• Personalising Communication during Educational Reviews with Children who have Special Educational Needs

      Dyer, Dawn A. (University of Chester, 2016)
      Current legislation and statutory guidance relating to those identified as having special educational needs (SEN), emphasises the importance of the involvement of children and young people and their families in matters affecting their educational experiences. Due to the heterogeneity of SEN and associated communication difficulties in particular, there may be challenges in successfully eliciting the views of children and young people as part of the annual educational review process. For this study, 61 parent/carer participants from across England responded to an online questionnaire. This was designed firstly to see whether communication methods were differentiated according to the child’s usual or preferred style of communicating, and secondly whether person-centred approaches to facilitate the child’s participation and inclusion had been adopted as part of the process. Correlation analysis found very little evidence of communication methods being differentiated according to usual preferences although there was some evidence of different methods being used during reviews. Further analysis found some evidence that adopting person-centred approaches to educational reviews had a positive effect on overall outcomes for children and young people. It is suggested that future research could seek to capture the perspectives, not only of parents/carers but also of educational practitioners and the children themselves to allow for greater exploration of some of the issues arising in this paper.
    • Perspectives on the conservation of industrial heritage in the National Parks with specific reference to the lead mining and smelting industry in the Yorkshire Dales National Park

      Pardoe, James; Green, Christopher (University of Liverpool (Chester College of Higher Education), 2005-10)
      The main aim of this study was to investogate the current state of the industrial heritage of the National Parks of England and Wales and the ways in which this industrial heritage is being preserved and interpreted from the specific standpoint of the reamining fabric of the lead industry within the Yorkshire Dales National Park. Assessments were made of the degree of decay of this fabric over the last 50 years by comparing the current state with that describned in a early study of the Industrial Archaeology of leading smelting in the Yorkshire Dales. Investogations were made into the policies and action plans followed by the National Park authority and voluntary bodies interested in this industry. Finally studies were made of other lead mining and smelting sites elsewhere in England and Wales to see how approaches varied and to compare them with thise taken in the National Park. The study found evidecenopf deterioration in the fabric, significant in places, as well as an apparent public indifference to it and the story it tells. However it generally did fins a positive attitude from the authorities involved towards conservation issues. This was especially true in the National Park, largely a consequence of the priority that National Park authorities must place on preserving their cultural heritage. However, the rate at which some of the fabric is deteriorating, along with the finances available, may mean difficult choices as to which sites get conserved, interpreted or simply recorded.
    • A phenomenological study of clients' experiences of counselling in a pastoral setting

      Lynch, Gordon; Edge, Barbara (University of Liverpool (Chester College of Higher Education), 1999-11)
      In this study four people were interviewed about their experiences of counselling in a pastoral setting. The setting is a Counselling Service which is one of the many projects under the auspices of the Church of England's Committee for Social Responsibility. Semi-structured interviews were used to obtain relevant information. The transcribed interviews were analysed in terms of the constant comparative method of qualitative analysis. The analysis of these interviews reveal that the Christian context of the counselling experience was by far the most reflected on by clients. This study provides evidence that the accommodation of Christian beliefs and values within the counselling process was instrumental for therapeutic change to occur for these particular individuals. The quality of the counselling relationship was of central concern to all the participants in the study and clearly underpinned the therapeutic process. Counsellors were reported as being, open, friendly, caring people without pretentious expertise. Feeling safe and comfortable, being accepted, and not being judged by the counsellor were reported as important aspects of the relationship and set the foundation for a positive therapeutic outcome. As discussed, the aim of this study is not to propose any 'universal truths' about clients' experience. However, this glimpse into the subjective experience of clients provides valuable learning about the nature of counselling from the point of view of the client and raises some implications for the Diocesan Counselling Service and for the practice of the counselling profession in general.
    • Physical activity and functional capacity and normal-weight, overweight and obese Greek young adults

