• The relationship between workplace stress and physical activity: A correlational study

      Fallows, Stephen; Grant, Loren C. (University of Chester, 2010-09)
      Objectives: This study examined associations between levels of physical activity (PA) in both leisure and work time and stress in a specific population of NHS managerial and administrative staff (n=174). Methods: Data was gathered via a modified version of the International Physical Activity Questionnaire (IPAQ) on physical activity (PA), perceived stress levels at work and in personal life, health status, age, gender, job band, commuting distance and methods of transport, caring status and a range of perceived barriers to PA. The sample was stratified into low, moderate or high categories of activity using the IPAQ scoring protocol to calculate MET-mins/wk. Stress levels were coded 1(low) to 6 (high) from a Likert-scale type question. Results: Overall, there was a significant difference in stress levels between low activity and moderate and high activity groups. As levels of PA increased, levels of stress tended to decrease. The mean difference in stress scores between the low-activity and moderate activity groups was 1.14 (SE: 0.45) (p = 0.01) and the mean difference in stress scores between low-activity and high activity groups was 1.68 (SE: 0.48) (p = 0.00). However, there was no significant difference between the moderate- and high-activity groups although the high activity group had the lowest mean of stress (2.8). When results were separated for age groups, gender and income levels, some of these effects, especially for job bands (as a proxy for income levels) and health, could be confirmed. There were significant differences between some age groups in levels of PA, showing that older age groups are more active; and significant differences in PA amongst people in different job bands, with people on the highest job bands achieving the highest levels of PA and reporting the lowest levels of stress. ii Conclusions: Individuals reporting low levels of physical activity report higher levels of stress, with a trend showing that as PA levels increase, stress levels decrease. However, as this is a cross-sectional study, the direction of the effect could not be confirmed. Further investigation into some of the barriers to PA amongst similar sedentary working populations may be of value for workplace health interventions.
    • Relationship Patterns between Self-esteem, Self-respect and Cognitive Effort as Measured by Story Recall and the Eye Tracker

      Clucas, Claudine; Kelecsenyi, Hedvig (University of Chester, 2018)
      High levels of self-esteem has been associated with success for decades, while at the same time its utility to predict achievement-related behaviours has been questioned. This controversy brought self-respect (an independent, theoretically grounded construct) defined as a person’s positive, affective self-regard for being a moral, principled, and honourable person, to the forefront of empirical research. Accordingly, the current study intended to examine the relationship between self-report measures of self-respect, self-esteem and cognitive effort as measured by story recall and eye tracker measures of eye fixation with pupil dilation while reading a morally neutral and a morally charged story. A total of 40 participants, comprising of 11 males and 29 females, with a mean age of 34, from a convenience sample completed the study. A stronger positive relationship was expected between self-respect and measures of cognitive effort than between self-esteem and the same measures. Also, there was an anticipation of a stronger interaction between self-respect and the type of story tested, because higher self-respect might have implications for the processing of moral information. Four repeated measures of ANCOVA analyses demonstrated significant negative relationship between self-respect and cognitive effort. They also revealed a strong trend towards a negative relationship between self-esteem and cognitive effort. The results quite interestingly are contrary to the declared hypotheses of the study with regards to the direction of the relationship. Findings indicate that the interaction between self-respect and story type on recall and eye tracker measures were not significant. Hence, failing to support the theory that high levels of self-respect enhances sensitivity to moral information through the link to the moral self. The outcome also highlights the possibility that certain factors undermine the effort or more meaningful engagement is needed, perhaps, through a more complex task. It would help to establish not only relationship patterns, but determine whether self-respect is unique enough as an independent construct that could add to the prediction of cognitive effort above and beyond what is explained by self-esteem.
    • Reliability and validity of the Chester treadmill walk test for the prediction of aerobic capacity

