• An investigation into the validity of percentage body fat estimations by a new bioelectrical impedance analyser

      Cotterrell, David; Williams, Alun G.; Irving, Catherine M. A. (University of Liverpool (Chester College of Higher Education), 1997-10)
      This study was designed to assess the validity of a new method of estimating per cent body fat (%BF) by bioelectrical impedance (BIA). Both models of the new analyser, Tanita TBF 305 and TBF 511 were used to estimate %BF in a sample of active Caucasian adults: 16 male and 23 female. Males: mean age 45.37+ 9.16 years, mean weight 62.10±8.30 kg. Females: mean age 41.96±8.01 years; mean weight 62.10±8.30kg. The new analysers were validated against estimates of %BF by Densitometry (D), compared with sum of skinfolds (SS), BIA Bodystat 1500 (BS) and calculated %BF from BMI. Paired 't' tests were conducted on all methods and compared to D. Bias and 95% Limits of Agreement were calculated using the method of Bland and Altman. Results showed that all methods overestimated %BF significantly in relation to D, except with BS in men. Statistical analysis using paired 't' test and the Bland & Altman method of calculating bias and 95% Limits of Agreement was TBF305 1.18 ± 7.50 %BF for men and 7.40 ± 12.84 %BF for women; TBF 511, 2.14 ± 7.54 %BF for men and 8.40 ± 11.72 %BF for women. It was concluded that because the bias and 95% Limits of Agreement suggested that the new method will overestimate significantly in comparison to D that it could not be recommended as a valid method of estimating %BF and that its use even as a comparative measure of %BF in large epidemiological studies is limited.
    • Investigation of Orlistat as an intervention for obesity and cardiovascular risk factors: A systematic review

      Fallows, Stephen; Wrigley, Daniel K. (University of Chester, 2010-09)
      Background – Obesity is an ever increasing problem in modern society. Numerous pharmacological interventions have been introduced to combat the detrimental effects of this major health issue, including the lipase inhibitor, orlistat. Objectives – To investigate, and assess, the pharmacological effect of two differing doses of orlistat (xenical® 120mg; and alli™ 60mg), on weight loss parameters and cardiovascular risk factors. Search Strategy – Studies were obtained through computerised searches of MEDLIN, PUBMED, CINAHL, EMBASE, The Cochrane Library, Web of Knowledge, and from manual searches in recognised scientific journals. Selection Criteria – Randomised controlled trials in adult only subjects, of any study duration, comparing orlistat against surgical interventionm alternative medical intervention, and placebo, for weight loss and cardiovascular risk factors. Data Extraction & Synthesis – One reviewer independently assessed relevant studies, risk of bias, and extracted data. Main Results – Nineteen studies deemed relevant were included for final review. No study included cardiovascular mortality as an outcome. All studies reported significant (p<0.05) weight loss in orlistat treated patients from baseline to end of treatment. Most frequent side effects were mainly gastrointestinal in nature. Onset of diabetes progression was reduced in orlistat patients. Other cardiovascular risk factors were shown to decrease in orlistat patients. Conclusion – In patients with body mass index ≥27kg/m², orlistat, sibutramine, and metformin reduce body weight to a similar degree. Orlistat reduces waist circumference to the greatest degree. Orlistat induces greater gastrointestinal side effects and a greater attrition rate. Alli™ needs greater investigation of effects.
    • An investigation of the experience of the role of Critical Incident Debriefer in a ‘Fire and Rescue Service in the North West of England’