      Buckley, John P.; Fallows, Stephen; Psichogiou, Athinais-Georgia (University of Chester, 2010-09)
      Objective: The aims of this study were to present information regarding the physical activity (PA) profile, functional capacity (FC) status and body composition of normal-weight, overweight and obese young Greeks, to investigate the impact of overweight and obesity on the subjects’ PA and FC and to explore possible interrelations between their anthropometric characteristics, PA and FC. Method: Sixty-two healthy, Greek young adults (27 males), with a mean age of 23.9 ± 3.9 years, attended a single testing session during which they were subjected to anthropometric and physiological measurements, they completed the Greek version of the Short International Physical Activity Questionnaire (IPAQ-SGR) and they performed two six-minute walk tests (6MWT) using a standardised protocol. Analysis of variance and post hoc analysis was used to investigate possible differences between the three groups, while bivariate correlational techniques were used to assess possible interrelations between the subjects’ anthropometric characteristics, their PA and FC. Results: During the 6MWT, overweight subjects walked significantly further (624.0 ± 88.8 m) than obese subjects (544.9 ± 108.4 m) (p<0.01). No significant differences were observed between the three groups regarding IPAQ scores. Significant associations were mainly detected between the subjects’ anthropometric characteristics and 6MWT-related variables. Conclusions: The FC of normal and overweight subjects appeared to be similar and better than that of obese subjects, while, all subjects, regardless of BMI categorisation, were found to have similar PA profiles. This study further supports the association between obesity indices and functional capacity.
    • Physical activity patterns of 10-11 year olds during the school week

      Fallows, Stephen; Robson, Maria (University of Chester, 2010-10)
      Physical inactivity among children has both immediate and long term health consequences. Recommended guidelines state that children should engage in at least 60 minutes of at least moderate physical activity each day to promote and maintain health. The main purpose of this study was to determine the proportion of 10-11 year old children who were engaging in sufficient physical activity to meet the recommended levels throughout the school week. This study also aimed to determine differences by day, to examine the contexts in which children were achieving their activity and to investigate gender differences. Fifty three 10-11 year olds (18 boys, 35 girls) completed activity diaries each day for one week during the school term. Activities were recorded for the whole of the waking day and intensity assigned to one of four levels, very light, light, moderate or vigorous. The contexts in which the activities took place were categorised as, school based clubs, school based free play, home based clubs or home based free play. Paired t tests, independent t tests, cross tabulation and Chi square tests were conducted to determine differences by day, by activity category, and by gender. The proportions meeting recommended levels varied from 64.2% on Sunday to 83.0% on Thursday. Lower proportions met recommended levels per weekend day, 70.8% than per school day, 78.5%. Significantly (P < 0.05) more time was spent in free play than organised activities. The proportion of total daily moderate to vigorous physical activity (MVPA) from free play was 74.2% on school days and 81.4% on weekends. Out of school activities were significantly (P < 0.05) greater than in school activities, accounting for 62.1% of total daily MVPA. The proportion of boys achieving recommended levels was greater than the proportion of girls on each day of the week, the differences between the genders being significant (P < 0.05) on Saturday and Sunday. Boys engaged in more free time activity than girls both on school days and weekend days, with in school free time and weekend day free time activity being significantly (P < 0.05) greater. Girls engaged in more organised activities than boys on school days and weekend days but not significantly (P < 0.05). On each day of the week a proportion of children did not meet recommended activity levels to benefit health. Activity levels differed by day, gender and context. Both boys and girls achieved more of their MVPA from free play than from organised activities both in and out of school. Initiatives which focus on improving the time and facilities available to children to enable them to participate in safe free play may be effective in increasing health enhancing physical activity.
    • Physical activity promotion in general practice: Irish GPs' knowledge, attitudes and self-reported practice

      Fallows, Stephen; Mortimer, Gary (University of Chester, 2015-09-30)
      Background and aims: Regular PA is one of the most important factors which influences good health and helps control and prevent several chronic diseases. Promoting PA in primary care through GPs could have a very significant health impact on the Irish public. The aim of this research project was to investigate and analyse Irish GPs’ knowledge, attitudes, and self-reported practice of promoting and recommending PA in Ireland. Methods: An electronic survey was used and sent to 711 GPs from 381 practices across Ireland in April 2015. A total of 80 GPs responded, giving a response rate of 11%. Results: The level of PA promotion claimed by Irish GPs was somewhat high (67% promoted PA often (31-50% of patients) or more often (>70% of patients)), however, only 30% (n = 24) of GPs knew the national PA recommendation for Irish adults. Irish GPs are more likely to promote PA if they perceive it as relevant to the patient’s condition (secondary prevention), rather than routinely with all patients (primary prevention). Conclusion: This study raises doubt as to the true level of PA promotion by Irish GPs, and highlights that many Irish GPs do not know and/or are unaware of the national PA recommendations. If no action is taken, there could be very serious implications for the future health of the nation.
    • Physical demands of elite rugby league match-play and the subsequent impact on recovery

