• Alternative methods of treating atelectasis in post-operative patients

      Fallows, Stephen; Mason-Whitehead, Elizabeth; Al Mutairi, Fouad (University of Chester, 2013)
      Cardiac surgery incisional pain can decrease inspiratory effort, alter normal respiratory mechanics, and increase the potential for post-operative pulmonary complications. Post-surgical atelectasis is the most frequent complication after coronary artery bypass grafting (CABG), ranging from 54% to 92%. All types of therapy such as an incentive spirometry (IS), deep breathing exercises (DBE) or continuous positive airway pressure (CPAP) have a valuable role to play in the prevention or the treatment of post-surgical atelectasis. However, the type of therapy that should be used is not completely clear yet. The present research aims to evaluate the benefit of early use of CPAP via mask therapy to treat or prevent post-surgical atelectasis after CABG, particularly in smokers and elderly patients, as compared to regular (IS) therapy. Also, it aims to evaluate the patients' and medical staff's experience about the use of the new method of CPAP via mask therapy. The present research was conducted at King Fahd Armed Forces Hospital in Saudi Arabia between March 2010 and December 2011. It used a mixed methods approach. The first two studies were intervention quantitative studies, which investigated the benefit of CPAP via mask therapy. The others were qualitative studies that evaluated the experience of patients and medical staff regarding CPAP therapy use.A total of 180 patients (male and female) (36 in each group) participated in the two quantitative studies. Ninety two participants (male and female) participated in the qualitative studies. The first quantitative study results showed an improvement in CPAP via mask therapy for half hours every two hours group measurements as compared to IS therapy groups. IC was increased significantly in the "CPAP every two hours group" as compared to control group (IS) (baseline mean for IS group 1.34L and "CPAP every two hours group" 1.42L, post- therapy mean 1.59L and 1.88L respectively, p= 0.037). In addition, when chest physiotherapy was added to the two regimens, the improvement of CPAP therapy measurements became more than IS therapy. Moreover, the patient’s acceptance rate for CPAP therapy every two hours was 93% and the medical staff acceptance rate was 86%. CPAP via mask therapy for half hour every two hours had better outcomes in treating or preventing post-surgical atelectasis after CABG, particularly in smokers and elderly patients. Adding chest physiotherapy led to even better outcomes. The use of the new method of CPAP therapy had high acceptance rate by the participants and medical staff.
    • Assessing efficacy of cardiac rehabilitation exercise therapy in heart failure patients

      Leslie, Rosalind (University of Chester, 2015-10)
      Background: Exercise-based cardiac rehabilitation (CR) is considered routine practice for patients following an acute cardiac event or surgical intervention. Although there is a seemingly strong evidence base supporting it for patients with chronic heart failure (CHF), provision in the UK remains poor for this patient group. In addition, data for CHF patients reported in key CR reviews and meta-analyses are not a true representation of the UKs CHF population. The transferability of current evidence into actual practice settings in the UK therefore remains incongruous. Rationale and aims: Study outcomes have typically included an increase in VO2 peak/ VO2 max, a decrease in natriuretic peptides, improved left ventricular function and improved health related quality of life (QoL). Access to facilities and equipment, such as cardiopulmonary exercise testing equipment is limited in the UK for the majority of CR services thus an alternative means of assessment and exercise prescription is required. The recommended alternative for testing CHF patients is the six-minute walk test (6MWT); this requires a given space and a full practice test, the latter which adds to valuable clinical and staff time available. Methods: The first set of studies of this thesis therefore investigated two adapted assessment procedures for use with CHF patients: i. the use of a shorter practice walk test of two minutes vs six minutes prior to a 6MWT and ii. the use of the space saving Chester step test with an adapted lower step height protocol to accommodate the anticipated lower fitness in CHF (4-inch vs 6-inch). Having determined a more practical and efficient means of assessing exercise capacity in CHF patients, this thesis then used the 6MWT to evaluate the efficacy of a typically recommended 12-week programme (for the UK) of exercise-based rehabilitation. It was the aim of this PhD to also combine the use of the Chester step test with cardiopulmonary measures as a corresponding physiological outcome in a sub-sample of participants; however due to resource problems, only validation of the low-step protocol was possible. In the main intervention study, the efficacy of a 12-week course of supervised moderate intensity exercise in CHF patients (ejection fraction <44%, NYHA class II to III) was then evaluated. For purposes of evaluating safety and recovery of any acute myocardial stress induced by exercise in CHF, a sub-group study was performed to evaluate the influence of an acute exercise session on two-day post-exercise levels of circulating NT-proBNP. Results: In this current suite of studies, participants were more representative of the UK CHF population than typically reported in the current evidence. Their profile involved a median age of 76 ± 16 years (mean: 67 years and range: 30 to 84 years). 98% of whom were prescribed beta-blockers, 66% were diagnosed with atrial fibrillation and 98% had two or more co-morbidities. Study 1 (Chapter 3a) verified the efficacy of a two-minute practice walk in comparison to the recommended six-minute practice walk prior to performing a baseline 6MWT in patients with CHF. Study 2 (Chapter 3b) demonstrated that a 4-inch Chester step test is a reliable assessment when space is an issue, but the criterion validity of the actual oxygen costs at each stage compared with those estimated in healthy populations were significantly lower than recommended estimations from healthy populations. Study 3 (Chapter 4) revealed individual variability in the acute response of NT-proBNP release to exercise that is worthy of further study. However the NT-proBNP data overall did not suggest a need for ‘rest days’ between exercise training sessions. The main intervention study (Study 4, Chapter 5) demonstrated a significant improvement in 6MWT performance responses, compared with control, where an increased walking distance of 25 m (p < .0001) was coupled with a reduction in heart-rate-walking speed index (T1 16.3 ± 7.3 vs T2 15.3 ± 8.7 beats per 10 walked; p < .0001). Perceptually, patients were walking faster for the same rating of perceived exertion (RPE 12 to 13). This improved aerobic functioning coincided with an improved NYHA class (T1 2.3 ± .5 vs T2 1.8 ± .6; p < .0001); however there was no change in resting NT-proBNP levels after 12 weeks. Patients in the “control group” who then went on to be offered the same 12-week intervention achieved similar outcomes, but delaying their commencement of an exercise programme by 12 weeks negatively impacted on participation uptake. Key findings and conclusions: These results have demonstrated that exercise training in CHF can lead to an improvement in both physical and perceived functioning (NYHA class). In light of some previous studies showing decreases in BNP following an exercise programme and others like this one showing no change, further questions are raised about the effect of different types and doses of activity being offered to CHF patients and the responsiveness to training of different types of patients (disease severity and demographics). The nature of the cross-over design of this study revealed that delayed commencement of exercise negatively affects participation uptake by patients, which supports current UK standards in aiming for early referral to CR.
    • Assessment of strength and power responses to resistance exercise in young and middle-aged trained males