      Morris, Mike; McGuigan, Ross A. (University of Chester, 2009-09-30)
      The aim of this dissertaion is to assess the validity and reliability of the Chester Treadmill Walk test (CTWT) for the prediction of aerobic capacity. Four males and three females aged 25.1 (±3.3) years old that were active and healthy volunteered to take part in this study. The CTWT was carried out on two separate days and on the third occasion participants completed a maximal test called the Bruce Protocol treadmill test. Each day of testing was separated by no longer than seven days. Heart rate and RPE were measured during the sub-maximal testing and heart rate, RPE and VO2 were measured during the maximal testing. The bias ±95% limits of agreement technique was used to assess the validity of the CTWT against the maximal testing. No significant differences were found between trial one and maximal testing (0.226) and between trial two and maximal testing (0.252). The CTWT showed over-estimations in VO2max in trial one and trial two by 4.0±15.4 ml•kg-1•min-1 and 4.8±19.7 ml•kg-1•min-1 respectively. Trial one, two and maximal testing obtained VO2max mean values of 49.5±7.8, 50.3±8.4 and 45.5±10.7 ml•kg-1•min-1 respectiviely. 95% LoA technique found an over-estimation of HRmax by 6.4±14.6 beats/min, woth no significant difference found (0.062). ICC and 95% LoA techniques were used to assess VO2 (-0.8±5.2 ml•kg-1•min-1), HR (3.0 ±2.8bpm) and RPE (-0.2±0.6) reliability between trial one and trial two. ICC of 0.95, 0.99 and 0.99 were found between trial one and two in VO2, HR and RPE respectively. It is questionable whether or not the CTWT is a valid sub-maximal test to conduct, however it was found to be a reliable test. VO2max was over-estimated in both trials when compared to actual VO2max but positive relationships were found between the HR and RPE values in trial one and trial two.
    • Reliability of the incremental shuttle walk test and the Chester step test in cardiac rehabilitation

      Fallows, Stephen; Reardon, Melanie (University of Chester, 2008-09)
      Background: Cardiac Rehabilitation at Southport and Ormskirk NHS Trust has been in operation since 1998 and is carried out on two different sites. The latter has a very small exercise area and at this site the Chester Step Test (CST) is used to measure changes in exercise capacity after an eight week exercise programme and also to prescribe exercise for that patient. The former site has a much larger exercise area and historically has always used the incremental shuttle walk test (ISWT) for the same purpose. At both sites a practice test has not been routinely used to familiarise the patient with the test although anecdotally this seemed to show a difference in results. The results of performing a practice test would be analysed to look at the reliability. Objective: To evaluate the reliability of the Incremental Shuttle Walk Test (ISWT) and the Chester Step Test (CST). To compare results from the Incremental Shuttle Walk Test (ISWT) and the Chester Step Test (CST) as measures of change in exercise capacity in patients following an 8-week, hospital-based cardiac rehabilitation exercise programme. Setting: Gymnasia at Southport & Ormskirk NHS Trust. Methods: 33 subjects (26 males and 7 females, mean age 57.3) attended an 8-week cardiac rehabilitation exercise programme. All were assessed using ISWT and CST on three separate occasions: firstly at the patient assessment appointment prior to attendance at the programme, secondly on commencement of the programme (within one week of the first test) and thirdly during the final session of the programme. Both ISWT and CST tests were performed on the same day with a rest period of at least 20 minutes between them, to allow the heart rate to return to normal. The patients were taken to either 80% of their maximum heart rate or RPE 15. The ISWT distance walked in metres was measured. The CST measures predicted VO2max which was worked out by plotting the heart rates on the appropriate graph. Results: The results demonstrated the ISWT showed an element of learning, there was a difference between the practice test and that carried out on the first session of the cardiac rehabilitation exercise programme. The difference between the practice test and the final test carried out after the eight week programme was 125.2m, and between the baseline test and final test was 74.3m, there was therefore an increase of 50.9m within one week. The CST did not show the same element of learning and the results from the two tests carried out within one week did not show a significant difference. The results also showed that the ISWT and the CST showed no significant difference in the percentage increase of parameters measured between the two tests. ISWT showed mean improvement of 21.3% whilst CST showed a mean improvement of 24.7%. The O2 Pulse showed a difference between the two tests, it did not improve in the ISWT but did in the CST. Conclusion: The ISWT requires a practice test to familiarise the participant with the running of the test whereas the CST does not. The ISWT and CST, in this study, showed no significant difference between the two tests in percentage increase of meters (ISWT) and predicted VC>2max (CST) measured and could be used on the two different sites to show changes in exercise capacity. The Patients preferred the ISWT. Relevance to practice: The CST can be used where space and/or time are limited. A practice test at the assessment to attend the cardiac rehabilitation would be performed for the ISWT to familiarise the patients with the test but not for the CST.
    • Religious Authority Online in the Diocese of York