      Highton, Jamie M.; Twist, Craig; Oxendale, Chelsea (University of Chester, 2014)
      Whilst fatigue in the days after elite rugby league match-play has been well documented, the specific match actions which contribute to fatigue are not well understood. Thus, the purpose of this study was to examine the relationship between the physical demands of elite rugby league match-play and fatigue in the days after. Twenty-eight individual performances from an English Super League team were captured using a 10 Hz global positioning system (GPS). Upper and lower body neuromuscular fatigue, plasma creatine kinase (CK) and perceptual well-being were assessed 24 h before, immediately after, and at 12, 36 and 60 h after a competitive match. Backs covered more distance during sprinting (214.5 ± 117.6 m) and highintensity sprinting (129.6 ± 110.9 m) than forwards (142.9 ± 86.2 and 57.1 ± 67.6 m, respectively), whereas forwards experienced significantly more collisions than backs (75.1 ± 64.1 cf. 37.6 ± 18.8). CK concentration peaked at 12 h and remained significantly elevated up to 60 h post-match (p < 0.05). Large decrements in countermovement jump (CMJ) and small to moderate decrements in repeated plyometric push-up (RPP) performance were evident at 12 and 36 h post-match. Well-being questionnaire (WQ) score was significantly decreased up to 36 h post-match (p < 0.05), specifically large increases in perceived muscle soreness were found at 12 and 36 h. Duration (r = 0.8), total distance covered (r = 0.79) and efforts performed over 18 km·h-1 (r = 0.78) were strongly associated with CK concentration. High intensity accelerations (r = 0.47) and decelerations (r = 0.45) were significantly associated with CK concentration. Total collisions and repeated high-intensity effort (RHIE) bouts were associated with decrements in RPP (r = -0.49 and r = -0.51, respectively), CK concentration (r = 0.56 and r = 0.63, respectively) and perceived muscle soreness (r = -0.52 and r = -0.48, respectively). The findings suggest duration of match-play, high intensity running and collisions experienced were the strongest predictors of fatigue following elite rugby league match-play.
    • Physicians’ attitudes towards human papillomavirus vaccination programme: A systematic review

      Fallows, Stephen; Franco, Maria F. (University of Chester, 2011-12)
      Human papillomavirus (HPV) vaccine is a newly introduced vaccine against cervical cancer in adolescent girls. Uptake of the vaccine will be dependent on parental acceptability and physician recommendation. To review physicians’ attitudes towards HPV vaccine and identify factors that may influence their intent. Also, to determine if there is any difference in the views of different medical specialties with regards to HPV vaccination. Articles were obtained through computerised searches of CINAHL, Pubmed, Web of Knowledge, Cochrane Library and Science Direct, as well as manual searches in recognised scientific journal. Articles involving physicians’ attitudes, knowledge and behaviour towards HPV vaccine published from 2007 onwards. One reviewer independently assessed relevant studies, risk of bias and data extraction. Twenty nine studies were included in the final review. Twenty four studies used survey for data collection and five studies used interview. Majority of the studies revealed positive view of physicians towards HPV vaccine with high intent to provide vaccination. Barriers identified against HPV vaccination include the following: cost and reimbursement issue; providers concern about vaccine safety; parental concern over vaccine’s safety and efficacy; age is considered too young for vaccination; issue that HPV vaccine could promote sexual activity, recommendation of HPV vaccine from organisations; communication related to sexuality; need for education and other factors like dosing, patient overload, boys should also be vaccinated and parental religious beliefs. No significant difference was noted between specialties with regards to their view about HPV vaccine. Physicians’ role is important in the promotion of HPV vaccine with their high intent and positive attitudes. In order for the HPV vaccination programme to succeed, vaccine should be made available and affordable especially to countries with high incidence of cervical cancer.
    • The Physiological and Perceptual Responses to Cycling Exercise in a Fully Immersive Virtual Environment