      Haynes, Tracy A. (University of Chester, 2015-10)
      AIMS: Psychological debriefing is a crisis intervention for use with people who are exposed to stressful events within their work. Research on crisis interventions is controversial, and further studies in this field are important to establish appropriate interventions for emergency workers. Debriefing has become an area for debate due to evidence of its benefits showing beneficial and negative outcomes, or no outcome at all. This study aims to qualitatively investigate the experience of the role of Critical Incident Debriefer in a Fire and Rescue Service in the North West of England. METHODS OF RESEARCH: A phenomenological approach was used to collect data via Collaborative Inquiry (CI) group meetings with the debriefers. The recorded CI meetings were transcribed into text and the transcripts were analysed using applied thematic analysis. A reflective diary was utilised to keep experiences, thoughts, feelings and opinions visible and an acknowledged part of the research. RESULTS: Review and analysis of the participants’ experiences identified six themes; policy concerns; organisational concerns; CID training; psycho-education; culture and the future of CID. CONCLUSION: These findings identified positive and negative elements of the CID process from the perspective of debriefers. Attitudes towards CID appear to be improving, however, debriefers feel they do not receive appropriate training, which corresponds with the findings of the Cochrane Review (2002) and suicide within the fire service is a serious concern.
    • An investigation of the impact on operational managers' psychological contracts of moving to Trust status

      Corbett, Catherine (University of Chester, 2010-06)
      Contemporary literature on change management suggests that the pace of change is accelerating and that public sector organisations are increasingly introducing change initiatives designed to move their services into the marketplace. As such, organisations must be aware of the likely impact of change on their employees to respond quickly and ensure change initiatives are effective. The impact of change on employees' psychological contracts in general, and specifically in relation to downsizing, is seen to reduce their level of commitment, loyalty and trust which can result in employees withdrawing their services, behaving such that change initiatives are adversely affected or deciding to leave the organisation. In addition, operational managers are seen to hold a unique position within an organisation and, at times of significant organisational change, their level of loyalty, commitment and trust is seen as vital to its effective implementation. Research in this area within the public sector is very limited. More specifically, no published research has looked at the impact of a significant change initiative within the UK Probation Service. This study therefore focuses on Cheshire Probation Area (CPA) and seeks to investigate the impact on operational managers' psychological contracts on moving to Trust status. A conceptual model was developed which drew together the key theoretical elements of both psychological contracts and change management, in which the interpretation of the change was seen as crucial to its effective implementation. A cross sectional design was used to assess the impact using a questionnaire providing both quantitative and qualitative data. Statistical analysis showed the majority of respondents' psychological contracts were unaffected by the move to Trust status. However, for those who were, trust was the main area affected. An interpretive analysis of the data also found that the majority of respondents felt their psychological contract was unaffected, or that it was too soon to appreciate its full impact. However all respondents felt they provided more loyalty to CPA than was reciprocated. It concludes that, in general, operational managers continue to hold a relational psychological contract with CPA that has largely been unaffected by the move to Trust status, and should therefore support the implementation of this change initiative.
    • An investigation of the strategic approach of a retail organisation and study the blue ocean opportunities: A case study of Wilkinson Retails, UK

      Rajkhowa, Gautam; Bukke, Gopinath (University of Chester, 2010-11)
      The current retail industry is characterised by hypercompetition and constant change. The UK market for retail services is continuously growing and allowing new comers to enter the market. Business opportunities as well as challenges in terms of competition and technology are growing because of the frequent changes in industry and rapid advancements in technology. Although Michael Porter’s theories force companies to choose either differentiation or cost-leadership, the recent theory, Blue Ocean Strategy suggests companies can make competition irrelevant. Rather than stealing the market share from the competitors of the “bloody red oceans”, companies can create new uncontested market space the “blue oceans”. The purpose of this dissertation is to understand the current competitive strategies of one of the UK’s leading retailer, Wilkinson, by focusing on whether it tend to pursue traditional competitive strategies or blue ocean strategies. This study is based on the data collected from interviews, questionnaires and of course from the existing strategic literature. Most of the retailers, to some extent, have outspoken differentiation focus and are cost conscious. Competition is also seen as a positive sign which promote the retailers own business. But the fact that majority of retailers are in expansion phase, the cost reductions seem less apparent. However, to pursue Value Innovation and become successful, the retailers should start considering the blue oceans.
    • An investigation of UK passenger attitudes towards the carbon offsetting of both flight and airport emissions