      Course, Eleanor (University of Chester, 2016-01)
      My aim in this dissertation is to research who the online authorities are in the Diocese of York, whether they have roles of authority in the offline church, whether these online roles are considered important by people in the offline church, and whether the online spaces managed by these people are part of wider mission and ministry. In this dissertation, I investigate these topics by collecting qualitative data from some of these people via an online survey and a focus group. I argue that many of the people who are authorities online do have positions of authority in the offline church, and are part of its hierarchy and structure, but that this authority does not necessarily extend online. I argue that there is often a real disconnection between a church’s offline mission and ministry, and the role of the church’s online spaces. This is partly due to conflicting understandings of the purpose or role of online spaces, and partly due to the fact that they are simply not seen as important. Finally, I argue that validation of authority is crucial to both our understanding of the attributes of religious authority online, and to the effectiveness of the mission and ministry online, both from people in the offline church and for the online religious authority themselves.
    • Repeated side-cutting knee and hip biomechanics for a macro-cycle of a professional rugby league season

      Smith, Grace; Stirling, Ben (University of Chester, 2016-09)
      The aim of this study was to determine the variability of lower-limb side-cutting biomechanics in professional rugby league players during a season. Thirteen male professional players were included with a mean age of 22 ±3.4 years. The study used a one-way repeated measures experimental design. Subjects were tested at three time points, separated by four weeks, over the last three months of a season. Peak knee valgus and internal rotation moments (Nm/kg- 1), and flexion angle (°), and hip abduction moment (Nm/kg-1) during the weight-acceptance of the stance phase were collected for all side-cutting maneuvers. A one way repeated-measures ANOVA was performed on the data with Bonferroni post-hoc analysis identifying differences between testing sessions. Mean hip and knee kinematics and kinetics were similar for all measures. There was a significant difference in peak knee flexion angle (°) (Left = F(1, 17) =4.895, Right = F(2, 24) =6.603) and knee valgus moment (Nm/kg-1) (Left =F(2, 24) =9.535, Right =F(2, 24) =6.060) showing significant variability between testing sessions one and three for right knee flexion and knee valgus in both limbs. Bi-lateral knee valgus moments were also significantly different between sessions two and three. Professional rugby league players have shown to be more efficient during the weight-acceptance phase of a side-cutting manoeuver compared to recreational athletes which may be beneficial to reducing frontal plane knee loading and injury risk at the knee. In addition, this study has reinforced the link between the hip and the knee in providing proximal stability for distal mobility.
    • The Representation of Female Prostitution in Victorian and Neo-Victorian Literature

      Heeley, Kate (University of Chester, 2015)
      This dissertation discusses the representation of female prostitution in Victorian and Neo- Victorian literature by analysing the following texts: Oliver Twist, Mary Barton, The Crimson Petal and the White and Mrs Warren’s Profession. It analyses the stereotypical figure of the nineteenth century prostitute and looks beyond this representation by exploring image, maternity, female friendship and biblical symbols. The dissertation considers prostitution in Victorian culture as well as literature, and uses contemporaneous sources such as letters from Charles Dickens, newspaper articles and artwork in order to reinforce ideas. Ultimately the dissertation attempts to determine whether the prostitute was a powerful or a powerless figure by comparing the prostitutes in all four texts to each other and to their ‘respectable’ sisters.
    • Resveratrol-induced cell death in leukaemia cells: The effect of Hsp72 expression and combination treatments with TRAIL and ethanol