      Twist, Craig; Lamb, Kevin; Fernandes, John (University of Chester, 2018-08-31)
      Little is known about the muscle function capabilities of trained middle-aged males and how they differ to younger counterparts. Accordingly, the overall aim of the research documented in this thesis was to compare the acute muscle function responses to resistance exercise in middle-aged and young resistance trained males. The first study (Chapter 3) examined the intra- and inter-day reliability of an ecologically valid device (FitroDyne rotary encoder) for measuring upper and lower-body muscle function during three popular multi-jointed resistance training exercises (bench press, squat, and bent-over-row), and confirmed that it was capable of detecting moderate changes in muscle function across a range of submaximal loads. In the second study (Chapter 4) the load-velocity and load-power relationships were investigated during the same exercises among 20 young (age 21.0 ± 1.6 y) and 20 middle-aged (age 42.6 ± 6.7 y) resistance trained males, and it emerged that, despite their regular training, the middle-aged males were unable to achieve velocities at low external loads and peak powers at all external loads as high as the young males across a range of external resistances. Study three (Chapter 5) proceeded to compare the internal (heart rate (HR), OMNI-ratings of perceived exertion (RPE) and sRPE) and external (peak velocity and power and volume load) loads experienced during high volume squatting exercise, and the fatigue responses among nine young (age 22.3 ± 1.7 years) and nine middle-aged (age 39.9 ± 6.2 years) resistance trained males. The findings highlighted that internal, but not certain markers of external (peak power and volume load), load responses can be monitored during exercise in a like manner between these age groups. Moreover, compared to young resistance trained males, middle-aged males can expect greater decrements in peak power after lower-limb resistance exercise. In the final study (Chapter 6), the time-course of recovery in nine trained young (age 22.3 ± 1.7 years) and nine trained (39.9 ± 6.2 years) and nine untrained (44.4 ± 6.3 years) middle-aged males after high volume lower-body resistance (muscle damaging) exercise was investigated. Of practical importance, it emerged that compared to the young males, the trained middle-aged males experienced greater symptoms of muscle damage and an impaired recovery profile, the implication of which is the need for trained middle-aged males to adopt strategies to enhance their recovery. Furthermore, both middle-aged groups experienced similar symptoms of muscle-damage, albeit the untrained group demonstrated greater losses in peak power at low and high external loads. For the first time, the current research has determined that middle-aged males, despite regular resistance training, are subject to losses in peak velocity and power output across a range external loads, compared to young males. When undergoing lower-body resistance training to ameliorate these decrements, applied practitioners can use internal load markers and peak velocity, but not peak power or volume load, to monitor trained young and middle-aged males alike. Furthermore, the muscle damage response (24 to 72 h), and losses in peak power (0 to 72 h), after lower-body resistance exercise are greater in trained middle-aged than young males. Consequently, future research should seek to corroborate these observations in upper-body exercise and determine the effectiveness of strategies (e.g. nutritional intake) to enhance recovery in middle-aged males.
    • Changes in selective biomarkers after transurethral resection of the bladder tumour (TURBT), and their association with Non-muscle invasive bladder cancer (NMIBC) recurrence and progression

