• How optimal is the management of patients attending cardiac rehabilitation with coronary heart disease?

      Meadowcroft, Melanie (University of Chester, 2014)
      Although evidence exists to suggest that post MI mortality is reducing in parallel with advancements in cardiology practice, ‘optimal medical management’ and risk factor control of patients with coronary heart disease (CHD) has been referred to as being sub-optimal compared to that shown to be effective in clinical research. With numerous treatment methods available for managing CHD, continuous analysis is required to ascertain which treatment methods are most beneficial in reducing mortality and improving outcomes for patients following a diagnosis of CHD. Additionally, increasing numbers of patients commence medical therapy with surgical intervention deferred. It is therefore imperative that patient treatment is optimised through adherence to clinical guidelines. This paper aims to explore the current standpoint on treatment options for CHD whilst analysing the extent to which evidence based guidelines translate into clinical practice. This will include the discussion of patient compliance and community follow up and the impact these factors have on outcomes for patients with CHD. This will be established by first exploring the effectiveness of treatment methods for CHD before discussing the use of cardiac rehabilitation as a resource for further improving outcomes following treatment.
    • How relevant and effective is the information given in a phase III cardiac rehabilitation programme?

      Fallows, Stephen; Williams, Margaret R. (University of Chester, 2008-09)
      The purpose of this evaluation study was to consider the views of people attending a phase III cardiac rehabilitation programme in respect of the relevance of the information given in the educational component of the programme and to examine if that information can positively influence behaviour change. A review of the literature confirms that there is strong evidence attesting to the benefits of cardiac rehabilitation, despite this, important questions remain to be answered as to the value of the non-exercise element of the programme. Exploring patients’ views and preferences is considered a valid method of assessing the value of health care. A questionnaire incorporating both quantitative and qualitative components was used to collect data from a selection of participants attending the programme (n=54, mostly middle aged males). Descriptive statistics including frequencies and percentages were formulated to summarize and present the quantitative data, the responses to the qualitative data were thematically collated and analysed manually. Overall, the participants agreed the information they received in all of the educational talks was relevant to their needs. The findings also indicate that the participants were encouraged to make positive lifestyle changes, confirming the effectiveness of the information given as a means of instigating behavioural change.
    • How reliable are standardised behaviour tests and are they valid in predicting the suitability for use in police horses?

      Creighton, Emma; Perry, Catherine; Flentje, Rachel (University of ChesterUniversity of Chester, 2008-09)
      Standardised behaviour tests have the potential to improve equine welfare by enabling the selection of horses suitable for a particular role. A range of tests are found in scientific literature which make such claims. However, with notable exceptions, authors have failed to establish the reliability of their tests or the validity of their claims. This study aimed to determine a set of reliable behaviour tests based on those reported in literature; and to test the validity of these as predictors of horses’ suitability as police horses. Reliability of response to a novel object, social isolation and handling tests was established by tests repeated at three week intervals on 33 horses. Behavioural responses were recorded post hoc to enable the full range of responses to be measured. There was some evidence that the horses habituated to static stimuli used in the tests, and the majority of the tests were at best moderately reliable, with only reactivity tests showing good or better reliability. Tests with moderately reliable results or results which could be explained by habituation, were included in the validity testing. This compared the horses’ responses to the behavioural tests with handlers’ ratings of key aspects of police horse performance. These subjective scales of suitability of police horses were developed from interviews with instructors and yard managers. The items were combined to develop a set of specific indices of police horse roles. Spearman’s rank order correlations were used to explore whether any relationships existed between the horses’ behavioural responses to the tests and subjective ratings of their suitability for their use. The results revealed eight moderate associations which were on the whole between horses’ responses to the reactivity tests (unexpected noise and sudden moving object) and the suitability scores. These findings suggest that standardised behavioural tests are not strongly reliable. The validity analysis indicated that either the tests used in this study did not serve as predictors of suitability for use, or that behavioural responses to standardised tests cannot be generalised to the wider challenges faced by these horses in their roles. However the reactivity tests did reveal stronger reliability and they were the only measures to show any association with the suitability scores, suggesting that reactivity tests may have some validity in measuring a horse’s suitability. Overall, the findings of this study cannot support claims made for these (or similar) tests to be valid predictors of a horse’s suitability for use.
    • How to catch a liar: The Effect of Communicative Channels on Accuracy in Detecting Deception in High-Stakes Situations