      Williams, John H. H.; Weaver, Annette S. (University of Chester, 2009-07)
      Resveratrol, a natural phytoalexin found in grapes and red wine, displays anti-cancer activities through a variety of mechanisms that include the induction of cancer cell apoptosis. Although high concentrations may be needed for the efficacy of resveratrol alone, the compound shows promise as a potent sensitizer of the apoptotic effect of other anti-cancer agents, including death ligand TRAIL. Intracellular heat shock proteins (Hsps) are frequently up-regulated in cancer cells, conferring resistance to apoptosis. Modulation of these proteins may overcome the resistance and increase efficacy of anticancer therapies. In this study, resveratrol caused significant dose-dependent apoptosis or necrosis in the lymphoid and myeloid leukaemia cell lines Jurkat and U937 at 50µM and above. Combination treatments with sub-lethal concentrations of ethanol or TRAIL showed synergistic effects on the dose-dependent cell death, such that significant apoptosis was achieved at 25µM resveratrol. Treatment with all compounds together showed the greatest efficacy with significant apoptosis occurring at 12.5µM resveratrol, but also greater toxicity demonstrated by a shift from apoptosis to necrosis occurring at 25-50µM as opposed to 100-200µM resveratrol in the other combination treatments. Low concentrations of resveratrol that were unable to induce apoptosis caused a significant increase in intracellular Hsp72, whilst intracellular Hsp72 was unchanged or reduced at higher concentrations. Increasing intracellular Hsp72 expression in cells with a mild heat shock prior to resveratrol treatment caused increased resistance to resveratrol-induced cell death at 50-200µM. It was not possible to show that lowering intracellular Hsp72 with ethanol treatment increased sensitivity to resveratrol-induced cell death. It was shown for the first time that resveratrol increased surface expression of Hsp72 at all concentrations, highlighting the potential for an additional anti-cancer effect in situ. The results indicate that combination treatments with resveratrol are promising for use in anticancer therapy, and manipulation of intracellular Hsp72 expression may modulate the efficacy of resveratrol-induced apoptosis. Further investigations are recommended into the clinical relevance of resveratrol, further synergistic compounds, and the effects of reducing intracellular and increasing surface Hsp72 levels.
    • A review of performance appraisal within Liverpool Direct Revenue Services

      Lamb, Frank (University of Chester, 2009-06)
      This dissertation sets out to review and explain the challenge of performance management and how this is addressed through the performance appraisal process within Liverpool Direct Revenues Service. The research will examine the elements which constitute a high performing appraisal process and consider the current problems inherent within the appraisal process within the revenues service and the impact this maybe having on service delivery. The study also considers the impact on staff and their development of an appraisal system which is not delivering key messages or addressing individual performance issues. The research used a number of data capture methods. Secondary survey data was used to underline and support findings from the primary interview data. In addition a survey of all frontline staff within the revenues service was undertaken to provide a greater wealth of data and enrich the overall research. As a result of this research it was discovered that the revenues service does not have a coherent performance appraisal process. There exists a clear dichotomy between senior managers and senior officers as to what elements should be present in the performance appraisal. The research also discovered there was little engagement or confidence in the process from the participants. The research makes several recommendations which include the training of all managers within the revenues service and the embedding of the appraisal process within the organisation. Further recommendations are made to improve staff engagement in the process and create better feedback of information.
    • A review of the methods for the solution of DEAs

      Ford, Neville J.; Lumb, Patricia M. (University of Liverpool (Chester College of Higher Education), 1999-06)
      Differential-Algebraic equation systems (DAEs) occur in a variety of applications in science and engineering and interest in them has grown considerably during the latter part of the twentieth century. The aims of this thesis are to provide the interested reader with a comprehensible and informative introduction to DAEs, whilst assuming no prior knowledge of the subject area; to give an indication to the reader with a DAE to solve whether or not they can hope to be successful; to introduce the reader to possible methods of solution (either analytical, numerical or both)
    • Risk factors for osteoporosis in South Asian and Caucasian postmenopausal women