      Ella-Twongiis, Peter (University of ChesterUniversity of Chester, 2019-10-01)
      Introduction Bladder Cancer (BC) is the 10th most common cancer in the UK, with about 10,000 new cases annually. It affects more men than women (ratio 3:1). Major risk factors include tobacco, chemical carcinogens, schistosomiasis infection and age. About 75-85% of BC are non-muscle invasive (NMIBC), which is associated with high recurrence and progression rates (50-60% within 7-10 years). Currently, diagnosis, treatment and management of BC is via clinical procedures such as transurethral resection of the bladder tumour (TURBT) and endoscopy. Concerning laboratory investigations, there are no routine biomarkers currently available for identifying BC patients at increased risk of developing recurrence and progression. By monitoring changes in selective biomarkers post-TURBT, any sustained changes may be a predictor of cancer recurrence or progression. The main-focus of this research study was to evaluate changes in selective novel biomarkers and their association with recurrence and progression in BC. Materials & Methods In this research, 40 patients (n=40) scheduled for TURBT at the Wrexham Maelor Hospital, North Wales were recruited after written informed consent. Ethical approval for the project was granted via IRAS (REC4: 14/WA/0033). Venous blood samples were taken at baseline (pre-operative) and following TURBT surgery at 1, 3 and 6 months post-operatively. Bladder tumour samples were also taken during TURBT according to standard procedure. Selective biomarkers to assess inflammation, angiogenesis and tumour growth, were measured using commercially available ELISA and BioPlex multiplex assay kits. Tissue immunoreactivity of novel biomarkers were also assessed in BC tissues using immunohistochemistry, with clinical outcome measures being recorded for all patients. Results Significant increases in serum Cluster of differentiation 31 (CD31) (p=0.003) and Stem Cell Factor (SCF) (p=0.032) concentration, as well as trends of increasing concentration of serum basic Fibroblast Growth Factor (bFGF) (p=0.14), Vascular Endothelial Growth Factor Receptor-1 and 2 (VEGFR-1) (p=0.15), VEGFR-2 (p=0.15) and Follistatin (p=0.40) were observed in BC patients up to 6 months post-operative. There were also significant decreases in serum Macrophage Inflammatory Protein -2 (MIP-2) (p=0.001), Platelet Derived Growth Factor (PDGF) (p=0.012), Matrix Metalloproteinase-9 (MMP-9) (p=0.002) and Vascular Endothelial Growth Factor C (VEGF-C) (p=0.04) serum concentration. Trends of decreasing concentration in MMP-2 (p=0.79), MMP-3 (p=0.15), interleukin-6 (IL-6) (p=0.26), interleukin-8 (IL-8) (p=0.15) and tumour necrosis factor-α (TNF-α) (p=0.69) were observed in BC patients up to 6 months post-operative. There was significant immunoreactivity of CD31 (p< 0.001), CD34 (p< 0.001), Human epidermal growth factor receptor-2 (HER-2) (p=0.032), S100P (p< 0.001), Cyclooxygenase-2 (COX-2) (p< 0.001), VEGFR-3 (p< 0.001), SOX-2 (p< 0.001) and thrombomodulin (p=0.010) in bladder tumours. Although recurrence was significantly associated with cancer grade, there was no association with antibody immunoreactivity. Conclusion Findings from the present study may indicate an alternative approach in the monitoring and management of patients with BC. It is proposed that by allowing urological surgeons access to laboratory markers such as MIP-2, MMP-9, PDGF, SCF, HER-2, Thrombomodulin and CD31 (biomarker profile), potentially, in the future, these biomarkers may be used in addition to, or in combination with, currently used scoring systems to predict cancer recurrence and progression. However, verification and validation of these biomarkers are needed using larger cohorts.
    • Commissioning training for behaviour change interventions: Guidelines for best practice

      Powell, Katie; Thurston, Miranda; Centre for Public Health Research, University of Chester (University of Chester, 2008-09-01)
      This report discusses advice in encouraging healthy behaviour to improve people's health and their quality of life through brief advice, brief intervention, motivational interviewing, social marketing, and training and delivery.
    • The development of an amateur boxing simulation protocol