      Wright, Clea; Murphy, Molly (University of Chester, 2018)
      Much past research states people are generally quite poor at detecting deception, with meta-analytic findings reporting an average accuracy rating of 54% (Bond & DePaulo, 2006). However, the majority of these previous findings stem from the use of ‘low-stakes’ lies as stimuli. This current study used real-life video clips of a ‘high-stakes’ nature, investigating the effects of three different communicative channels on a novice lie detector’s ability to detect deception; an Audio-Visual channel, a Visual-Only channel and an Audio-Only channel. The effects on both participant accuracy and participant confidence scores were analysed, with further investigation into a potential relationship between participant accuracy and confidence. On reviewing previous literature, the current study hypothesized the following; participant accuracy in detecting deception across all modalities will score above the level of chance; the highest accuracy scores will be found within the Audio-Visual condition; the Audio-Only condition will produce higher levels of accuracy than those found in the Visual-Only condition; the Audio-Visual condition will produce the highest confidence ratings; no relationship will be found between overall levels of accuracy and confidence ratings reported. The current study also explored what behavioural cues are relied upon by novice lie detectors in their attempts to identify deception. No hypothesis was generated for the justification of decisions i.e. (the cues participants report using). However, information provided will help identify what behavioural cues members of the general public rely upon when detecting deception. A total of 60 participants were recruited for the current study, with an equal number of participants observing video-clips within each presentation modality (n=20). 8 video-clips were shown, all involving real-life ‘high-stakes’ situations i.e. an appeal for a missing relative. Half of the clips involved innocent individuals (telling the truth and not involved in the crime) and the other half were deceitful (involved in the crime and attempting to deceive observers). Overall, participant accuracy scored significantly above the level of chance (M=55, t(59)=2, p=0.05.). No statistically significant differences were found in participant accuracy and participant confidence between the three presentation modalities F(2,57)=.36, p=.70, n2=0.01; F(2, 57)=.58, p=.84, n2=0.02. Nor was a significant relationship observed between participant accuracy and participant confidence r(60)=.11, p=.43. Participants reported relying on behavioural cues involving ‘Nervous Behaviours’ and ‘Fake Emotion’ when determining a sender’s veracity. Implications and suggestions for future research are discussed.
    • The human delusion: A discussion into the emergence of the posthuman through the deconstruction of the liberal humanist view of the self in Margaret Atwood’s Oryx and Crake and Paolo Bacigalupi’s The Windup Girl

      Stephenson, William; Kelly, Sarah (University of Chester, 2013-09)
      This dissertation will serve to investigate the deconstruction of the liberal humanist vision of the ‘self’ through a posthumanist reading of the two dystopian novels Oryx and Crake and The Windup Girl by Margaret Atwood and Paolo Bacigalupi respectively. By engaging with these two novels, this dissertation will focus primarily on a posthumanist reading of the texts and analyse the perceived image of the nineteenth century ‘man’ and discuss the possible disappearance of this view of what it means to be a human being. The introduction will explain the differences between the liberal humanist subject, the transhumanist subject and the posthumanist subject. The main body of the dissertation will then discuss key issues surrounding these three subjects. By focusing on epistemic shifts, the blurring of boundaries between humans and animals and the end of a capitalistic model of living, this dissertation serves to prove how these two novels expose the threat that the liberal humanist subject poses to itself and highlights the inevitable move to the posthuman. This dissertation also serves to discuss the possibility of the human and posthuman being able to survive together.
    • Human resource devolution: A local authority perspective