      Gifford, Heather (University of Chester, 2011-10-31)
      There is evidence to show that the risk of osteoporosis is greater for South Asian females compared to Caucasian females. This is due to differences in bone mineral density and other risk factors which contribute to this condition such as calcium and vitamin D intake and exercise levels. The present study set out to examine such differences between these two communities. Postmenopausal females were studied as the risk of osteoporosis is greater after the menopause. Bone mineral density was assessed using the Achilles Insight heel scanner, dietary intake was assessed using a 24 hour recall and lifestyle factors were assessed using a questionnaire. Total participants - 282 Caucasian and 41 South Asian women. Postmenopausal participants – 144 Caucasian and 7 South Asian women. No significant differences were found in bone mineral density between Caucasian and South Asian females, however differences in other risk factors for osteoporosis such as calcium and vitamin D intake were found between the two communities. There were also significant differences in bone mineral density between pre and postmenopausal participants (P<0.001). Although no differences in bone mineral density were found between the two communities, there were significant differences between the pre and postmenopausal participants. This shows how important it is to raise awareness of this public health issue and target other factors associated with osteoporosis in already high risk individuals.
    • Ritual, learning and memory: Engaging with monuments at the National Memorial Arboretum

      Hogg, Callum (University of Chester, 2014)
      Memorial engagement, that is an interactive experience between a person and a created monument commemorating the dead, is a process which as a learning process and agent of change has been unexplored. Even further than this, multiple memorial experiences and the chain of encounters this would produce has not yet been theorised. As archaeologists, the further understanding of the role of memorials play in the lives, learning and world of the people engaging with them is vital to understanding the significance of the memorials themselves. The National Memorial Arboretum (NMA) in Alrewas, Staffordshire, is a heritage centre containing an assemblage of over 240 individual memorials commemorating a wide range of groups and individuals. The NMA constitutes a complex intersection of memorial, museum, heritage centre and tourist attraction. This project will seek to explore the nature of personal engagement with memorials within the context of the NMA. This will be achieved through the use of both previous theoretical viewpoints as well as first person accounts of the NMA itself.
    • The role of employee engagement and communication in gaining competitive advantage

      Rowland, Caroline; West, Simon R. (University of Chester, 2008)
      There are many challenges facing today’s modern organisations, not least of which is to keep the employee workforce motivated and performing in the way in which the organisation requires in order to attain and sustain competitive advantage, and to satisfy stakeholder expectation. This can be understood as leveraging employee engagement in the organisational workplace. This dissertation reported on a real live and current organisational issue within the Authors most recent employer (The Author left Organisation X on 26/3/08 to complete this dissertation)- Organisation X (The Author has been asked to use any reference to the subject organisation within the dissertation as ‘Organisation X’, in order to maintain anonymity, and preserve any sensitive commercial intelligence regarding strategy and direction), a large UK Plc and a member of the FTSE 250 with c£10bn turnover, and c2300 retail locations; many of them prime High Street. The dissertation debated the impact of employee engagement, what it is, how it links to competitive advantage, the tools and behaviours of employee engagement and the merit to Organisation X of having an engaged workforce in their retail estate, (through which 85% of their profitability is delivered). The paper crucially offers recommendations on what Organisation X can do to progress their employee engagement. Concluding with a critical synthesis of whether Organisation X is following the correct route to leverage their internal resource – the employees, and thus provide maximum value to their stakeholders. The outcomes from this research greatly assisted the Author in developing and communicating his own employee engagement strategy within his area of responsibility thus impacting positively on his domain business and trading performance. These outcomes yielded an opportunity to be adopted in the peer areas of Organisation X’s retail network thus building a firm platform for competitive advantage, which in turn drives performance ahead of the sector market, and delivers growth in shareholder value. A robust research methodology is provided, discussing aspects of research philosophy (epistemology; ontology), research methodology (qualitative; phenomenalist and inductive approach), research methods (two-way feedback questionnaire and focus groups) and ethical considerations. A literature review of the main content and process theories of employee engagement is set out and discussed. This proposal would be useful for anyone interested in organisational employee engagement, (specifically aligned to the case organisation), how it links to competitive advantage and to those who want to know how to write a coherent dissertation with a strong methodology and literature review.
    • The role of heat shock proteins in colorectal diseases