      Ribchester, Chris; Cliffe, Anthony D. (University of Chester, 2014)
      Airlines and airports have to meet strict carbon emission reduction targets by 2050. Technological improvements and operational efficiencies can only go so far, in an industry that relies on hydrocarbons. To help the industry meet its targets, carbon offset schemes are a viable tool. These schemes are voluntary to passengers and so to become successful passengers in large numbers need to engage with them. At present less than 9% of passengers have ever donated to a carbon offset scheme. The industry has failed to promote such schemes with 60% of passengers unaware that they exist. Despite this, 82% would offset in the future, women and under 40’s in particular. Factors such as gender and a passenger’s belief in the existence of climate change play a key role in affecting a passenger’s likelihood of donating to a scheme. The airport offset scheme is a viable one, however there is mixed reaction from passengers.
    • Is chronic pain a small-t trauma? A systematic review of the use of EMDR in the treatment of chronic pain.

      Patel, Kim L. (University of Chester, 2012-10)
      Aim: Chronic pain (CP) hugely impacts negatively on the individual. Similarities between post-traumatic stress disorder (PTSD) and CP include neuro-plasticity, affect and memory, suggesting CP is a small-t trauma with PTSD a big-T Trauma. As such there is a theoretical rationale for the use of eye movement desensitisation and reprocessing (EMDR) in CP treatment. Methodology: A systematic review of the available literature (eight papers) identified two different EMDR protocols. Standard EMDR protocol was used in phantom limb pain (PLP) subjects. Pain protocol EMDR was used in headache, fibromyalgia, and musculoskeletal pain subjects. The papers varied greatly in robustness. Results: PLP subjects had higher pain intensity scores pre-intervention and lower pain intensity scores post intervention compared to other CP subjects. Both EMDR protocols demonstrated significant pain reduction/amelioration, maintained at follow-up. Further research is required; however this systematic review offers that EMDR has the potential to be a useful adjunct in CP management and treatment.
    • Is customer perceived value influenced by national culture in business to business marketing? An empirical investigation

      McKeown, Ian (University of Chester, 2006-06)
      The study forms an empirical investigation that uses a census approach to determine which business factors are most valued by Asian toothpaste producers. A positivist approach, supported by an interpretivist philosophy is used to gain understanding of how culture affects perceived value in business-to-business relationships. This takes the form of deriving and testing a conceptual model, using a questionnaire as the research instrument. Covering 4 countries in the region (China, Indonesia, Japan and Korea) the study finds that while 'low cost in use' is a common desire for all respondents, a number of differences exist concerning the relative value of other business factors and elements forming these. A random sample of recipients was not used, but rather a focused census of toothpaste producers in the Asian region. This limits the scope of study's conclusions. Findings from the study are used to formulate recommendations that INEOS Silicas might follow to leverage competitive advantage in the region, based on cost, service and reliability. A difference in emphasis was found for each of these elements in the different counties surveyed.
    • Is exercise training safe and effective for ALL heart failure patients: A retrospective service evaluation of a hospital based cardiac rehabilitation programme

      Buckley, John P.; Fallows, Stephen; Burgess, Laura A. (University of ChesterUniversity Hospital of South Manchester, 2010-09)
      The main purpose of this study was to investigate whether exercise training is safe and effective for all classifications of heart failure, female and elderly (70 years and above) heart failure patients and also those heart failure patients with significant co-morbidity. Much of the research into exercise training and heart failure has been carried out on middle aged men in NYHA II-III classification of heart failure who have no other significant co-existing conditions. This is not reflective of the population of heart failure patients in general. The cardiac rehabilitation records (n=1000) of heart failure patients who had attended an exercise programme at a hospital based NHS service over a period of ten years were retrospectively evaluated to investigate the safety and efficacy of exercise training. Analysis of baseline statistics and repeated outcome measures were used to investigate the significance of the service and to ascertain where similarities and differences lay with the research. 74% were male, the age range was 17-90 years and 52% of patients had one or more significant co-morbidity. The acute event incidence was recorded at four per 1000 patients. NYHA I patients, female, elderly heart failure patients and those with significant co-morbidity showed significant improvements in functional capacity and quality of life measures with exercise training (p< 0.05). However no conclusion on the effectiveness of exercise could be drawn for NYHA IV heart failure patients due to insufficient recorded data and reduced adherence to exercise sessions for this group. A hospital based exercise programme, therefore may not be the most appropriate setting for the NYHA IV patient. This study supports previous research of the benefit of exercise training in heart failure but broadens it further to show that exercise is safe for all heart failure patients and is also effective for all heart failure patients with the exception of NYHA IV patients where further investigation is needed.
    • Is physical inactivity related to body mass index and waist circumference in a sample of Maltese adult population?