      Farrell, Paul (University of ChesterLiverpool City Council, 2010-06)
      This dissertation asks the question “What are the barriers to the successful devolving of Human Resource Management to First Line Managers?” and the dissertation makes an attempt to connect what is already known within existing contemporary research about devolved Human Resource Management and the barriers to it being successful, and what First Line Managers within Liverpool City Council find in reality. A conceptual model is formulated which identifies the main concepts that influence the Human Resource role of the Line Manager. The Human Resource role that First Line Managers undertake is explored through the use of a case study within the Environment Business Group of Liverpool City Council using multiple qualitative methods. The findings of the case study support the validity of the key aspects identified as being barriers to the successful Human Resource devolvement to First Line Managers i.e. communication, skills/training and staff management. The dissertation therefore proposes how these key aspects need to be addressed to improve Human Resource Management within Liverpool City Council to enhance the Human Resource function, First Line Manager and staff performance.
    • I do not understand – or the art of understanding: When do language barriers matter in art therapy and how to overcome them? A qualitative research into the experiences of art therapists when working with clients of other language origin

      Ridgway, Victoria; Shorney, Louise; Annett, Ros; Gallagher, Anja-Katharina (University of Chester, 2014-10)
      This research study, placed within interpretivist/constructivist paradigm and informed by phenomenologist tradition, set out to explore art therapist experiences whilst working with clients whose first language was not shared with the art therapist themselves. It aimed to explore questions such as: if language barriers would matter within art therapeutic practice; how and if language difference would be experienced and may influence the therapeutic relationship and processes, and how art therapists would overcome such situations in which communication may have been experienced as difficult. To answer such questions, this enquiry focused upon the strategies employed by the art therapists in order to overcome such difficulties, relating to language difference. Three monolingual art therapists were interviewed utilising a semi-structured interview approach. Their accounts were analysed through Interpretative Phenomenological Analysis (IPA). Six master themes were identified which were: ‘Language barriers / barriers of understanding (general)’, ‘Client group (bilinguals / language learner) specific observations’, ‘Language difference = cultural difference’, ‘Impact on therapeutic relationship’, ‘Approaches to aid understanding (non art based)’ and ‘Art as language’. Based upon these results it was concluded that language difference matters within art therapeutic practice. Art therapy can be seen already as a successful approach, when working with clients whose language origin differs from that of the therapist. However, it was also highlighted that there is a general lack of understanding of wider psychological and psychodynamic implications associated with language difference and bi or multilingualism. Proposing to be cautious upon the role of the image within this unique working relationship and to recognise bilingual/language learning clients as a subordinate client group, it was argued that promoting bilingual awareness and its inherent implications within art therapeutic training and practice would allow art therapy to become a truly powerful therapeutic approach, when working with this, indeed, suborientated client group. Recommendations for further research, art therapeutic training and practice were made.
    • If a service quality measurement questionnaire is applied across the key stages of the customer relationship lifecycle, would the results provide an insight into current deficiencies with existing service quality measurement tools?

      University of Chester, 2012-11
      Over the last three decades, researchers have been attempting to understand the dimensions associated with Service Quality and Customer Satisfaction. A conclusion is being drawn that improved Service Quality leads to greater customer retention and market share, therefore there are rich rewards for any service company that can adopt a strategic Customer Service philosophy in a cost effective manner. Many constructs have been developed in an attempt to derive a measure of Customer Satisfaction, but none to date have demonstrated a universal approach capable of coping with the nuances of all service typologies. As the goal of improved Customer Satisfaction is to increase customer engagements and therefore profit for the adopting company, this dissertation deploys a Service Quality Measurement instrument across the stages of the Customer Relationship Lifecycle. There are few academic examples of research instruments being deployed in this manner however; many of the existing constructs contain elements of this conceptual model. The research evaluates whether the stages of the Customer Relationship Lifecycle should be the starting point for service providers to build their own Service Quality customer surveys. It examines whether this process is an appropriate construct for service providers to evaluate how to capture customers, and then build the relationship through to successful and hopefully repeat transactions. The researcher goes on to examine the data captured to establish whether there are issues associated with the profile of the customer which would influence the results of a Customer Satisfaction Survey and consequently provide insight as to potential reasons why existing Service Quality questionnaire constructs produce inconsistencies. Finally, consideration is given to development of this conceptual model and its potential for understanding how Service Quality is influenced by different Service Typologies.
    • Immune Function Assessment with ABEL®-Sport Test in Trained Rowers