      Williams, John H. H.; Skellern, Luke I. G. (University of Liverpool (University of Chester), 2008-10)
      Introduction: This thesis examines the roles of Hsp10, Hsp60, and Hsp7O in colorectal diseases, in particular Inflammatory Bowel Disease, Colonic Polyps, and Colorectal Cancer. HSPs are reported to be elevated in a number of human diseases, including autoimmune diseases and cancers. On a daily basis the colon is exposed to a number of harsh stresses, including fermentation of foodstuffs as well as a high bacterial load. These stresses are thought to possibly induce the expression of HSPs in colonic mucosal cells, where it is thought that they may influence cellular function. HSPs are known to regulate apoptosis and coordinate certain immune functions that may provide either beneficial or detrimental effects depending upon the situation. Deranged apoptosis and inappropriately coordinated immune responses, possibly as a consequence of HSP activity, are thought to be implicated in the pathogenesis of some colorectal diseases. This project aims to find correlations in the concentration of a number of important HSPs in colorectal mucosa with colorectal diseases to enhance our knowledge of the roles that HSPs might play in pathogenesis of inflammatory bowel disease, colorectal polyps and colorectal cancer. Methods: 81 subjects were recruited prior to colonoscopy or sigmoidoscopy and consented to the removal of blood and colorectal mucosal biopsies for the purpose of this study. Colonic mucosal biopsies were analysed for protein levels of Hsp70 by ELISA, in addition the mRNA expression of HsplO, Hsp60 and Hsp70 was quantified by RT-PCR in colonic mucosal specimens. A further 20 patients were venesected so that whole lysed blood could be analysed by flow cytometry to determine the cellular localisation of Hsp70 concentration in neutrophils, monocytes and lymphocytes, to understand the involvement of Hsp70 in the coordination of immune responses appropriate to colorectal diseases. Kruskal-Wallis, Mann-Whittney, and Linear regressional analysis were performed to determine statistical significance. Results: Endoscopic appearance and pathological diagnosis separated the 81 patients into the following groups: normals (n = 42), inflammatory lesions (n = 23), polyps (n = 10), and colorectal cancer (n = 6). Hsp70 protein expression appears to be most elevated in normal mucosa, while lower levels are measured in inflammatory lesions and polyps, and minimal levels seen in colorectal cancer specimens (P-value = 0.447). A similar pattern is seen in the levels of Hsp70 mRNA expression, again with lowest levels measured in the colorectal cancer specimens (P-value = 0.528). The gene expression of both HsplO (P-value = 0.977) and Hsp60 (P-value = 0.245) is raised in inflammatory and polypoid lesions, but as with Hsp70, is lower in colorectal cancer specimens than in healthy colonic mucosa. Too few patients with colorectal disease were evident among the 20 patients for whom blood was sampled for flow cytometry therefore statistical significance was not achieved. The percentage of neutrophils and monocytes expressing Hsp7O was maximal in the colorectal cancer patient and lowest among healthy patients, however the average concentration of Hsp70 on these cells was lower in the colorectal cancer patient than healthy patients. Discussion: Pathological group sizes were a representation of the epidemiology of colorectal diseases and hence some sample sizes, particularly the colorectal cancer group, were too small to obtain significant conclusions. Further work with larger groups is therefore required to build upon the results of this pilot study. Contrary to what was predicted, high levels of Hsp70 in healthy bowel mucosa may be a cytoprotective mechanism ensuring the survival of the cell. In contrast, cells with lower levels of Hsp70 may be more likely to undergo spontaneous mutations this could explain lower Hsp70 levels measured in the pathological groups. Alternatively, low levels of Hsp70 in the pathological groups could be due to active secretion as part of a 'danger signal' by these cells to mount an effective immune response.
    • The role of interpreters in art psychotherapy settings: Understanding the way art therapists deal with their need for language interpreters in therapeutic work with their clients and their experience of that