      Highton, Jamie M.; Nowlan, Gerard (University of Chester, 2016-09)
      An innovative piece of digital technology which has recently come to the attention of sports scientists as a potential ergogenic aid is the use of immersive virtual reality (VR) technology. Whilst the effects of VR on performance have begun to be explored, the physiological and perceptual responses to exercise when combined with VR remain relatively unknown. Accordingly, this study investigated both the physiological and perceptual responses to exercise in a fully immersive virtual environment viewed through a stereoscopic head-mounted display. Thirteen recreationally active males (n=12) and females (n=1) (age = 24.9 ± 4.6 y; body mass = 78.7 ± 6.3 kg; stature = 178.6 ± 3.7 cm; VO2max = 55.1 ± 7.1 ml·kg-1·min-1) completed a time to exhaustion (TTE) test under control (CON) and virtual reality (VR) conditions in a repeated measures randomized crossover design. Effect sizes (ES) and magnitude-based inferences were calculated for all variables between conditions using a predesigned spreadsheet (Batterham & Cox, 2006). TTE (ES = 0.78; ±0.37), enjoyment (ES = 0.85; ±0.49) and positive affect (PA) (ES = 0.78; ±0.65) were all greater in the VR compared to CON condition. HR and RPE, analyzed over a 6 minute isotime, were lower at minute two only (ES = 0.33; ±0.38) and (ES = 0.88; ±0.52) respectively, in the VR compared to CON condition. There were no changes in VO2 peak, b[La] and negative affect (NA) between conditions. The use of a fully immersive VR headset in combination with a traditional cycling task was shown to elicit improvements in TTE performance and increase affective responses and enjoyment of the exercise, likely due to a dissociative effect. These findings support the use of fully immersive VR in the exercise domain as an ergogenic aid.
    • The physiological and perceptual responses to cycling exercise in a fully-immersive virtual environment

      Highton, Jamie M.; Williams, Thomas (University of Chester, 2016-09)
      With recent advancements in technology, fully-immersive virtual reality (VR) is now fast emerging as the latest piece of equipment that may revolutionise the way in which athletes are able to train. However, as of yet, few have examined the perceptual and physiological responses to exercising in VR and the subsequent impact it may have on performance. Using a repeated measures randomised crossover design, thirteen recreationally active participants (age = 24.9 ± 4.6 y; body mass = 78.7 ± 6.3 kg; stature = 178.6 ± 3.7 cm; VO2max = 55.1 ± 7.1 ml·kg-1·min-1, P-VO2 =344.7 ± 49.7) completed a time to exhaustion test (TTE) at 80% of P-VO2 under a control (CON) and virtual reality (VR) condition, with a minimum of 48h between trials. TTE (ES = 0.78; ±0.37), enjoyment (ES = 0.85; ±0.49) and positive affect (ES = 0.78; ±0.65) were all greater in the VR condition compared to CON. Rating of perceived exertion (RPE) increased similarly over time in both conditions with the exception of minute 2, whereby RPE was lower in the VR condition (ES = 0.88; ±0.52). There were no changes in VO2 peak, b[La] and negative affect between conditions. These findings provide evidence to suggest that during the early stages of high intensity activity fully-immersive VR has the potential to reduce RPE. Further to this, VR also appears to increase the enjoyment of exercise at a high intensity and therefore increase the motivation to continue exercising. Future research should continue to explore this rapidly developing technology.
    • Physiological responses to six weeks unsupervised walking exercise in patients with intermittent claudication