      Fallows, Stephen; Labedzka, Maria (University of Chester, 2017-08-18)
      Background and aims: Rowing induced muscle stress may have impact on athletes’ immune-system and lead to an increased incidence of upper respiratory tract infection (URTI) symptoms. This study aimed to evaluate the capability of ABEL®-Sport test used in the field of to assess the susceptibility of rowers to URTI pending their exercise-loads. Methods: 6 male (aged 50 ± 16.9 y) and 5 female (aged 47 ± 9.6 y) club rowers recorded their habitual training and URTI symptoms daily for two weeks and performed a 6.8 km race-simulation on a rowing ergometer at the beginning of third week. The immune function of the rowers was assessed via the quantification and kinetics of oxidative burst response of leukocytes in 10 μl capillary blood using ABEL®-Sport test throughout the study in the field. Results: The severity of URTI symptoms increased from pre-race median value of 0 (0 – 9) to 3 (0 – 13) within two weeks post-race but was not statistically significant (p>.0125). There was very high correlation between the frequency of the occurrence of abnormal ABEL® Sport kinetics up to the 48h post-race for 7 rowers with URTI symptoms two weeks post-race (r = .930, p = .002). All 4 participants with a final URTI score >10 had irregular oxidative burst kinetics before the race and 48h after and 2 of them have not reported any URTI symptoms before the race. Conclusion: The study results indicate that ABEL®-Sport test used in the field is capable of detecting susceptibility to URTI in club rowers and could guide individual athletes in training-loads suitable for their well-being.
    • Impact in law but what about practice? Intermediaries and how they aid vulnerable people to access the Criminal Justice System.

      Mattison, Michelle L. A.; Owen, Rebecca S. (University of Chester, 2016)
      Vulnerable people are more likely to encounter the justice system but less likely to achieve justice. This is due in part to the psychological and developmental challenges they face but also due to lack of recognition and appropriate adaptation in professional practice. Legislation has recognised the need for change by introducing special measures for vulnerable victims and witnesses, particularly appointment of an intermediary and further guidance for practitioners has developed in turn. To date, little is known of the practical application of such changes and whether the additional needs of the vulnerable are now adequately addressed within the justice system. To provide more insight, 20 participants engaged in a survey based study. Participants were questioned in relation to their previous experience of working with vulnerable people, their understanding of such additional needs, their use of special measures and their experience of The Advocate’s Gateway website (TAG). All respondents, primarily intermediaries were aware of how to identify vulnerabilities and the associated challenges faced in accessing the justice system. Respondents’ confidence within role increased with the number of vulnerable people worked with and communication aids were utilised appropriately but with further guidance needed. All respondents utilised TAG and found its resources invaluable. These findings build on the widespread knowledge surrounding intermediaries and vulnerable people in the justice system. However, a wider sample to include legal professionals is called for in future studies to better understand the current landscape for vulnerable people attempting to access the justice system.
    • The impact of a traumatic birth: An exploration of mothers’ experiences

      Parnell, Tony; Todd, Ann M. (University of Chester, 2013-10)
      This study took a qualitative approach to explore mothers’ experiences of the impact of traumatic birth. Four women who had experienced a self-defined traumatic birth took part in taped semi-structured interviews. Interpretative phenomenological analysis was chosen as the means of evaluation. The research found mothers experienced feelings of fear, shock and being out of control during the trauma. Coping mechanisms of dissociation and repression were reported. Feelings of failure, anger, inadequacy and depression featured postpartum. The trauma also impacted on marital relationships, mother baby bonding, attachment behaviour and decisions about future pregnancies. Post traumatic growth was also a feature of the impact of traumatic birth.
    • The impact of building customer loyalty as a means of sustaining continuous organisation growth in the highly competitive UK retail market