      Young, Susan; Hama, Darron (University of Chester, 2015-07)
      This research is an attempt to explore the experience of art therapists’ work with interpreters in their clinical settings with non-English speaking clients. Since only in year 2014, 624,000 people immigrated to the UK (http://www.ons.gov.uk), more extensive use of interpreters for psychotherapy became inevitable. However, the presence of interpreters in all psychotherapeutic settings has been considered and there is a consensus that this phenomenon is a complex and multi-faceted experience. To acquire an in-depth understanding of this phenomenon, art therapists’ account about their feelings and viewpoints towards their experience with interpreters has been considered. This resulted in emergence of several theoretical themes; I was able to conclude that despite some difficulties and reluctance that some authors expressed in their studies, (a few of these being confirmed by some of the participant art therapists in this study), no one has declined the need for interpreters at some points when clients have difficulty using English language to communicate with therapists. Further to this, in the literatures and participants’ interviews, the obstacles and difficulties that may face therapists have been highlighted along with suggestions and recommendations to overcome them.
    • The role of midwives with reference to preparation for parenthood: A case study

      Brady, Maureen T.; Grundy, Lynne M. (University of Liverpool (Chester College of Higher Education)Glan Clwyd Hospital, 1996-06)
      This dissertation is predominately a review of literature regarding the midwives' role in preparation for parenthood. The literature is reviewed to assess the evolution, purpose and aims and effectiveness of antenatal education. Funfamental issues regarding how education in general can serve to oppress or liberate are examined along with the purpose and aims specific to antenatal education. The study concludes that there are many differing aims of antenatal education, often causing a lack of clarity for the midwives who deliver this education.This dissertation examines studies on measures, benefits and effectiveness and finds that the results of these stdies are often inconclusive and sometimes contradictory. A small scale primary study using postal questionnaires informs the dissertation. Qiestionnaires were sent to all mothers who delivered during a two week period three months and six months prior to receiving the questionnaire.Questionnaires were also given to all practising midwives working in the same area. The questionnaires aimed to identify whether clients' expressed needs were matched with midwives' perceptions of client needs. An analysis of the results shows that both midwives and clients agree that the subjects of labour and delivery and pain relief during labour are the most important subjects to discuss during antenatal education. In the study both clients and midwives prefer antenatal education to be delivered on a one-to-one basis. Midwives recognise a need for increased education for themselves to develop their teaching skills with regular updates. It was found that most midwives considered that their training was not sufficicent for this role. The dissertation recommends that antenatal education should serve to liberate parents and empower women, enabling them to take contrl and make informed choice during the process of childbirth. It advocates that midwives should be supported and helped to take on this role. The need to explore alternative methods of delivering antenatal education is identified.
    • The role of physical education, sport and exercise in a female prison

      Fallows, Stephen; Ozano, Kimberley A. (University of Chester, 2008-09)
      The purpose of this study was to investigate the role of physical education, sport and exercise in the rehabilitation process of female prisoners. Research in this area is limited and often focuses on young offenders and male prisoners. Nine female prisoners from HMP Drake Hall, between the ages of 21 and 40, who participated in gym activities, at least three times a week were interviewed. This was a qualitative study using a grounded theory approach through in-depth open ended interviews. Questions focused on experiences and perceived outcomes related to their sport and exercise involvement. The data collected was then analysed using open, axial and selective coding. Five phenomena emerged from the raw data including Participation outcomes; General health awareness; Role of sport and exercise on rehabilitation for release; Developmental skills and experiences; Influence of sport, exercise or dietary awareness on plans post prison. Links between the phenomena were identified and a theory emerged beginning with the initial incarceration of a female through to participation in exercise and sport and results in the final release of a rehabilitated woman armed with the tools to cope with society in an acceptable manner. The Progression Model of Behaviour Changes through Sport and Exercise in Female Inmates developed from this research summarises the theory which evolved from grounded research. There were clear psychological, social and physical benefits of sport and exercise participation for the interviewees including increased confidence and self-esteem which contributed to the attraction to exercise and sport. The female prisoners also found that sport/exercise could be used as a coping mechanism to release feelings of aggression and anxiety. Due to the many positive outcomes associated with sport/exercise the prisoners planned their futures around this discipline. They chose to undertake coaching and academic qualifications, gained experience of instructing exercise and sport in Drake Hall and planned their careers upon release around sport and exercise. The prisoners expressed a desire to lead a healthy, socially acceptable and crime free life. This study will add to the limited body of literature in this minority population and will inform other female institutions of the rehabilitative processes associated with sport and exercise participation.
    • The Role of Social Support in Helping People with EDS Manage Their Condition