      Fallows, Stephen; Micallef, Maria C. (University of Chester, 2013-09)
      Physical inactivity and excess weight are two major public health problems (World Health Organisation [WHO], 2000, 2006). In 2008, the worldwide prevalence of overweight and obesity was estimated to be more than 1.4 billion adults (over 20 years), of these over 200 million men and almost 300 million women were obese (WHO, 2008). Furthermore, WHO (2013) estimated that in 2008, globally, 31% of adults aged 15 and over were insufficiently active (28% men and 34% women). This unhealthy behaviour was estimated to cause 600,000 deaths annually and lead to a loss of 5.3 million years of healthy life due to premature death and disability (WHO, 2002). If physical inactivity were to be reduced by 10‐25%, more than 1.3 million lives could be saved annually (Lee et al., 2012). In Malta, the situation is similarly grim. It is troubling to note that Maltese men rank top in European obesity chart and Maltese women place third (Eurostat, 2011). Furthermore, Malta is labelled as one of the most sedentary populations on earth (Stagno‐Navarro, 2012), with 71.9% of the population failing to meet recommended levels of PA (Hallal et al., 2012). It was estimated that Malta could gain an increase of 1.2% years in life expectancy if physical inactivity were eliminated (Lee et al., 2012). Lee et al. (2012) revealed that Malta has the highest estimate for coronary heart disease (CHD), type 2 diabetes, breast cancer, colon cancer and all‐cause mortality, compared to other European countries, almost double to the European and Worldwide median in all variables (Table 1).
    • Is talking alone enough in the 21st century? A qualitative exploration into the therapeutic helpfulness of creative and symbolic methods in school-based counselling (Wales)

      Swinton, Valda; Tebble, Gary (University of Chester, 2014-10)
      This qualitative study sought to examine the nature of School-Based Counselling from the subjective understanding of the therapeutic practitioner, where two central objectives were examined: (1) To investigate the assertion that talking alone is enough when engaging a young person in School-Based Counselling. (2) To demonstrate the usefulness of creative and symbolic method and to explore whether these can be helpful when enhancing the therapeutic relationship. Semi-structured interviews were conducted with five School-Based Counselling practitioners who worked exclusively across Wales. The study was then extensively analysed using The Constant Comparative Method. Three master themes emerged from the data: (1) Adopting a 'Young Person-Centred Approach; (2) From the 'Silenced Youth' to the 'Expressive Person'; (3) The usefulness of Creative and Symbolic Methods. School-Based Counselling was identified as predominately Young Person-Centred in its therapeutic practice. The role of School-Based Counselling was also placed into a wider societal context which illustrated the role of a key adult, whilst also suggesting that certain fractions of the adult world still deemed young people as powerless. Talking alone was also identified as 'enough' when promoting therapeutic development for most young people in School-Based Counselling. However the use of Creative and Symbolic Method seemed particularly powerful for those young people who found talking difficult or who belonged to an additional educational needs group. The therapeutic processes of Creative and Symbolic Method were also seen as significant and helped facilitate greater communication. These findings highlight a gap in knowledge in the School-Based Counselling field particularly around young people accessing therapy who also have additional educational needs. The current findings support existing School-Based Counselling literature but offer new clinical insights, advocating opportunities for future research.
    • Is the best recovery drink already in your fridge? The effect of milk post-exercise on subsequent performance among female Gaelic football players aged 16-18 years.