      Webb, Paul; Adeniyi, Esther (University of Chester, 2009)
      This research examines the impact of building customer loyalty as a means for sustaining continuous organisation growth in the highly competitive UK market. The research presents the results of a study undertaken in Sports Direct Unit 6 Chester. The study examined the antecedent factors of customer satisfaction and customer relationship management in the bid to understand the concept of loyalty. From the study, it was concluded that customer satisfaction is an important necessity to generate customer loyalty. It was also noted that service quality is an integral part of customer satisfaction that cannot be overlooked. The study also identified the importance of effective complaint handling as it helps shapes overall satisfaction and in turn affect customer loyalty. The second antecedent- CRM was critically looked into. The study found out that the image of the organisation plays a role in forming customers’ perceptions about the organisation. The use of database marketing and loyalty schemes were also considered in the research. Overall, the quantitative and qualitative data collected reveals that customer satisfaction and customer relationship management both contribute to customer loyalty. It was also noted that although both antecedents were important, they are not solely responsible for generating loyalty from customers. The study therefore agreed with other previous researches that customer loyalty is not as simple as it sound. It involves coordinating many antecedents to make it worthwhile for both the organisation and the customers. However, it was noted that as complicated as it seem, building a loyal customer base is worthwhile for organisations to survive in the fierce competition emerging everyday in the UK retail market.
    • Impact of different training regimes on adherence and “correctness” of exercises in elderly

      Fallows, Stephen; Lim, Peiying Serene (University of Chester, 2010-09)
      Introduction: Adherence and accuracy of home exercises contribute largely to the effectiveness of physiotherapy treatment. Poor memory attributed to aging can however impede these two key factors. Although exercise sheets are often provided to help the elderly remember their exercises, little is known about how different modes of training with exercise brochure may impact these factors over time. Aims: To investigate the impact of various training regimes on adherence and “correctness” of exercise in the elderly and its resultant effect on fall risk factors such as lower limb strength, dynamic standing balance and fear of falling. Methods: 17 community dwelling elderly (aged 78+6.5 years) from three falls prevention classes in Cheshire were recruited. Participants from the same falls prevention class were clustered as a research group. Five home exercises were taught to all participants individually. Each group randomly received exercise instructions through verbal instructions and live demonstration only (no brochure group), verbal instruction and live demonstration with reference and explanation to pictures in the brochure (brochure (before) group) or verbal instruction and live demonstration with an unexplained brochure provided only after the training session (brochure (after) group). Participants continued to perform the exercises unsupervised at home, for six weeks. Exercise adherence was assessed with an exercise log book and “correctness” of exercise was scored against an exercise assessment scale at the end of six weeks. Measurement of fall risk factors such as lower limb strength (using 30 seconds chair stands), dynamic standing balance (using four square step test) and fear of falling (using the Activities-specific Balance Confidence scale) were also assessed prior to the research and at the end of six weeks. Results: No statistically significant difference was found in exercise adherence and “correctness” of exercise scores between the no brochure group, the Brochure (after) group and the Brochure (before) group (62+ 26.6 %, 70+15.1 %, 77+13.7 %, p=0.448 and 33+8.7 marks, 34+4.6 marks, 38+1.3 marks, p = 0.175, respectively). Fall risk factors such as lower limb strength (r=0.205, p=0.429), dynamic standing balance (r=-0.253, p=0.327) and fear of falling (r=0.255, p=0.322) were also not found to be significantly correlated with “correctness” of exercise scores after six weeks. “Correctness” of exercise scores was found to be significantly correlated with exercise adherence (r=0.506, p=0.038). Conclusion: There is little evidence that a clearly explained exercise brochure coupled with live demonstation of the exercises improves exercise adherence or “correctness” of exercise in the elderly, compared to no exercise brochure or providing an unexplained exercise brochure. There is also little evidence to suggest that the more accurately exercises are performed, the better the improvement in fall risk factors. There is evidence, however, that accuracy of exercise performed is dependent on how well an exercise regime is adhered to. Hence, it is important that the elderly are encouraged to adhere to exercising regularly, in order to reap the benefits of exercise.
    • The impact of elected member development on Local Authority performance: How can effective elected member development be provided to enable performance improvement at Liverpool City Council?