      Carroll, Janine; Appleby, Kate (University of Chester, 2016)
      The Ehlers-Danlos syndromes (EDS) are complicated, multisystemic disorders that can impact almost every aspect of an individual’s life and severely affect functioning. Research into optimal long-term management of EDS is still sparse and recommended medical treatments are largely based upon the clinical opinions of healthcare providers. Social support is linked to coping with adversities such as chronic health conditions, and has a relationship with health-related quality of life. This qualitative study examined the role of support in optimal management of EDS. Five participants with EDS were interviewed, and thematic analysis was carried out. Four themes relating to disparate sources of support emerged: community incorporated personal or face-to-face support (e.g. spouse, family, friends, and peers). Medical support included specific professionals and types of care available to people with EDS. The role of self-support included and focused on resilience and how support helps development of resilience. The results of this study suggest that external support can facilitate the development of resilient behaviours and attitudes in individuals with EDS, which enable better management of their condition. Interventions that incorporate appropriate, multidisciplinary, medical care with the goals of improving individuals’ access to support, such as information and peer support, could enable better management of EDS. Optimal management of EDS is likely to result in better HrQoL and reduce healthcare-related expenditure associated with treatment of EDS.
    • The role of Tai Chi Chuan in health related quality of life in chronic obstructive pulmonary disease and heart failure: A literature review

      Buckley, John P.; Fallows, Stephen; Themistocleous, Irene-Chrysovalanto (University of Chester, 2014-09)
      The purpose of this study was to examine the impact of chronic obstructive pulmonary disease (COPD) and heart failure (HF) and therefore to evaluate tai chi chuan (TCC) in general health. Despite the advances in clinical care and medicine, cardiopulmonary diseases continue to be the principal cause of morbidity and mortality. In spite of the symptoms of these chronic diseases; the negative psychological status of the patients has been also demonstrated. The importance of the alleviation of the symptoms, the management of psychological disorders is essential in the progress of the disease. Complementary interventions like TCC appears to be a desirable option that can be used in rehabilitation. A search was conducted to detect reviews, meta‐analyses, systematic reviews and large randomized control trials. Several interventions along with medication contribute to the management of these diseases. A growing number of studies have demonstrated beneficial effects of TCC, such as: improvement in balance, reduction in falls, increase in social interaction; decline in cardiac risk; reduction of disease symptoms; and improvement in pulmonary system, functional and psychological status. However, most of these studies were focused on the physiological improvement rather than on the quality of life (QOL). Further studies are required to investigate the effect of TCC on QOL in patients with HF and COPD.
    • The role of the Chaplain in the strategic facilitation of multi-faith sacred space to alleviate the suffering associated with death and dying

      Baker, Christopher; Rusted, Giselle (University of Chester, 2014-09)
      The aim of the research was to observe and scrutinise how chaplains go about facilitating a sacred space when requested, in the last days and hours of death. It sought to identify the context in which chaplains are compelled to facilitate religious and spiritual rituals and what perspectives participants have of chaplains when creating a sacred space within non-orthodox, clinical spaces. It also sought to understand the added value of chaplaincy in relation to high quatlity patient care and who was best placed to faciliate a sacred space at the point of death and dying. The research used a cross sectional design study with purposive sampling and carried out ten one to one interviews with hospital staff, who had experienced chaplaincy. They were selected from different areas of the hospital. Additionally, the research used the participant observations of the researcher who is a chaplin. Using a thematic annalysis process to identify emerging themes, the research was able to achieve an indepth understanding of the contributions made by chaplains to patient and family experience, at the point of death and dying. The research concluded that death is perceived as a significant rite of passage which requires marking; subject to a variety of expectations and that those best placed to deliver this service are chaplains, perceived as practioners in this field. The research indicated that chaplains care and are compassionate, courageous, competent and committed to providing high quality patient and family experience. Recommending that there should be greater collaboration between clinicians and chaplaincy because chaplains use their experience and knowledge when they are alongside patients and family, normalising death and contribute to a good death.