      Nicholas, Ceri; O'Donovan, Caroline (University of Chester, 2016-06)
      Background: The beneficial role of milk and milk-based products in the area of recovery nutrition has been reported in the literature; with milk’s natural nutritional composition addressing the main priorities of recovery suggested as the mechanism for its effectiveness. However, no studies exist to date investigating this potential benefit among female, adolescent athletes. Objective: To investigate the effectiveness of milk post-exercise on subsequent performance among female Gaelic football players aged 16-18 years. Methods: In this randomised, counter-balanced, cross-over study, ten participants (age 16.5 ± 0.6 years; height 166.4 ± 6.9 cm, body weight 58.2 ± 9.2 kg) completed two trials consisting of a typical training session, consumption of a test drink (500 mL of milk [M] or 500 mL of water [CON]) followed by a 2 hour (2-h) recovery, after which performance indicators were measured: countermovement jump height [CJH]; drop jump [DJ]; and 20 metre sprint [20-m]. Results: No significant (p>0.05) difference was observed between M and CON for: CJH (35.7 ± 8.5 cm; 34.9 ± 5.3 cm, respectively; p=0.603); or DJ (36.4 ± 7.9 cm; 36.4 ± 5.1 cm, respectively; p=0.971). A significant (p=0.02) difference for 20-m sprint speed was reported between M (3.85 ± 0.35 s) and CON (4.02 ± 0.32 s). Conclusion: This study demonstrates a role for milk – a natural, accessible, affordable and calcium-rich beverage – post-exercise among female Gaelic football players aged 16-18 years for improving subsequent sprint performance. This is of particular 63 relevance for this cohort who has the highest calcium requirements and, concurrently, the highest calcium insufficiencies of the Irish population. Future studies should include larger sample sizes with expansion to explore potential roles among male adolescents and across a variety of sports and competitive levels.
    • Is the SERVQUAL questionnaire a capable and reliable instrument for measuring service quality in a retail supermarket context?

      Weston, Pippa; Dayarathna, Sarath (University of Chester, 2009-06)
      During the last two decades, efforts have been made to understand the criteria and attributes customers use to evaluate service quality, by measuring the perceived service quality using the SERVQUAL instrument in various industries. This dissertation evaluates the criteria and attributes customers use to evaluate service quality in a retail supermarket context, the connection between good perceived service quality with customer satisfaction and repeat patronage, and the capabilities and limitations of the three column format SERVQUAL instrument in measuring service quality in a retail supermarket context. It concludes that the three column format SERVQUAL questionnaire is capable of identifying the service quality shortfalls by measuring the customers desired, adequate and perception of service quality. However, it raises the questions of validity and reliability of the questionnaire for measuring the service quality as a gap score between 'Desired' and 'Perceived' quality due to a psychometric problem; hence the identification of a requirement for a carefully modified single scale measurement to overcome it. Finally, it acknowledges the possibilities of future research for developing a hybrid version (combination of Nordic and American perspectives) of a retail supermarket specific service quality measuring instrument using industry specific attributes.
    • Is there agreement on the pathogenesis / pathophysiology of exercise induced asthma?

      Caulfield, Una (University of Chester, 2009)
      Purpose: Exercise Induced Asthma was formally proposed as a concept to the medical profession in 1966. However up to 1990 two different hypotheses were being put forward to explain the mechanism involved. Methods: A literature search of Pubmed, Google Scholar, Ovid and The Cochrane Library was conducted in May 2009 using a combination of controlled vocabulary and truncated text words to capture relevant articles. All relevant randomised controlled trials, case control studies and case series were included in the review. Results: The initial search identified 2361citations. Following the removal of duplicates and the application of selection criteria, a total of 36 articles were included in this review. Two scales were used to assess the data the Jadad Scale and The Scottish Intercollegiate Guidelines Network Grading Review Group guidelines known as SIGN Criteria. Discussion: Within the studies reviewed a particular issue encountered was the definition of EIA itself. Thirteen of the studies gave no definition, ten used FEV1≥10%, seven used FEV1≥15%, four used FEV1≥20% with the remaining two studies using FEV1≥12% and FEV1≥7%. Accordingly pooling of the data for analysis was only possible under the broader headings of the two original hypothesis and two new categories Inflammatory Causative Factors and Emerging Science. Studies into Inflammatory Causative Factors had by far the highest number of studies (15) and participants – with 497 in total. The participants in the McFadden and Emerging Science studies were almost equal at about 180 participants each. While a total of only 63 subjects participated in the Anderson hypothesis studies While the current balance of evidence clearly suggests a more probable relationship with inflammation for asthmatics with EIA. Clearly further work is required to explore the pathogenesis of EIA in non asthmatics. Conclusions: While a number of possible mechanisms involved in the pathogenesis of EIA were evaluated it would still appear that the studies reviewed do not allow any firm conclusions to be drawn. However the evidence appears to be currently weighted in favour of inflammatory causative factors as the basis for EIA.
    • Issues, response and support needs of parents if their child had self-harmed, from a parents and professionals perspective