      Sykes, Kevin; Edwards, Paul; Morris, Michael (University of Liverpool (University of Chester), 2005-03)
      Objective: It is well established that exercise training improves walking distance in patients with intermittent claudication. However the physiological mechanisms responsible for explaining these increases are not fully understood. The aim of this study was to investigate the physiological mechanisms and to provide a rationale as to why patients with intermittent claudication improve pain free and maximum walking distances following a programme of unsupervised exercise. Methods: 10 claudicants with a mean age of 70 years (± 9.84) were studied. Pain free walking distance (PFWD), maximum walking distance (MWD), heart rate (HR), microalbuminuria, ankle brachial pressure index (ABPI), respiratory exchange ratio (RER), C>2 uptake and lactate were measured. Patients performed a graded treadmill protocol at baseline and following six weeks of an unsupervised exercise programme. The exercise programme consisted of patients performing 1 hour of walking per day above and beyond their normal daily activities. Patients were monitored by the use of an exercise diary, pedometer and a weekly phone call. Results: MWD improved by 5% although this difference was not found to be significant. Positive differences were also observed in ABPI (5.5%) and resting lactate levels (10%), once again these differences were not found to be significant. No differences were observed between heart rate, RER and C>2 uptake. A significant difference was observed in PFWD (p = 0.02), Microalbuminuria levels at rest (p = 0.03) and post exercise (p = 0.01), lactate levels at rest (p = 0.0005) and 6 minutes (p = 0.001) post a graded treadmill protocol. Conclusions: Exercise training improves walking distances in claudicants and reduces post exercise lactate levels. Exercise has a significant effect on two of the physiological variables measured (Microalbuminuria and post exercise lactate) and a positive effect on ABPI and resting lactate although no significant difference was found. This could possibly be due to a number of limitations in this study including small sample size (n = 10), the exercise programme was too short and also unsupervised. It is still unclear how exercise improves walking distances in claudicants and further research is required to investigate this.
    • A pilot randomised controlled trial investigating psychotherapeutic interventions for improving therapist engagement

      Hochard, Kevin D.; Flynn, Samantha; Hubert-Williams, Lee; Gidlow, Anna (University of Chester, 2016)
      Evidence consistently shows that therapist verbal and non-verbal behaviours both contribute to the outcome of psychotherapy. Therapists must learn how to deal with, and control these behaviours during uncomfortable discussions with clients. The present pilot study investigated whether brief cognitive behavioural therapy (CBT)-based or acceptance and commitment therapy (ACT)-based interventions could improve therapists’ levels of engagement with a video scenario in which the sensitive topic of an attempted suicide is discussed. Participants in the CBT group (n = 10) and the ACT group (n = 10) were compared on levels of implicit attention (measured by a recall questionnaire), and explicit attention (measured by eye gaze) to the scenario. Behavioural measures assessed differences between groups in terms of connectedness with the client and her story. No significant main effects were found between the two groups for levels of engagement or connectedness. This study suggests that both CBT- and ACT-based interventions may help to improve therapists’ skills in dealing with uncomfortable discussions. These initial findings also suggest that ACT-based interventions may be more effective than CBT-based interventions but a fully-powered study must be completed before drawing conclusions.
    • A pilot study of the possible effects of early morning fasting on blood glucose levels and cognitive preformance, which may impact on work safety

      Thornton, Ev; Barnes, Michael (University College Chester, 2005)
      Objectives: Previous investigations have demonstrated that blood glucose might play a role in the action of some aspects of cognitive performance in adults of various age ranges. Generally these studies have used a procedure where participants were tested after administration of a glucose drink. The aims of the study, was to investigate the glucose cognitive facilitation affects under more natural conditions of breakfast consumption or early morning fasting. Method: 20 participants with a mean age of 50.4 years (± 4.22) were studied. Measures of auditory verbal learning, executive function, visual attention and motor speed were compared following overnight fasting and after breakfast consumption with presumed elevation of glyceamic conditions Results: There was a significant difference under the two conditions (overnight fasting vs., breakfast consumption) on time taken to complete the motor speed test (p< 0.0005). There was also a significant condition effect on the amount of words recalled immediately on the auditory verbal learning test (p< 0.005) and the time taken to complete a simple executive function test (p< 0.0005). There was no significant effect on delayed word call on the auditory verbal learning test, attention test or the more complex executive function test. Changes in cognitive performance were significantly correlated with levels of blood glucose. Conclusion: The results of the study support the hypothesis that during neuropsychological testing, capacities of cognitive performance were inversely affected by early morning fasting and may have an impact on work place safety.
    • Plantar pressure measures of running and cutting movements on third-generation artificial turf and natural grass

