• Acquiring and marketing eBooks at University College Chester - it's all down to teamwork and communication

      Stockton, Christine; University College Chester (SCONUL, 2004)
      This article discusses the events leading up to the launch of the eBooks collection at University College Chester.
    • Anxiety and depression among adults with haemophilia A: Patient and physician reported symptoms from the real‐world European CHESS II study

      Ferri Grazzi, Enrico; orcid: 0000-0002-0567-0260; Blenkiron, Thomas; orcid: 0000-0002-5716-0748; Hawes, Charles; Camp, Charlotte; O'Hara, Jamie; Burke, Tom; O'Brien, Gráinne (Wiley, 2024-03-20)
      AbstractIntroductionThe physical pain and disability affecting many people with haemophilia A (PwHA) are known detractors from psychological wellbeing. While psychosocial support is considered a core tenet of the haemophilia comprehensive care structure, the extent to which mental health challenges are detected and monitored by the individuals treating haematologist remains relatively unexplored.AimTo describe prevalence of anxiety and depression in a real‐world cohort of adult PwHA and evaluate the congruence in reporting of anxiety or depression (A/D) between PwHA and their treating physicians.MethodsData for PwHA without inhibitors was drawn from the European ‘Cost of Haemophilia: A Socioeconomic Survey II’ (CHESS II) study. Haematologist‐indicated comorbidities of anxiety and depression were unified into a single A/D indicator. The EQ‐5D‐5L health status measure was used to characterise self‐reported A/D, with individuals stratified into two non‐mutually exclusive subgroups based on level of A/D reported (Subgroup A: ‘some’ or above; Subgroup B: ‘moderate’ or above).ResultOf 381 PwHA with evaluable EQ‐5D‐5L responses, 54% (n = 206) self‐reported at least some A/D (Subgroup A) and 17% (n = 66) reported at least moderate A/D (Subgroup B). Patient‐physician congruence in A/D reporting was 53% and 76% for Subgroups A and B, respectively. Descriptive analysis suggested that individuals with physician‐ and/or self‐reported A/D experienced worse clinical outcomes (bleeding events, joint disease, chronic pain).ConclusionWhile adverse clinical outcomes appear to correlate with A/D, self‐reports of moderate–severe symptoms occasionally lacked formal recognition from treating physicians. Cross‐disciplinary surveillance of mental health issues could improve both psychological and clinical outcomes among PwHA.
    • Aspartame in conjunction with carbohydrate reduces insulin levels during endurance exercise

      Siegler, Jason; Howell, Keith; Vince, Rebecca; Bray, James W.; Towlson, Chris; Peart, Daniel; Mellor, Duane; Atkin, Stephen; University of Western Sydney ; University of York ; University of Hull ; University of Hull ; University of Hull ; University of Hull ; University of Chester ; University of York (01/08/2012)
      As most sport drinks contain some form of non-nutritive sweetener (e.g. aspartame), and with the variation in blood glucose regulation and insulin secretion reportedly associated with aspartame, a further understanding of the effects on insulin and blood glucose regulation during exercise is warranted. Therefore, the aim of this preliminary study was to profile the insulin and blood glucose responses in healthy individuals after aspartame and carbohydrate ingestion during rest and exercise. Each participant completed four trials under the same conditions (45 min rest + 60 min self-paced intense exercise) differing only in their fluid intake: 1) carbohydrate (2% maltodextrin and 5% sucrose (C)); 2) 0.04% aspartame with 2% maltodextrin and 5% sucrose (CA)); 3) water (W); and 4) aspartame (0.04% aspartame with 2% maltodextrin (A)). Insulin levels dropped significantly for CA versus C alone (43%) between pre-exercise and 30 min, while W and A insulin levels did not differ between these time points. Aspartame with carbohydrate significantly lowered insulin levels during exercise versus carbohydrate alone.
    • Association of apolipoprotein E gene polymorphisms with blood lipids and their interaction with dietary factors