      Heath, Hannah; Ruck, Samantha (University of Chester, 2018)
      Self-harm for young people has been considered to be a significant health concern (Byrne et al., 2008) and is understood to be typical amongst young people (Hawton et al., 2002). Parents experience an array of overwhelming emotions on finding out about their child’s self-harm (Raphael et al., 2006). To date, little attention has been paid to exploring the understanding and experiences of parents whose children have not self-harmed or looking at the role of mental health (MH) professionals supporting parents from the professional view point. The aim of this research was to understand from both a parents and professionals perspective, what the perceived issues for parents are if their child self-harmed; how would/do parents respond to self-harm; and what support needs do the parents have. A multiple qualitative perspectives design was used. Seven parents were interviewed, alongside two focus groups and one interview with six Mental Health (MH) Professionals and were analysed with Thematic Analysis (Braun & Clarke, 2006). The results indicated that parents had a perceived lack of knowledge about self-harm and available support services. How parents respond to a child’s self-harm is influenced by their lack of understanding, how they find out and their natural desire to protect their child. Education about self-harm, strategies for parents and peer support group were identified as key mechanisms for professionals to provide support to parents. Parents and professionals both highlighted the lack of knowledge parents have about self-harm and their desire for support to help their child. There is a future research need to explore the processes which parents follow to seek information and help regarding self-harm and the impact of parent peer support in both community and clinical settings.
    • An Italian Affair: the impact of Italy on the woman traveller in George Eliot’s Middlemarch and Henry James’s The Portrait of a Lady

      Wynne, Deborah; Walker, Naomi (University of Chester, 2015)
      The aim of this dissertation is to examine the impact of Italy on the woman traveller, primarily through an analysis of the ways they are presented in George Eliot’s Middlemarch and Henry James’s The Portrait of a Lady. The dissertation will examine the travel writings, journals and letters of George Eliot and Henry James in order to gain an insight into their own perceptions of the country. The travel writings of Victorian women travellers will also be discussed. The investigation is split into three chapters. The first chapter analyses the time spent by George Eliot and Henry James in Italy and their thoughts and experiences of the country and how this impacted on their novels. It will be discussed whether the style of their writing in their journals, letters and essays is different to their novels. The second chapter focuses mainly on the two heroines of the novels, Dorothea Brooke and Isabel Archer, and examines the effect that Italy had on them. This chapter will also look briefly at other women characters in The Portrait of a Lady, and in other novels and novellas by Henry James, and how Italy affected their lives and situations. The third chapter studies the travel writings of Victorian women who visited Italy. This chapter also reflects on how tourism to Italy enabled Victorian women to re-imagine their own reality at home. The conclusion will briefly discuss two novels by E. M. Forster to analyse how the depiction of the woman traveller to Italy had changed by the early twentieth century.
    • It’s the singer, not the song: A critical investigation into perceptions of the benefits of singing in daily life

      Hall, Louise E. C. (University of Chester, 2014-12)
      The purpose of this study is to consider how people feel about singing, particularly but not exclusively if they do not identify themselves specifically as singers. Any benefits of singing that were perceived or experienced by a group of adults are described, and consideration is given to whether measurement or monitoring of these benefits is necessary or helpful. The review of literature is based on answering the following key questions: Why is singing important? Where is singing situated culturally in contemporary British society? Does this have any bearing on how adults feel about singing both individually and chorally, as part of a group? Consideration is given to the evidence supporting a range of claimed benefits of singing and the location of singing in a postmodern, neo-liberal culture is discussed. Finally, the results of a small-scale ethnographic survey and focus group session are detailed and interrogated. This investigation concludes that singing is perceived by many as being of social, cultural and emotional significance which may have wider implications for health and education policy. Implications for further research include creating research models which might interrogate further the emotional impact of singing and how that impacts on other activities.
    • Keeping up with technology – The development of a tablet-based multimedia education programme for women with a history of gestational diabetes: a formative evaluation