      Robertson Collins, Laura (University of Chester, 2006-06)
      This dissertation aims to discover whether elected member development can lead to performance improvement in councils, and if so, how it can best be provided to do so at Liverpool City Council. Public funds are provided for elected member development on the assumption that this will assist performance by improving governance and leadership, but there is little conclusive evidence to show that this is the case. This dissertation shows there is a relationship between providing development for members and improved performance in councils, but cannot prove that the development causes the improved performance. However, the dissertation does identify particular elements within the provision of elected member development that are particularly linked to higher performance in local authorities. Liverpool City Council has had a member development programme since 2000, but its overall performance is apparently deteriorating, with particular issues around governance and leadership having been the subject of recent criticism. Liverpool received only two stars in its most recent Comprehensive Performance Assessment, and its 'direction of travel' was assessed at only level two on a scale of four - 'improving adequately'. If elected member development is linked to improved performance, it is important then to discover how development can best be provided to councillors at Liverpool to ensure this. Chapter 1 of the dissertation describes the changes in the councillor role and the consequent need for training and development to support elected members, who are part-time volunteers in their role as governors of local authorities. In Chapter 2 the literature review examines the improvement agenda for local government, and in particular the need for improvement at Liverpool City Council caused by the apparent decline in performance since 2004. Additional pressures on Liverpool City Council, for example the bid to become a 'City-Region', are also examined. The literature review contains discussion on the performance management of organisations via managing the performance of the individuals in them, and on how elected members do not easily fit the traditional human resource development models used in employment situations. Finally, the chapter examines the development issues specific to elected members, including the adversarial environment caused by the democratic system and the role of the political parties in recruiting and selecting the members, which leads to complexity in appraisal and identifying development needs. From this literature search three main issues emerge which require further investigation: first, whether elected member development can improve local authority performance; second, if so, how development can best be provided; and third, what special consideration is needed within the cross-party development provision for the political groups on the authorities? Chapters 3 and 4 look at the primary research undertaken for this dissertation. Chapter 3 describes the methodology of the research, including how both inductive and deductive strategies are used, as well as different data collection methods, to answer the three parts of the research question. The chapter also looks at the limitations of the research, which is conducted with members of one political party only due to the researcher's professional role, and at the small sample size. Chapter 4 gives an overview of all the authorities in the survey, showing that these are varied in political control and type. The chapter presents the results of the survey of each identified element of local authority provision of cross-party elected member development, and the provision of each element of development within the political groups there. It also presents some of the data from the semi-structured interviews with members from Liverpool City Council where this is directly related to the survey. 11 In the analysis in Chapter 5 the results of the survey on corporate provision are cross-referenced with the performance scores of the local authorities to investigate whether there is a relationship between the provision of development and the performance of the authority. Here we see that the higher performing councils do have higher levels of elected member development provision, although it is not clear if the development is the cause of better performance or the result of it. This shows that some of the identified elements of provision are particularly linked to performance scores. The second part of the analysis examines the situation at Liverpool City Council by examining the results of the case study and member interviews, in the light of the information from this cross-referencing. This indicates what changes can be recommended for Liverpool's provision of corporate, cross-party development for all its members. The dissertation suggests that such corporate development cannot of itself be sufficient, however, due to the nature of the political groups and the relationship of the political parties to the local authority. Thus the final part of the analysis examines issues specific to the political groups at the surveyed authorities and in Liverpool, in order to make recommendations for development and training within Liverpool's Opposition Group. In particular the need for training of potential candidates prior to selection and election is identified from the interview data, and the complexity of providing such training outside of the local authority is discussed. Chapter 6 summarises the recommendations for the provision of corporate (cross-party) member development which emerge from the analysis in Chapter 5. It also suggests recommendations for action within individual political groups' development, including the possibility of a 'Liverpool Academy' for potential elected members. Chapter 6 also contains recommendations for further research in this field. The dissertation shows that particular ways of providing elected member development can impact on performance, and that improvement in this provision at Liverpool City Council can be achieved requiring relatively little additional resources, but by more effective use of existing resources within the City Council and local government.
    • The impact of exercise training on endothelial function in heart failure patients: a systematic review