      Shatwan, Israa M.; Winther, Kristian H.; Ellahi, Basma; Elwood, Peter; Ben-Shlomo, Yoav; Givens, Ian; Rayman, Margaret P.; Lovegrove, Julie A.; Vimaleswaran, Karani S.; University of Reading; King Abdulaziz University; University Hospital Denmark; University of Chester; University Hospital of Wales; University of Bristol; University of Surrey (BMC, 2018-04-30)
      Background: Several candidate genes have been identified in relation to lipid metabolism, and among these, lipoprotein lipase (LPL) and apolipoprotein E (APOE) gene polymorphisms are major sources of genetically determined variation in lipid concentrations. This study investigated the association of two single nucleotide polymorphisms (SNPs) at LPL, seven tagging SNPs at the APOE gene, and a common APOE haplotype (two SNPs) with blood lipids, and examined the interaction of these SNPs with dietary factors. Methods: The population studied for this investigation included 660 individuals from the Prevention of Cancer by Intervention with Selenium (PRECISE) study who supplied baseline data. The findings of the PRECISE study were further replicated using 1238 individuals from the Caerphilly Prospective cohort (CaPS). Dietary intake was assessed using a validated food-frequency questionnaire (FFQ) in PRECISE and a validated semi-quantitative FFQ in the CaPS. Interaction analyses were performed by including the interaction term in the linear regression model adjusted for age, body mass index, sex and country. Results: There was no association between dietary factors and blood lipids after Bonferroni correction and adjustment for confounding factors in either cohort. In the PRECISE study, after correction for multiple testing, there was a statistically significant association of the APOE haplotype (rs7412 and rs429358; E2, E3, and E4) and APOE tagSNP rs445925 with total cholesterol (P = 4 × 10− 4 and P = 0.003, respectively). Carriers of the E2 allele had lower total cholesterol concentration (5.54 ± 0.97 mmol/L) than those with the E3 (5.98 ± 1.05 mmol/L) (P = 0.001) and E4 (6.09 ± 1.06 mmol/L) (P = 2 × 10− 4) alleles. The association of APOE haplotype (E2, E3, and E4) and APOE SNP rs445925 with total cholesterol (P = 2 × 10− 6 and P = 3 × 10− 4, respectively) was further replicated in the CaPS. Additionally, significant association was found between APOE haplotype and APOE SNP rs445925 with low density lipoprotein cholesterol in CaPS (P = 4 × 10− 4 and P = 0.001, respectively). After Bonferroni correction, none of the cohorts showed a statistically significant SNP-diet interaction on lipid outcomes. Conclusion: In summary, our findings from the two cohorts confirm that genetic variations at the APOE locus influence plasma total cholesterol concentrations, however, the gene-diet interactions on lipids require further investigation in larger cohorts.
    • Autologous chondrocyte implantation-derived synovial fluids display distinct responder and non-responder proteomic profiles

      Hulme, Charlotte; Wilson, Emma; Peffers, Mandy J.; Roberts, Sally; Simpson, Deborah M.; Richardson, James B.; Gallacher, Pete; Wright, Karina; Keele University; Robert Jones and Agnes Hunt Orthopaedic Hospital; University of Chester; University of Liverpool (BMC, 2017-06-30)
      Background Autologous chondrocyte implantation (ACI) can be used in the treatment of focal cartilage injuries to prevent the onset of osteoarthritis (OA). However, we are yet to understand fully why some individuals do not respond well to this intervention. Identification of a reliable and accurate biomarker panel that can predict which patients are likely to respond well to ACI is needed in order to assign the patient to the most appropriate therapy. This study aimed to compare the baseline and mid-treatment proteomic profiles of synovial fluids (SFs) obtained from responders and non-responders to ACI. Methods SFs were derived from 14 ACI responders (mean Lysholm improvement of 33 (17–54)) and 13 non-responders (mean Lysholm decrease of 14 (4–46)) at the two stages of surgery (cartilage harvest and chondrocyte implantation). Label-free proteome profiling of dynamically compressed SFs was used to identify predictive markers of ACI success or failure and to investigate the biological pathways involved in the clinical response to ACI. Results Only 1 protein displayed a ≥2.0-fold differential abundance in the preclinical SF of ACI responders versus non-responders. However, there is a marked difference between these two groups with regard to their proteome shift in response to cartilage harvest, with 24 and 92 proteins showing ≥2.0-fold differential abundance between Stages I and II in responders and non-responders, respectively. Proteomic data has been uploaded to ProteomeXchange (identifier: PXD005220). We have validated two biologically relevant protein changes associated with this response, demonstrating that matrix metalloproteinase 1 was prominently elevated and S100 calcium binding protein A13 was reduced in response to cartilage harvest in non-responders. Conclusions The differential proteomic response to cartilage harvest noted in responders versus non-responders is completely novel. Our analyses suggest several pathways which appear to be altered in non-responders that are worthy of further investigation to elucidate the mechanisms of ACI failure. These protein changes highlight many putative biomarkers that may have potential for prediction of ACI treatment success.
    • Back into the light: The unveiling of Chester Royal Infirmary’s stained-glass windows at the University of Chester