      Thomson, Edward (University of Chester, 2015)
      There is a dearth of research attempting to quantify the external (physical) and internal (physiological) demands of amateur boxing performance. Therefore, the purpose of this programme of research was to investigate the external demands of amateur boxing performance, and subsequently, develop a sport-specific simulation protocol that could replicate these demands and the accompanying physiological responses while appraising the reliability and validity of the attempt.To achieve this it was necessary initially to identify key offensive and defensive performance indicators and assess the intra- and inter-observer reliability with which such actions could be quantified. Intra-observer reliability was deemed excellent with high agreement (>92%) for all actions identified. Inter-observer reliability was less impressive (>75%), though remained consistently high nevertheless. Subsequently, research utilising this template quantified the offensive and defensive external demands and effectiveness (i.e. frequency of actions deemed successful) according to the independent and interactive influences of contest outcome, weight class and ability using post-contest video analysis. Main effects, two- and three-way interactions were established when appraising the frequency of actions and their outcomes in relation to the independent variables. Whilst the ability of the boxers evidenced the most prominent impact, contest outcome and weight class remained important influences for most actions. Moreover, substantial (CV >30%) within-group variation was evidenced implicating the role of boxer ‘styles’ and strategies in modifying the demands. The offensive and defensive demands were then supplemented with Global Positioning System (GPS) analyses of the boxers’ sport-specific time-displacement movements. Having established the GPS’s reliability and validity for assessing the boxingmovements, it was observed that boxers typically moved a distance of 35.9 m·min-1 at an average speed of 0.6 m·s-1. Such data was amalgamated with the technical demands to produce a boxing-specific simulation protocol that was reflective of the average competitive demand and thus had the potential to be a boxing conditioning and fitness test (BOXFIT). Despite providing the most valid external demand to-date, owing to confounding influences and within-group dispersion, application of the typical external demand was shown to afford only an approximation of the actual demands in all boxers. As such an issue is characteristic of simulation protocols, the BOXFIT was still employed to evaluate the physiological response and appraise the associated reliability and validity. The internal demand was characterised by a high aerobic cardiopulmonary response (peak heart rate > 189 b·min-1; peak 𝑉̇O2 > 55 ml·kg-1·min-1) coupled with a marked indication of anaerobic energy provision (blood lactate = 4.6 ± 1.3 mmol·l-1). The reliability of the physiological responses elicited by BOXFIT performance was generally sufficient to enable the detection of moderate effects (i.e. 0.6 x pooled SD) and practically relevant changes in physiological and physical performance owing to training and nutritional interventions. However, the BOXFIT-induced responses underestimated selected markers of internal load (e.g. Mean heart rate ≈ -4.5%), questioning its validity. Thus, application of the average external demand typically approximated, rather than replicated, the actual physiology of boxing. With modifications, the validity of the external demands and internal response could be improved. The BOXFIT might therefore be used as part of a boxer’s conditioning, providing a sport-specific means of training and offers an ergonomic framework to assess the impact of systematic, intervention-based changes in boxing-specific exercise physiology.
    • Development, Digestibility and Oxidation Properties of LC3PUFA Nanoemulsion and Its Effects on Sensory Profile of Food

      Zhou, QiQian (University of Chester, 2019-02)
      The long chain omega-3 polyunsaturated fatty acids (LC3PUFA) in human diets are mainly derived from oily fish and fish oil based supplements. Currently, the consumption of oily fish in the UK is far below the recommended level. LC3PUFA's non-fish sources such as algal oil with DHA (docosahexaenoic acid) are particularly important for vegetarians, non-fish eaters, and pregnant women. In previous work, high DHA vegetative algal oil load 50% w/w was successfully used to develop an oil-in-water nanoemulsion system suitable for functional food enrichment. The aims of this study included to investigate the effect of selected emulsifiers on oil-in-water nanoemulsions of algal oil prepared using ultrasonic technology. To improve the stability and digestibility of nanoemulsions within an In vitro digestion model. To examine the oxidation stability of nanoemulsions of algal oil and bulk algal oil with composition and droplet size changes during a 5 weeks storage trial at a temperature of 4 °C, 20 °C and 40 °C respectively. To evaluate sensory properties and consumer acceptability of food products with the incorporation of resulted nanoemulsion and find out possible relationship between the sensory profile of foods and the characteristics of added nanoemulsion. Nanoemulsion of LC3PUFA algal oil was developed with selected 6% w/w emulsifiers, including Lecithin (LN), Tween 40 (TN), Tween 60, equal ratio of Tween 40 and lecithin (LTN), 50% w/w Algal oil and 44%w/w water using a homogenizer and ultrasound processor. The results show that the nanoemulsion has been stabilised with selected emulsifiers (LN, TN & LTN) and the smallest droplet size of nanoemulsion was obtained using the combination of lecithin and Tween 40 at ratio 50:50. The In vitro digestion experiments were conducted with a model of fed state gastric and duodenal digestion using method of Lin et al (2014). The results show that the omega-3 oil nanoemulsion (LE/TW 50:50) were stable over 60 min in the gastric phase, in contrast omega-3 nanoemulsion (LE 100%) was destabilised at the gastric phase in 60 min, in which the droplet size diameter was significantly larger than at the beginning of gastric phase (P ≤ 0.05). The droplet size, fatty composition and oxidised compounds were measured to compare bulk algal oil and nanoemulsions stabilised with lecithin (LN) and Tween 40 (TN) solely and in combination (LTN) over a storage period of 5 weeks at temperatures of 4, 20 and 40°C. The results show the droplet size of nanoemulsions had no significant changes for samples stored at tested temperatures over 5 weeks storage. There were no significant differences in DHA composition within the weeks and temperatures used. For the GCHS analysed results, the increase in temperature to 40 ºC and storage time had a significant effect on the development of propanal for all samples (P≤0.05). Nanoemulsions prepared with lecithin alone had significantly higher development of propanal in week 1 at both 40 ºC and 20 ºC (P≤0.05). Lecithin (sole and combination with Tween 40) had more significant increases in oxidised volatiles at 40°C, which may be due to the instability of linoleic acid found in lecithin molecules which located in the outer layer of the oil droplets. There were no significant increase in oxidised compounds from the beginning to the end of storage for all tested samples stored at 4 °C. The sensory testing was also conducted on white sauce incorporated with omega-3 nanoemulsions with selected emulsifiers and bulk algal oil. The results show that the sensory attributes and overall acceptability of foods enriched with omega-3 nanoemulsion were statistically significantly lower than that of control sample (P≤ 0.05). Overall, the smallest droplet size of nanoemulsion was achieved with combination of lecithin and Tween 40 at a ratio of 50:50 by using ultrasonic processor. The stability and digestibility of nanoemulsion with the combination of lecithin and Tween 40 was improved in an In vitro digestion approach. A storage period of 5 weeks and temperature have no significant effect on the droplet size of tested nanoemulsion samples. However, there is a significant increase of the oxidised volatiles at 40 °C for all samples. Sensory testing show the white sauce with nanoemulsion has a stronger fishy taste and less overall liking than with bulk oil, indicating the smaller drop size is more ready to spread and reach the sensors of the mouth.
    • Education and welfare in professional football academies and centres of excellence: A sociological study