      Obinna, Ndukwu P. (University of Chester, 2015)
      9.1 BACKGROUND Flow mediated dilatation (FMD) is attenuated in Heart failure (HF) and this leads to worsening of symptoms. In Europe, the number of HF patients is estimated to be approximately 15 million and that number is set to rise due to ageing of the population. A research conducted between 1999 and 2000, showed that mortality rate was 50% in males and 46% in female within 5 years after the diagnosis of HF. It is estimated that 50% die within four years whereas the other 50% do not survive beyond the first year after diagnosis. Endothelial dysfunction has been implicated in disease progression, however, it is known that increase in physical activity improves and corrects endothelial dysfunction. 9.2 OBJECTIVES The aim of this systematic review is to examine (i) the effect of exercise modalities (aerobic, strength or combined) on FMD in HF and (ii) to determine which modality confers the greatest benefit and to what extent. 9.3 METHOD The following databases (MEDLINE, Cochrane library, PubMed, science direct,) were searched for sources that met the inclusion criteria such as (i) randomized controlled trials of 31 exercise with non-exercise, routine care or sedentary lifestyle. (ii) Duration of the exercise should be at least 2 weeks (iii) age of participant should not be below 18 years. (iv) Endothelial function as measured by FMD before and after the intervention. 9.4 RESULTS 14 studies were included in this review with a total of 583 participants predominantly with reduced ejection fraction (<40%) and New York Heart Association II and III. Compared with control, there were significant improvement (p< 0.005) in endothelial function as measured by FMD in the exercise group across all the studies involving HF with reduced ejection fraction (HFREF). Aerobic exercise at a moderate intensity resulted in significant increase in FMD in 12 studies but higher outcome were noted when it was performed in combination with resistance training at a higher intensity. Conversely, one study done among HF with preserved ejection fraction (HFPEF) did not show any significant improvement. 9.5 CONCLUSION Exercise training is effective in correcting the prevailing endothelial dysfunction common with HF. Combination of aerobic and resistance training as against only aerobic at moderate to high intensity offers the greatest benefit.
    • The impact of field vision on performance within an English Premier league academy soccer team: A case study

      Worsfold, Paul R.; Spearritt, Daniel (University of Chester, 2013-09-30)
      Previous perceptual-cognitive skill research in sport has often applied laboratory-based protocols to examine differences amongst elite and sub-elite performers. Contemporary research within the area has started to move away from such protocols and has begun analysing visual search behaviours within competitive adult soccer matches. The purpose of the current study was to develop an understanding of visual search behaviour in relation to performance outcome amongst elite level youth soccer players, within competitive match performance. Thirteen matches from an English Premier League academy soccer team (under 15 age group) were analysed using a specifically designed notational analysis system created in Microsoft Excel. Visual explorations conducted by individual players were collated, followed by their subsequent action when in possession of the ball. The results show significant visual exploration differences between higher and lower ability elite level youth players (p=0.000). The results of a series of categorical logistic regression analyses also show a clear positive relationship exists between visual exploratory behaviours that are initiated prior to a player receiving the ball and performance with the ball. This relationship remains when assessed amongst several match conditions including overall pass completion, attacking third pass completion and forward pass completion. Practical implications for coaches, scouts and players are discussed.
    • Impact of hand-held weights on treadmill walking in previously sedentary women

      Morris, Mike; Savin, Deborah J. (University of Chester, 2012-07-31)
      The aim of this dissertation was to study the physiological adaptations when hand-held weights are incorporated into a six-week programme of regular walking. Fourteen sendentary women aged 37+/-8 years were randomly allocated into one of two groups; hand-held weight group (HWG) and control group (CG). Twelve women (six per group) completed the study. Both groups completed a six-week unsupervised exercise programme comprising three 30min treadmill walks per week at 60-75% of predicted maximal oxygen uptake (VO2max). HWG carried two 0.91kg (2lb) hand-held weights using an active arm swing, CG exercised without weights. All walks were undetaken at 0% incline. Participant progress was monitored via the study website (www.sleepy8.com). Predicted VO2max, distance walked in 10min, body mass, waist circumference and sum of four skinfold sites were measured at Baseline, Week 4 and Week 6. The 12 participants completed 100% of the programme walks. Both groups experienced an increase in predicated VO2max; 37.0+/-4.7ml/kg/min to 40.0+/-4.7ml/kg/min (8%) for HWG, 33.4+/-6.4ml/kg/min to 38.9+/-2.8ml/kg/min (16%) for CG. These increases were neither statistically significant nor significantly different from one another. No significant differences between or within groups were found for body mass, waist circumference or sum of four skinfold sites. The addition of 0.91kg hand-held weights to a six-week regular walking programmes when undertaken by previously sedentary women, does not have a significantly greater impact on aerobic fitness or body composition than unweighted walking. Both forms of exercise were shown to produce meaningful improvements in aerobic fitness, but it is likely that the small sample size prevented these results from registering as statistically significant. There is no evidence to support the introduction of hand-held weights at the beginning of a walking programme for previously sedentary women if the objective is one of acelerating the improvement in aerobic fitness or body compostition. Conversely, no negative consequences of doing so have been observed here.
    • The impact of keeping the secret of childhood sexual abuse: A qualitative research study