      Griffiths, Sarah; Chatterton, Claire; University of Chester; Open University (UK Association for the History of Nursing, 2023-12)
      On 7 June 2023, the University of Chester’s Faculty of Health, Medicine and Society (FHMS) Historical Society hosted an event at the University’s Wheeler Building, when four stained glass windows from the former Chester Royal Infirmary were unveiled in their new home
    • Children’s participation in research: tensions and dilemmas around ethical practice

      Devarakonda, Chandrika (Index Copernicus, 2024-03-20)
      Are young children respected and cared for or overlooked by the practitioner or researcher’s personal goals in research? Are issues, related to ethics in relation to children’s consent and participation in research lost in translation especially in terms of expectations and interpretation in different cultural contexts. This paper explores the diverse perspectives of issues around ethics related to research with young children in early years settings.. It questions the perceived tensions around adults’ decisions about children’s participation in research. The issues related to children’s voice, gatekeepers of consent, participation, power and children’s rights will be discussed and the extent to which they influence the decisions which adults make about children’s participation in any research.
    • The cost of severe haemophilia in Europe: the CHESS study

      O’Hara, Jamie; Hughes, David; Camp, Charlotte; Burke, Tom; Carroll, Liz; Diego, Daniel-Anibal G.; University of Chester; HCD Economics, Daresbury; The Haeomophelia Society, London; FedHemo, Madrid (BMC, 2017-05-31)
      Background Severe haemophilia is associated with major psychological and economic burden for patients, caregivers, and the wider health care system. This burden has been quantified and documented for a number of European countries in recent years. However, few studies have taken a standardised methodology across multiple countries simultaneously, and sought to amalgamate all three levels of burden for severe disease. The overall aim of the ‘Cost of Haemophilia in Europe: a Socioeconomic Survey’ (CHESS) study was to capture the annualised economic and psychosocial burden of severe haemophilia in five European countries. A cross-section of haemophilia specialists (surveyed between January and April 2015) provided demographic and clinical information and 12-month ambulatory and secondary care activity for patients via an online survey. In turn, patients provided corresponding direct and indirect non-medical cost information, including work loss and out-of-pocket expenses, as well as information on quality of life and adherence. The direct and indirect costs for the patient sample were calculated and extrapolated to population level. Results Clinical reports for a total of 1,285 patients were received. Five hundred and fifty-two patients (43% of the sample) provided information on indirect costs and health-related quality of life via the PSC. The total annual cost of severe haemophilia across the five countries for 2014 was estimated at EUR 1.4 billion, or just under EUR 200,000 per patient. The highest per-patient costs were in Germany (mean EUR 319,024) and the lowest were in the United Kingdom (mean EUR 129,365), with a study average of EUR 199,541. As expected, consumption of clotting factor replacement therapy represented the vast majority of costs (up to 99%). Indirect costs are driven by patient and caregiver work loss. Conclusions The results of the CHESS study reflect previous research findings suggesting that costs of factor replacement therapy account for the vast majority of the cost burden in severe haemophilia. However, the importance of the indirect impact of haemophilia on the patient and family should not be overlooked. The CHESS study highlights the benefits of observational study methodologies in capturing a ‘snapshot’ of information for patients with rare diseases.
    • Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer

      Eccles, Suzanne A.; Aboagye, Eric O.; Ali, Simak; Anderson, Annie S.; Armes, Jo; Berditchevski, Fedor; Blaydes, Jeremy P.; Brennan, Keith; Brown, Nicola J.; Bryant, Helen E.; et al. (BMC, 2013-10-01)
      Introduction: Breast cancer remains a significant scientific, clinical and societal challenge. This gap analysis has reviewed and critically assessed enduring issues and new challenges emerging from recent research, and proposes strategies for translating solutions into practice. Methods More than 100 internationally recognised specialist breast cancer scientists, clinicians and healthcare professionals collaborated to address nine thematic areas: genetics, epigenetics and epidemiology; molecular pathology and cell biology; hormonal influences and endocrine therapy; imaging, detection and screening; current/novel therapies and biomarkers; drug resistance; metastasis, angiogenesis, circulating tumour cells, cancer ‘stem’ cells; risk and prevention; living with and managing breast cancer and its treatment. The groups developed summary papers through an iterative process which, following further appraisal from experts and patients, were melded into this summary account. Results The 10 major gaps identified were: (1) understanding the functions and contextual interactions of genetic and epigenetic changes in normal breast development and during malignant transformation; (2) how to implement sustainable lifestyle changes (diet, exercise and weight) and chemopreventive strategies; (3) the need for tailored screening approaches including clinically actionable tests; (4) enhancing knowledge of molecular drivers behind breast cancer subtypes, progression and metastasis; (5) understanding the molecular mechanisms of tumour heterogeneity, dormancy, de novo or acquired resistance and how to target key nodes in these dynamic processes; (6) developing validated markers for chemosensitivity and radiosensitivity; (7) understanding the optimal duration, sequencing and rational combinations of treatment for improved personalised therapy; (8) validating multimodality imaging biomarkers for minimally invasive diagnosis and monitoring of responses in primary and metastatic disease; (9) developing interventions and support to improve the survivorship experience; (10) a continuing need for clinical material for translational research derived from normal breast, blood, primary, relapsed, metastatic and drug-resistant cancers with expert bioinformatics support to maximise its utility. The proposed infrastructural enablers include enhanced resources to support clinically relevant in vitro and in vivo tumour models; improved access to appropriate, fully annotated clinical samples; extended biomarker discovery, validation and standardisation; and facilitated cross-discipline working. Conclusions With resources to conduct further high-quality targeted research focusing on the gaps identified, increased knowledge translating into improved clinical care should be achievable within five years.
    • Darzi's vision becomes a reality

      Holly, Chris; University of Chester (Royal College of Midwives, 2009-12)
      This articles discusses the new webside NHS Evidence - which aims to provide easy access to a comphrehensive evidence base for healthcare professionals.
    • Designing usable and accessible content

      Sumner, Ken (2007-06-01)
      This presentation examines the needs and requirements of learners to ensure accessibility. Ensuring accessibility is a universal goal for design. International guidelines surrounding design are discussed and good practice that can be embedded into any online development is demonstrated.
    • Development and feasibility of a Swallowing intervention Package (SiP) for patients receiving radiotherapy treatment for head and neck cancer—the SiP study protocol