      Smith, Grace; Page, Matthew (University of Chester, 2013)
      In dynamic team sports such as rugby, football and American football, non-uniform differences in Anterior Cruciate Ligament (ACL) and ankle sprain injury rates have been found between third generation artificial turf and natural grass surfaces (Dragoo & Braun, 2010; Fuller, Dick, Corlette & Schmalz, 2007b). The purpose of this study was to assess differences in plantar pressure measures, during a straight run, 45 ° and 90 ° cut, performed on each of these surfaces. Eight male university rugby players completed three trials of each movement on both a third generation artificial turf and natural grass surface. Speed was controlled, and pressure insoles were used to collect peak pressure, peak force, pressure-time integral and relative load data under the Medial Heel, Lateral Heel, Midfoot, Medial, Central and Lateral Forefoot, Hallux and Lesser Toes. No surface effect was found for any of the above variables. A significant movement effect was found, whereby cutting increased peak pressures, force and pressure-time integrals under the Medial Heel, Lateral Heel, Medial Forefoot, Central Forefoot and Hallux. Cutting reduced peak pressures, forces and pressure-time integrals under the Lateral Forefoot and Midfoot. Relative load data suggested a medial shift in loading underneath the foot during cutting compared to running; however larger increases in loading at the heel may have masked differences in loading at other foot regions. The results suggest that no surface is likely to increase ACL or ankle sprain risk. Further study is needed to establish the causes of differences in injuries sustained on these surfaces.
    • Political Marketing and Professionalisation of Campaigns: A Factors and Perceptions Investigation (Malawi and South Africa)

      Simenti-Phiri, Easton D. (University of Chester, 2014-06)
      This thesis investigates the nature of political marketing practice and identifies factors affecting adoption and utilisation of political marketing and professionalisation of campaigns in a Southern African context. It applies Sriramesh and Vercic (2009) framework to the study of political marketing in emerging international markets, Malawi and South Africa, two countries in Southern Afric Development Community (SADC). These countries share in common their geographical, cultural and democratic foci, but differ in terms of economic and media development.
    • A post trek exploratory study on the physical and psychological ill health effects of trekking to Everest base camp following observations by the author

      Fallows, Stephen; Gellatly, Pamela (University of Chester, 2011-10)
      The purpose of this retrospective study was to understand and test the theory that multiple physical and psychological ill health effects occur when trekking at high altitude to Everest Base Camp (EBC), Nepal. The tour operator, The Adventure Company, agreed to send out 100 questionnaires to clients who had undertaken either the 11 day trek via Tengboche or the 16 day via Goyko Lakes, to EBC. The questionnaires also considered: age, gender, general levels of fitness and previous experience of trekking at altitude. The respondents (n=49) were 53% male (n = 26) and 45% female (n=22) and one unknown. Of the 49 participants, 36 lost weight (p < 0.001) sd ± 2.95 of which 17 were males (p < 0.001) sd ± 2.6 and 19 were females (p <0.001) sd ± 3.3. Altitude sickness was experienced by 38 trekkers or 78% (p < 0.001) using the Lake Louise Score for Acute Mountain Sickness (AMS); 35% (n=17) had mild AMS, 43% (n=21) had severe AMS. The incidence of other conditions was: bacterial infections = (n= 31) or 57% (p < 0.001); general heart rate (n=26) or 55% (p<0.0001); and 71% (n=35) heart rate at night (p <0.0001); low mood = (n=16) or 33% (p< 0.001). The incidence of AMS was higher on reaching 4000m and was consistent with the literature. Other factors identified and consistent with the literature included: significant weight loss; bacterial infections; increase in heart rate in general and at night. Low mood was present during the trek and for some people continued on returning home and has not been well documented in other studies reviewed. Further research on the multiple ill health effects of trekking and how they may be prevented or better managed is needed to reduce risk and aid overall enjoyment.
    • Poverty and malnutrition in urban sub-Saharan Africa: A systematic review

      Fallows, Stephen; Muriuki, Mercy S. N. (University of Chester, 2009-11-09)
      Poverty contributes to many problems globally and its resultant effects are many,, varied and have their greatest impact in poor countries. One of the major effects of poverty is malnutrition, which has a hold on all facets of life due to the vicious cycle associated with it. In sub-Saharan Africa, malnutrition is rampant and as a result has led to morbidity and mortality, has affected cognitive development and physical growth and has also diminished physical work capacity. The main purpose of this study was to explore the strategies that have been used to combat poverty and malnutrition in sub-Saharan Africa and to also be able to understand the reasons why those strategies worked or did not work. To do this, articles written on the topics related to poverty and malnutrition from sub-Saharan Africa were reviewed. From this it has emerged that poverty should be addressed and that education would have the greatest impact in doing so. Community participation has also emerged to be instrumental in ensuring that the poverty and malnutrition combating strategies are embraced and accepted by the community in general. The reason for this is that, a community will participate actively only if it can relate to the objectives of the project or programme being set up and also be involved in the planning, negotiations and implementation of the strategies.
    • Pregnancy and birth outcome in underweight mothers