      Bloyce, Daniel; Lamb, Kevin L.; Platts, Chris (University of Chester, 2012-01)
      A career as a professional footballer has long been regarded as a highly sought after occupation for many young males within the UK and, against this backdrop, since the 1970s increasing attention has come to be placed on the way young players are identified and developed within professional clubs. Particular concern has been expressed over the number of players who, having been developed by professional clubs, fail to secure a professional contract, and the ways in which clubs should help young players safeguard their futures through alternative career training. There, have, however, been very few studies that have analyzed the education and welfare provisions that are offered within professional football Academies and Centres of Excellence, and fewer still that have done this from a sociological perspective. By drawing upon the figurational sociology of Norbert Elias, concepts derived from symbolic interactionism, and existing work in the sociology of youth, the objective of this study is to examine the realities of young players' day-to-day working-lives, the experiences they have of the educational programmes they follow, and the welfare-related matters that arise within present-day Academies and CoE. Using data generated by self-completion questionnaires and focus groups with 303 players in 21 Academies and CoE in England and Wales, the findings of the study suggest that players continue to be socialized into a largely anti-academic culture that has traditionally underpinned the world of professional football, and in which the demonstration of a 'good attitude' and commitment to the more central members of players' interdependencies (especially coaches and managers) dominated all other concerns. Indeed, it was also clear that the deep-seated values players held in relation to the professional game as part of their individual and group habituses were shaped by the figurations into which they were born and had been developed during the more impressionable phases of childhood and youth. Players' welfare needs were significantly compromised by the strong degree of suspicion and obvious degree of mistrust that characterized their relationship with club management, which emanated from players' fears that confidential matters would always 'get back' to others inside the club. This was exacerbated, in almost all cases, by players' observations that they were treated as if they were 'bottom of the club' and whose welfare needs were not generally well understood by those working within Academies and CoE.
    • The effect of dietary components on non-haem iron absorption in healthy and iron-deficient women

      Mushtaq, Sohail; Ahmad Fuzi, Salma F. (University of Chester, 2017-02)
      Two clinical trials investigating the effect of modulating two dietary components, tea containing polyphenols and vitamin D aimed at improving non-haem iron absorption and iron status recovery, were carried out in a cohort of healthy and iron deficient UK women, respectively. Tea has been shown to be a potent inhibitor of non-haem iron absorption but it remains unclear whether the timing of tea consumption relative to a meal influences iron bioavailability, with limited published evidence, especially in human trials. The aim of the first study was to investigate the effect of tea consumption on non-haem iron absorption and to assess the effect of time interval of tea consumption on non-haem iron absorption relative to an iron-containing meal, in a cohort of healthy female participants using a stable iron isotope (57Fe).
    • The effects of exercise-induced muscle damage on endurance performance