      Wells, Mary; King, Emma; Toft, Kate; MacAulay, Fiona; Patterson, Joanne; Dougall, Nadine; Hulbert-Williams, Nicholas J.; Boa, Sally; Slaven, Eleanor; Cowie, Julie; et al. (BMC, 2016-08-04)
      Background Head and neck cancer (HNC) is the sixth most common cancer worldwide, and the functional, psychological and social consequences of HNC cancer and its treatment can be severe and chronic. Dysphagia (swallowing problems) affects up to two thirds of patients undergoing combined chemoradiotherapy. Recent reviews suggest that prophylactic swallowing exercises may improve a range of short- and long-term outcomes; however, the importance of psychological and behavioural factors on adherence to swallowing exercises has not been adequately studied. This study aims to develop and test the feasibility of a Swallowing intervention Package (SiP) designed in partnership with patients, speech and language therapists (SLTs) and other members of the head and neck multi-disciplinary team (MDT), for patients undergoing chemoradiotherapy (CRT) or radiotherapy (RT) for head and neck cancer. Methods/design This feasibility study uses quantitative and qualitative research methods, within a quasi-experimental design, to assess whether patients will tolerate and adhere to the SiP intervention, which aspects of the intervention can be implemented and which cannot, whether treatment fidelity can be achieved across different contexts, whether study processes and outcome measures will be feasible and acceptable and to what extent the intervention is likely to have an impact on swallowing dysfunction and quality of life. Patients are being recruited from five sites in Scotland and England (three interventions and two usual care). The SLT based in the relevant intervention centre teaches the exercise programme and provides supporting materials. A combination of patient-reported outcome measures (PROMs), adherence measures and clinical swallowing assessments are used prior to intervention (baseline), at the end of treatment, 3 and 6 months post-treatment. Discussion This collaborative study has taken a unique approach to the development of a patient-centred and evidence-based swallowing intervention. The introduction of an e-SiP app provides an exploration of the use of technology in delivering this intervention. The study provides an opportunity to examine the feasibility of delivering and participating in a supported swallowing intervention across several different NHS sites and will provide the evidence needed to refine intervention and study processes for a future trial. Trial registration NCRI portfolio, 18192 & 20259
    • Eating for 1, Healthy and Active for 2; feasibility of delivering novel, compact training for midwives to build knowledge and confidence in giving nutrition, physical activity and weight management advice during pregnancy

      Basu, Andrea J.; Kennedy, Lynne; Tocque, Karen; Jones, Sharn; University of Chester; Wrexham Maelor Hospital (BMC, 2014-07-04)
      Background: Women in Wales are more likely to be obese in pregnancy than in any other United Kingdom (UK) country. Midwives are ideally placed to explore nutrition, physical activity and weight management concerns however qualitative studies indicate they lack confidence in raising the sensitive issue of weight. Acknowledging this and the reality of finite time and resources, this study aimed to deliver compact training on nutrition, physical activity and weight management during pregnancy to increase the knowledge and confidence of midwives in this subject. Methods A compact training package for midwives was developed comprising of evidence based nutrition, physical activity and weight management guidance for pregnancy. Training was promoted via midwifery leads and delivered within the Health Board. Questionnaires based on statements from national public health guidance were used to assess changes in self-reported knowledge and confidence pre and post training. Descriptive statistics were applied and 95% confidence intervals were calculated. Results 43 midwives registered for training, 32 (74%) attended and completed the questionnaires. Although, pre training knowledge and confidence varied between participants, statistically significant improvements in self-reported knowledge and confidence were observed post training. 97% indicated knowledge of pregnancy specific food and nutrition messages as ‘better’ (95% CI 85 to 100), as opposed to 3% stating ‘stayed the same’ – 60% stated ‘much better’. 83% indicated confidence to explain the risks of raised BMI in pregnancy was either ‘much’ or ‘somewhat better’ (95% CI 66 to 93), as opposed to 17% stating ‘stayed the same’. 89% indicated confidence to discuss eating habits and physical activity was ‘much’ or ‘somewhat better’ (95% CI 73 to 97) as opposed to 11% stating ‘stayed the same’. Emergent themes highlighted that training was positively received and relevant to midwifery practice. Conclusions This study provides early indications that a compact nutrition, physical activity and weight management training package improves midwives self-reported knowledge and confidence. Cascading training across the midwifery service in the Health Board and conducting further studies to elicit longer term impact on midwifery practice and patient outcomes are recommended.
    • Effective e-moderating: Engaging your students in online discussions

      Weatherston, Debra (2007-06-01)
      This presentation discusses how to engage students in online discussions. The skills required to become an effective e-moderator and how online discussion board technology can improve engagement and focus discussion will be discussed.
    • Enabling collaborative lesson research