      Cohen, Tabitha (University of Chester, 2009-09)
      The aim of this dissertation is to examine the association between maternal underweight and preterm delivery. Using the MEDITECH database from Liverpool Womens Hospital we were able to look at women booking on for ante natal care between January 2005 and December 2007. This gave access to 23651 subjects. These subjects were grouped according to pre pregnancy BMI into five groups; severe-moderately underweight (BMI <18.5), moderate-mild underweight (BMI 18.6-19.9), acceptable weight (BMI 20-24.9), overweight (BMI 25-29.9) and obese (BMI >30). The gestation time of the pregnancy was classified into four groups with standard term delivery being >37 weeks gestation. The three classifications of premature delivery are; preterm delivery (32-36 weeks & 6 days), very preterm delivery (28-31 weeks and 6 days) and extremely premature delivery (<27 weeks and 6 days). Birth outcome was also investigated as associated with preterm delivery. Association between pre pregnancy maternal BMI and both gestation time and birth outcome were examined, with reference to maternal age, smoking behaviour and parity. Results: Women with pre pregnancy underweight were at increased risk of premature delivery. The risk of still birth was also slightly increased with severe-moderate underweight. There were also interesting findings on smoking and pre pregnancy underweight. Severe-moderate underweight (BMI <18.5) shows increased risk of both premature delivery and stillbirth. The more underweight BMI groups have a higher percentage of preterm deliveries. This is more pronounced in the severe-moderately underweight group with a total of 11.8% of infants born prematurely.
    • ‘Pregnancy, Boobs, Breastfeeding & Babies’ - An explorative insight into the enabling factors supporting successful breastfeeding among young mothers from low socioeconomic groups in Cheshire

      Dunne, Seona (University of Chester, 2015-09)
      Exclusive breastfeeding to six months of age has been one of the primary aims of nutrition and public health programs across the world (Shahla, Fahy, & Kable, 2010). The benefits of breastfeeding particularly in recent times have been quite established and despite public health initiatives,breastfeeding practice rates in western countries including the UK do not appear to be significantly improving; with most women not continuing breastfeeding until six months postpartum (Shahla, Fahy, & Kable, 2010). Globally, breastfeeding makes an important contribution to meeting the target to reduce infant mortality (Youens, Chisnell, & Marks-Maran, 2014). It has been shown that mothers from lower socio-economic groups, who are less educated, single and younger are less likely to breastfeed (Stewart-Knox, 2013). Low breastfeeding rates in the UK have led to an increased incidence of illness which in turn, has a significant cost implication on the health service (Entwistle, 2013). According to UNICEF, increasing breastfeeding rates in the UK could save the NHS up to £40 million (Thomas, 2014). The Infant Feeding Survey (IFS) 2010, has shown initial breastfeeding rates in the North West of England at 76%. This is below the national average of 83% for England. After 6 months this rate drops to 29%. The Department of Health in England recommends exclusive breastfeeding for the first six months of life yet by six months, in England, only 34% of babies are breastfed and only 1% of infants are exclusively breastfed (Health and Social Care Information Centre, 2012). Many women do want to breastfeed but without the necessary support, many do not achieve this goal (Thomas, 2012). By understanding what encourages and supports this 29% breastfeeding group to continue breastfeeding, it can help breastfeeding leaders, coordinators and support workers to apply these factors to future campaigns and activities surrounding breastfeeding practices.
    • A preliminary analysis of team performances in English List A cricket

      Key, Stuart (University of Chester, 2013)
      Consequently, the aims of this study are to: preliminarily investigate and quantify the magnitude of differences between key performance indicators of winning and losing teams in a selection of English List A matches and preliminarily investigate pitch-level analysis data, including the line and length of wickets taken and boundaries scored, and its impact on winning or losing in a selection of English List A matches.