      Twist, Craig; Lamb, Kevin L.; Nicholas, Ceri; Burt, Dean G. (University of Chester, 2013)
      It is well documented that engaging in resistance exercise can lead to further improvements in endurance performance. Whilst, not fully understood, it is speculated that increased motor unit recruitment, improved muscle coordination and enhanced utilisation of stored elastic energy after resistance-based exercise improves exercise economy. Nevertheless, while prolonged exposure to resistance training improves endurance performance in the long-term, a consequence of such training when unaccustomed is the appearance of exercise-induced muscle damage (EIMD). Exercise-induced muscle damage is well known to affect athletic performance requiring muscular strength and power; however, its effects on markers of endurance exercise are unclear. Therefore, the aim of this thesis was to investigate the effects of EIMD on endurance performance, with an emphasis on the physiological (oxygen uptake; , minute ventilation; ), metabolic (blood lactate; [La]), perceptual (rating of perceived exertion; RPE) and kinematic (stride length; SL, stride frequency; SF) responses during sub-maximal endurance exercise.
    • The effects of targeted therapy on cell viability and apoptosis on CML and AML cell lines

      Williams, John; Ireland, Elyse; Marsico, Paolo (University of Chester, 2019-01-15)
      Tyrosine kinase inhibitors (TKIs) are currently the first therapy option for chronic myeloid leukaemia (CML) and acute myeloid leukaemia (AML) patients. However, many patients affected by CML and AML may develop resistance to TKIs or may not recover under this treatment regime. New potential and more effective treatments are recently emerging. Heat shock protein inhibitors (HSPIs) and the proteasome inhibitor Bortezomib are drugs which have been yet to be successfully tested on leukemic patients, despite being successful on other malignancies such as multiple myeloma (MM). The combination between HSPIs and Bortezomib could potentially be successful in killing leukemic cells, by enhancing their respective molecular mechanisms. Indeed, HSPIs would bind to HSP72 avoiding the protein to exert its ligase function to the proteasome, whilst Bortezomib could stop the ubiquitinated proteins to enter the proteasome and ultimately inducing apoptosis. To test the effects of such combination, cell viability was measured via MTS assay, apoptosis levels were tested through Annexin V\PI assays. Involvement of HSP72 and pro-survival protein Bcl-2 were measured via flow-cytometry. The cells were administered with HSPIs and Bortezomib first as single agents for 24 hours, to establish working minimal concentration. Also, the drugs were tested for a shorter time, to understand when the drugs start to be effective. It emerged that one hour is sufficient for the drugs to give an initial effect in terms of cell viability and apoptosis. Following, combination experiments of HSPIs and Bortezomib were performed; the first drug was administered for one hour, the second following one hour and the cells were incubated for 24 hours. This was repeated alternatively for both type of drugs on the different cell lines. MTS and Annexin V\PI showed that there is not a synergistic effect between drugs, but instead there is antagonism. No necrosis was found at any level of the study. The cells were then probed for HSP72 and Bcl-2, to investigate their involvement in apoptosis mechanisms. Following 6 hours of combined and single agent treatment, both type of drugs inhibit HSP72 but failed to reduce the expression of Bcl-2, particularly on AML cells. It is thus proposed that CML and AML cells may die by apoptosis following a short time of treatment with HSPIs and Bortezomib by an extrinsic pathway of apoptosis, independent from Bcl-2 involvement and from mitochondrial pathway of apoptosis. This study may be the first to indicate a potential use of HSPIs and Bortezomib on CML and AML patients for a short time of treatment, although not in combination. Future studies are needed to further investigate the mechanisms of action of these drugs, aiming to potentially give CML and AML patients another successful therapy option to overcome resistance to canonic chemotherapy.
    • Enhancing the formulation of Shared Mental Models in football players