      Bamber, Sally; orcid: 0000-0002-4671-4565; Blears‐Chalmers, Sarah; Egan‐Simon, Daryn; Packer, Christine; Guest, Sarah; Hall, Joanna (Wiley, 2024-03-18)
      AbstractIn this paper, we interrogate and justify the design of a local project that used collaborative design research in a secondary school in England. As authors, we represent teachers and teacher educators engaged in design research, whereby we acknowledge the difficulties implicit to university and school collaborations within a performative culture. Our analysis recognises the struggle for research‐informed professional judgement in the decision‐making and actions of educators that are situated in schools. A professional learning project is analysed to position teachers and teacher educators as practitioner researchers. In this respect, Stenhouse's work provides an analytical framework that is both a lens through which to interpret the nature of collaborations, as well as a methodology that allows us to understand the way in which we navigate the gap between educators' aspirations and the curriculum design and teaching within the project. The collaborative design research project was stimulated by an aspiration to make trigonometry accessible to low prior attaining pupils in a secondary mathematics classroom. This provides a stimulus for understanding the conditions that enable collaborative lesson inquiry and to question whether it can provoke raised aspirations for young people in inclusive classrooms. This allows us to understand the work of teachers as researchers and research users in an increasingly messy teacher education context. We interrogate the potentially problematic connection between research and practice within collaborative inquiry, as we understand how we enable research that is “held accountable for its relevance to practice” because “that relevance can only be validated by practitioners” (Stenhouse, 1988, p. 49).
    • Ethical issues in pedagogic research

      Regan, Julie-Anne; Baldwin, Moyra A.; Peters, Lisa; University of Chester (University of Bedfordshire, 2012-10)
      This paper explores the ethical issues identified by a research ethics committee (REC) over a three-year period. The REC is situated in a medium-sized univerity in the north west of England and deals exclusively with proposals for pedagogic research. The purpose of the research was to identify the nature and frequency of ethical concerns expressed by the REC, in order to improve guidance for future applicants. The most common concern was the lack, or inaccuracy, of the information provided to potential participants by which they were expected to make an informed decision about participation. Other concerns included the potential for bias, the lack of information provided to the REC, the provision for fair access by vulnerable groups and undue influence on voluntary particpation. The paper concludes that the potential risks of practitioners researching their own students are not given due consideration by many applicats. In particular the potential threats to valid informed consent are identified. Implications for improving the relationship between researchers and RECs are discussed, as is the guidance for applicants.
    • Ethical issues in pedagogic research

      Regan, Julie-Anne; Peters, Lisa; Baldwin, Moyra A.; University of Chester (2011-12-06)
      This presentation discusses the ethical issues identified by a research ethics committee (REC) over a three year period. The REC deals exclusively with proposals for pedagogic research. The purpose of the research was to identify the nature and frequency of ethical concerns expressed by the REC, in order to improve guidance for future applicants.
    • Evaluating the Cephalonia method of library induction

      Peters, Lisa; Brown, Judith; Davies, Eric; Hultum, Sue; Thompson, Marion; Thomas, Pam; Williams, Anne; University of Chester (SCONUL, 2007-12)
      This article discusses the results of a survey carried out at the University of Chester library into student feedback of the Cephalonia method of library induction.
    • Examining the workings of a late nineteenth century provincial press conglomerate: Frederick Edward Roe and his newspapers

      Peters, Lisa; University of Chester (2012-07-12)
      This presentation discuss four newspapers located in north Wales and the Marches owned by Frederick Edward Roe between 1880 and 1887. It analyses the relationship between the four titles and the extent to which they shared content, advertising, and staff.
    • Exploring the Development Needs of Postgraduate Taught Dissertation Supervisors

      Regan, Julie-Anne; Taylor, Kirsty; Simcock, Thomas; University of Chester (2014-10)
      The Graduate School, in collaboration with the Learning and Teaching Institute (LTI), undertook this project to explore the development needs of PGT dissertation supervisors. This information was vital to the effective planning of development opportunities, in order to enhance dissertation supervision on PGT programmes and ultimately improve the overall postgraduate student experience.