      Jacobs, Helen (University of Chester, 2015-12)
      BACKGROUND A history of gestational diabetes significantly increases the risk of progression to type 2 diabetes (T2DM). Lifestyle intervention is an effective technique for delaying or preventing the onset of T2DM in this population and represents a unique opportunity for the primary prevention of type 2 diabetes. Following gestational diabetes, women face significant barriers to engaging in education and achieving health behaviour change. A multimedia patient education programme could overcome the barriers and be an effective method of reaching this population. OBJECTIVE The aim of the programme was to support women with a recent history of gestational diabetes to make lifestyle changes with the view to reduce the risk of type 2 diabetes in the future. This stage of the project aimed to evaluate the relevance, usability, content and appearance of the programme and also to identify any issues with the programme prior to proceeding to clinical trial. METHODS The multimedia education programme was developed using a five stage system development method: identification of user requirements, system design, system development, system evaluation and system application. Experts and patient representatives assessed the relevance, usability, content and appearance through a formative evaluation. RESULTS The multimedia education programme ‘Keeping Healthy after Gestational Diabetes’ contained seven modules: introduction, health, diet, lifestyle, baby health, living post GDM and warning signs. The formative evaluation by 22 experts and 20 patient representatives has provided valuable direction for the on-going development of the programme and suggest that the programme is relevant, easy to use, interesting and visually appealing. CONCLUSION Findings suggest that users found the programme relevant, easy to use, interesting and visually appealing; suggesting that this may be a feasible and acceptable mode of education.
    • Knowing and complying: Patient awareness of aspirin use for secondary prevention of stroke and transient ischaemic attack

      Hogard, Elaine; Little, Victoria (University of Liverpool (University College Chester)Arrow Park Hospital, 2005-11)
      The aim of this study was to gain understanding into compliance behaviour with aspirin as prescribed for secondary prevention of stroke. The study used a convenience sample of 20 patients who had been admitted to a NHS Trust following a subsequent stroke or transient ischaemic attack. Semi-structured interviews were used to explore the use of aspirin at the time of admission. Patient perception of personal risk and risk factors for stroke were explored. Where appropriate, responses were checked against health care records for comparison. The findings suggested that the majority of patients were compliant with aspirin, however deficiencies in current practice were identified. Patients lacked awareness of their risk factors and their risk of having a further stroke. They were also unaware why they were taking aspirin. Strategies that assisted compliance behaviour and reasons for non-compliance were identified.
    • Knowledge and attitudes of obesity in university students

      Fallows, Stephen; Morris, Mike; Giglia, Melissa (University of Chester, 2012-09)
      This paper reviews the literature which has measured individual’s knowledge on the health risks associated with obesity, and individual’s attitudes towards obese persons. This review primarily focuses on studies that recruited students, health care professionals, and the general population. The inclusion criteria was: students, health care professionals, general population, studies that used the Obesity Risk Knowledge (ORK-10) scale, studies that used the Attitudes Towards Obese Persons (ATOP) scale, and any other validated questionnaire which measured obesity risk knowledge (ORK), and attitudes towards obese persons. Results revealed high obesity risk knowledge among health care professionals, primarily dieticians and general practitioners, and low obesity risk knowledge amongst the general population. Negative attitudes towards obese persons were prevalent in most studies, and were evident in students, health care professionals and the general population. The variables gender and BMI yielded conflicting results among the selected studies. Education is needed to increase obesity risk knowledge among a number of health care professionals and the general population, this will aid preventative techniques towards overweight and obesity. In addition, educational tools to raise awareness and reduce weight related bias and stigma need to be implemented in employment and educational settings, amongst the general population and health care professionals.