      Robbins, Mandy; Newton, Joseph L. (University of ChesterWrexham Glyndwr University, 2020-06-24)
      A significant amount of research has examined the development of Decision-Making (DM) in sport. However, only a limited amount of research has explored decisions in the context of which they are made. Using the Naturalistic Decision-Making (NDM) paradigm this thesis employs Cognitive Task Analysis (CTA) approaches and Performance Analysis (PA) within a professional football environment, through the lens of a performance analyst. Applying the DM Framework, outlined by Richards, Collins and Mascarenhas (2016), this thesis applied a mixed method approach using three CTA approaches; Critical Decision Method (CDM), Thinking Aloud Problem Solving (TAPS) and Concept Mapping (CM) to examine the development of Shared Mental Models (SMMs). Additionally, PA data was collected to measure on-field application of SMMs in the format of match performance. Method: The development of DM ability was examined using professional footballers (n=16) and professional coaches (n=2), over an eight-week period. PA provided video footage of critical attacking play situations for use in team meetings. Meetings were designed to empower players in the DM process and involved the integration of CTA approaches in the form of a DM booklet. The booklet consisted of questions and diagrams relating to six clips identified by the coaches. Players and coaches would reflect on the clips individually and collectively as a team in an off-field setting. Each clip was split into three Phases, and six clips were shown to all team members in weekly meetings. To ascertain the retention of SMMs developed over the eight weeks, qualitative narratives recorded by the players (DM booklets) were analysed. No CTA processes were applied on week seven, as this was classified as a retention week. The CTA booklet recorded individual team members understanding of the situation and facilitated group discussions after clips. PA analysed data in the form of match statistics to assess transference of SMMs to the field of play. Results: CTA analysed data qualitatively indicated that individual Situational Awareness (SA) improved. Players identified more key themes in weeks six and eight compared to week one, indicating a development in SMMs and increased compatibility of SMM outlined by the two expert coach’s SA. Additionally, the complexity of the players SMMs and team SMMs developed. The PA data illustrated that the team generated more shots on target and more shots on target per Phase 3 entry in weeks six and eight than week zero (pre-investigation). The improved on-field performance of key performance indicators, combined with the increased identification of key themes and growing compatibility of players SMM in line with the expert coaches, demonstrate a more developed SMM which resulted in enhanced DM by the team. In summary, the application of PA and CTA methods within an off-field environment provides a mechanism to develop SMMs in a professional football team which transfer to enhancing on-field team DM in competitive play. However, this work utilising off-field learning environments to enhance DM, is still in its early stages and more research is needed.
    • Establishing the reach of Cheshire Children's Fund: April 2006 - March 2007

      Alford, Simon; Thurston, Miranda; University of Chester, Centre for Public Health Research (University of Chester, 2008-01)
      Monitoring and evaluation is a significant and obligatory element of Children’s Fund projects nationwide, with statutory returns made to the Department for Children, Schools and Families. The aim of the additional monitoring work commissioned by Cheshire Children’s Fund and carried out by the Centre for Public Health Research was to provide a more detailed picture of the children who had been referred to services, and for what reasons. This was made possible through the development of a system to track individuals and capture routine service data.
    • Evaluation of the Dads group at Blacon Children's Centre

      Alford, Simon; Perry, Catherine; Mann, Frances; University of Chester, Centre for Public Health Research (University of Chester, 2008-04-27)
      This study was designed to evaluate Blacon Children’s Centre Dads Group. A mixed method approach was used, incorporating both quantitative and qualitative methods. Through combining the findings from the various sources, some key issues were identified, as well as areas for development. Nearly all of the dads who were attending the Dads Group, along with all of the regular service providers, participated in this study, and thus the findings should accurately reflect perceptions of the service.
    • An evaluation of the delivery and outcomes of Halton Lodge Children's Centre's French language teaching service: La Petite Ecole

      Alford, Simon; Perry, Catherine; University of Chester, Centre for Public Health Research (University of Chester, 2008-07)
      This was an exploratory study designed to provide an overview of the processes and outcomes of the La Petite École service, to aid Halton Lodge Children's Centre staff in deciding future strategy with regard to language teaching activity. A combination of quantitative and qualitative methods were employed. The evaluation found evidence that the La Petite École service at Halton Lodge Children’s Centre was meeting its aims and objectives. The La Petite École service provides opportunities for enjoyable and shared experiences leading to the learning of basic French vocabulary for both children and adults.
    • Exploring hygiene compliance in the small independent restaurant sector in Abu Dhabi

      Fallows, Stephen; Bonwick, Graham A.; Idriss, Johaina (University of Chester, 2017-10)
      Introduction: Food safety is widely recognised as one of the problems in the fight for improving public health. Many governments are trying to improve public health through reducing foodborne illnesses and setting the climate for implementing HACCP-based food safety management systems (FSMS). Following the global trend, Abu Dhabi Food Control Authority (ADFCA) launched the HACCP for Catering Project (2010 – 2014), which aimed at helping foodservice businesses, licensed in the Emirate of Abu Dhabi, in implementing HACCP-based FSMS. Purpose: The project team recognised the limited resources and the diversity in education levels, ethnic backgrounds, and number of languages spoken among managers/supervisors and food handlers, as points of concern in the small independent restaurant (SIR) subsector. Thus, the Salamt Zadna (SZ) initiative, a simplified FSMS, was developed to train SIRs on implementing a set of safe operating procedures to improve compliance with food safety laws and regulations. Previous studies in the GCC region have mainly focused on governments’ attempts to enhance public health by developing laws, regulations, and policies, and recounting the barriers to implementing food safety controls. Methodology: This thesis took a different approach to food safety issues in the GCC region. It is comprised of two studies, which were conducted in two groups of SIRs – seven SZ participants and five non-participants – licensed in Al Ain, a major city in the Emirate of Abu Dhabi. The first explored awareness and understanding of food safety, related laws, regulations, and policies, and attitudes towards ADFCA services and inspectors, among managers/supervisors, by interviewing them. The second examined the efficacy of SZ in improving food handlers’ food-safety behaviours by observing their conduct, and comparing between the two SIR groups. Results: The study indicated low levels of awareness and understanding of food safety, related laws, regulations, and policies, in both groups of managers/supervisors; regardless of whether or not they were SZ Cparticipants. Both groups of interviewees expressed both negative and positive attitudes towards ADFCA’s services and inspectors; sometimes by the same interviewees, within the same, or between the two groups. However, SZ participating SIRs were slightly more positive than their counterparts. Key results highlighted the low impact of SZ on changing food handlers’ behaviours, except in two areas; namely, the food handlers working in SZ-participating SIRs scored higher than the other group in handwashing and changing gloves between handling raw meats and other foods. Implications: This research adds a new dimension to the food safety profile of the UAE, since it is the first of its kind in the UAE and the region as a whole. Its originality opens the door for other researchers to increase the volume of research in this field, which would help in understanding and tackling the barriers to improving the food safety status in the country, as well as the region.
    • Exploring the London 2012 Olympic legacy experiences of a non-host city: a policy based case study of those delivering sport in Birmingham before and after the Games

