the transition, to enable the effective implementation of institutional measures, and to mitigate against potential transition bottlenecks.
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‘Marked Out’: An exploration of the role of stigma in the marginalisation and racialisation of young peopleStigma and the labelling process have been conceptualised and debated for decades (Link & Phelan, 1999). Stigma was first examined by Goffman (1963), whose work was valuable in explaining and drawing attention to stigmatisation and individual strategies of stigma management. This thesis moves beyond this individualising definition to consider stigma as a mechanism of power, examining the role of stigmatisers in conveying and (re)producing labels and stereotypes (Link & Phelan, 2001) through exploring the potential influences of institutional structures on stigmatisation. Through an examination of the lived realities of young people, this thesis seeks to understand the role and reproduction of stigma in their lives, tied to the determining contexts of race, gender and class, and created within constructs of power. This study provides an empirical example of stigma power in the lives of young people living in two Manchester neighbourhoods. Working with 28 young people aged 16-19 in two stigmatised areas of Manchester, this research was grounded in ethnographic principles, serving as a foundation for a participatory-informed research design developed to discover, interpret, and apply knowledge. In addition to conducting over 300 hours of participant observation of the young people’s lives, the research involved the use of participatory-informed, creative methods. In consultation with young people, this was facilitated through various creative approaches, including geographical mapping, creative writing, flashcards, and a blog. Based upon its findings, this thesis will argue that the lives of young people are layered through pre-existing faultlines that can be understood and determined within the structures of society. By revealing the experiences of young people through the institutional structures of public and media narratives, and police and educational encounters, this thesis illustrates how institutionalised narratives may contribute to the (re)production of stigmatised identities. By understanding how the lives of young people can become structured within the determining contexts of society, directly from the individuals to whom this applies, this thesis offers the potential to explore how the lives of some young people are (re)produced through cycles of stigma.
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Interwar Women: The Psychogeographic Nature of Detection in Golden Age Detective FictionThis thesis theorises female detection psychogeographically. Through an examination into the very mechanics of spatiality, the overall argument unearths an inherently psychogeographic nature of detection within specific figures of female detectives within Golden Age Detective Fiction. A psychogeographic perspective unearths the influential nature of space, and its impact on the construction of gendered and social identity. Moreover, specifically female detectives as psychogeographers voice the shifting social and cultural position of women during the period. Engaging with the cultural, social and political influences of the time, the thesis analyses the spatially imbued nature of space, and the ways in which it effects the spatial, temporal and cultural performance of femininity throughout the period of 1918 to 1954. Examining individual decades, the thesis analyses the transformations of imposed femininity, and the ways in which hegemonic gendered behaviour embedded in physical space, influence and impose the formation and enactment of identity. Within these reformed notions of the feminine, Agatha Christie and Dorothy L Sayers’s female detectives directly exploit and manipulate the process of spatial influence. This process of feminine manipulation of imposed identity is encapsulated through the process of subversive detection methods embedded in psychogeographic means of expression. Overall, the literature voices a shift in female psychogeography as well as voicing the transformation in a woman’s place in society and culture during the first half of the twentieth century through the metaphor of detection.
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A multi-study paper on the development and validation of the Value Clarity Questionnaire in adults and adolescentsEngaging in behavior that promotes flourishing is a key outcome sought in several evidence-informed psychotherapies (e.g., “valued action” within Acceptance and Commitment Therapy). However, we cannot deliberately engage in valued action without first having value clarity. Having value clarity means understanding and being aware of the qualities of character we want to embody (i.e., the type of person we aspire to be). To date, there is no distinct process or outcome measure evaluating value clarity. In this multi-study paper, including two cross-sectional studies (Studies 1 and 2) and one, three-wave longitudinal study (Study 3), we describe the development and validation of a novel, unidimensional measure of value clarity (the Value Clarity Questionnaire; VCQ). Study 1 (convenience sample of adults, total N = 506) describes the development of and the empirical refinement of the VCQ through a series of exploratory and confirmatory factor analyses. Study 2 confirmed the VCQ’s factor structure and internal consistency (a United Kingdom-representative sample, N = 491). Study 3 (a school-aged sample (N1 = 468 boys) revealed that the VCQ showed good internal consistency over time, test-retest stability, and a series of longitudinal measurement invariance tests supported configural, metric, scalar and strict invariance. Across the studies, value clarity was correlated with and predicted multiple aspects of flourishing including engaged living, depression, behavioral activation, assertiveness, productiveness, and energy levels, over and above known predictors. Overall, the results show that the VCQ is a reliable and valid measure that could be an especially useful proximal index of the effectiveness of targeted value clarification interventions.