      Le'Surf, Anne; Smith, Lyndsey P. (University of Chester, 2011-09)
      This is a small scale qualitative research study exploring the impact of keeping the secret of childhood sexual abuse. Five qualified counsellors who had experienced sexual abuse in their childhood explore the impact of keeping their secret. The data were collected using semi-structured interviews and four of the participants produced creative illustrations relating to the impact of keeping their secret. The data were analysed using an inductive approach, the constant comparative method, as described by Glaser and Strauss (1967). The findings of the study indicate that the impact of keeping the secret is difficult to separate from the impact of abuse. However threats to ensure silence, children’s difficulty in using their voice, negative impact on relationships, loss of sense of self and seeing self as ‘different’, Post Traumatic Stress Disorder symptoms and withdrawing behaviour appeared to be more closely related to the impact of keeping the secret. Potential areas for further research are also indicated.
    • The impact of leadership and management approaches on the delivery of excellence in social care services

      Rowland, Caroline; Barker, Christine (University of Chester, 2010-06)
      This research examines the impact of leadership and management approaches on the delivery of excellence in social care. It focuses on four residential care homes with nursing, operated by a national Third Sector provider of services for disabled people. The purpose of the study was to investigate how services defined quality and to examine the extent to which leadership and management approaches facilitated staff engagement in quality improvement and contributed to 'Good' or 'Excellent' Care Quality Commission ratings. This multi-method, qualitative study was underpinned by a phenomenological research philosophy. Data collected from semi-structured interviews with managers and care supervisors was triangulated through the analysis of opinion data from rating questionnaires completed by frontline nursing, care staff and non-care staff. Data was analysed using methods adapted from Interpretative Phenomenological Analysis. The study did not establish a clear association between leadership and management approaches and the achievement of a 'Good' or 'Excellent' CQC rating. The collaborating organisation's comprehensive operational policy framework and ethos of service user empowerment appeared to be higher determinants of service quality than leadership and management approaches. However, findings did indicate that, where leadership and management approaches help followers to feel valued and psychologically safe, managers can engage staff successfully in the quality improvement process. An unexpected outcome of the study was that it identified a possibility that an individual's leadership and management approaches may change when they are highly stressed, causing a negative impact on their followers, the working environment and the service culture. It was beyond the scope of this research to take forward an exploration of these issues. However, it provides the opportunity for further research to examine the ways in which managers respond to high stress levels, how followers are affected when managers are overly stressed and the overall implications for staff welfare and service quality in the social care context.
    • Impact of living away from home country on the health behaviours of international students at the University of Chester, UK. A cross-sectional study

      Sowah, Soloman A. (University of Chester, 2016-09)
      Background: A fairly substantial body of evidence indicates that modifiable health behaviours may vary contingent upon a students’ residency, including whether students are studying away from their home country. This study aimed to investigate the impact of living away from home country on some lifestyles of international students at the University of Chester, UK. Method: Twenty-two international postgraduate students (23-41 years) at the University of Chester completed validated questionnaires relating to self-reported dietary patterns, physical activity and sleep quality based on circumstances before and after arrival in the UK. Self-reported body mass index (BMI) and self-reported waist circumference were also recorded. Results: Arrival in the UK was associated with a decreased adherence to the Mediterranean diet (p= .857), manifested in decreased fish, fruits and vegetables consumption. Decreased participation in sports (p= .007), as well as decreased sleep duration (p= .179) was reported upon arrival in the UK. Poor sleep quality was found to be prevalent within this sample (54.5%). The study observed both positive and negative lifestyle changes overall, although the latter was predominant. Conclusion: This sample of international students made more unfavourable changes in their dietary intake, physical activity levels and sleep duration upon relocating to the UK. It is imperative that close attention is paid to how international students adjust to life within the UK in order to provide healthier climate for learning.