      Bloyce, Daniel; Lovett, Emily L. (University of Chester, 2016-11)
      In bidding to host the 2012 Olympic and Paralympic Games, the London bid committee promised a range of ambitious legacies. Planning for legacy pre-Games was a relatively new aspect of event planning (Leopkey & Parent, 2009). For the London Organising Committee of the Olympic Games and Paralympic Games (LOCOG) and the Department of Culture Media and Sport (DCMS), the sporting legacy from London 2012 was intended to be experienced across Britain. As such, a significant impact was expected on the sporting lives of people in non-host areas. To this extent it seems entirely appropriate, therefore, to examine the attempts to establish a ‘legacy’ in a city outside of London. Birmingham, one of the most populated cities in the UK, is therefore the focus of this study. The aim of this project was to investigate the legacy experiences of those delivering sport in Birmingham prior to, and soon after, the Games. This research was conducted from a figurational approach. A case study design was used to provide a detailed insight into a complex network of people and their perceptions that influence sport policy and development. The methods employed within this case study include documentary analysis of national policy documents and semi-structured interviews with key personnel in Birmingham. Interviews were conducted in the months prior to the Games and follow-up telephone interviews several months after the Games.
    • Factors affecting the quality of Acacia senegal gums

      Al-Assaf, Saphwan; Hamouda, Yasir (University of Chester, 2017-04)
      Gum arabic is a natural gummy exudate from acacia trees and exhibits natural built-in variations commonly associated with hydrocolloids. This study is concerned with the determination of factors which could influence its properties and functionality. These factors include origin (location, soil type, rainfall), different collections, age of the trees and storage condition. Previous studies acknowledged the influence of some of these factors but somehow lack providing definitive answers to questions being asked by the end user and required for the development of Gum arabic industry in Sudan. Local knowledge as well as the various stages of gum collection and processing were reviewed in order to provide a clear background and the justification for the experimental design. In this study samples were collected from six plantations located in the west and east regions in Sudan. Samples were collected from trees of different age (5, 10, 15 and 20 years old) and also from different picking interval (1-4). Each sample was divided into three portions (UK, Khartoum and Port Sudan) and stored for 5 years in order to determine the effect of the respective location. Various analytical parameters (% loss on drying, Optical rotation, % protein, intrinsic viscosity, molecular weight and molecular weight distribution) were measured to fully characterise the gum samples and to determine their functionality (emulsification). The results obtained for all samples were consistent with those previously reported in the literature (see Chapter 4). The only exception, identified in a number of samples from the western region, is the high proportion (~30%) of high molecular weight fraction termed arabinogalactan-protein complex (AGP). The results clearly demonstrated significant variations between plantations located in western region compared with the eastern region. However, the variations between the plantations within the same region are statistically not significant. High values of % protein, viscosity, Mw and % AGP were obtained from the 1st pick, from both regions, and then significantly decreased thereafter to the fourth pick. Samples from west region in Sudan, from 1st and 2nd pick and from tree age (15) years gave the highest viscosity, molecular weight, % AGP and superior emulsification performance compared to other samples from different tree ages. The regression statistical analysis for the physiochemical properties correlation with emulsification performance demonstrated the role of % AGP to be the most influential factor followed by viscosity. The major finding of this study is the effect of storage condition on the properties and functionality of Acacia senegal. An increase in the molecular weight for all stored samples (for 5 years) irrespective of region was evident and statically significant. However, this increase was more prominent for samples from the western region compared to the eastern region. The AGP fraction was increased by the storage treatment up to 40% in Port-Sudan, 20% in Khartoum-Sudan and 15% in UK. The result clearly demonstrated that the temperature and humidity are the crucial factors to induce the natural maturation process in acacia gums. Statistical analysis (linear regression) suggested statistically significant models and equations to predict and explain the variations in the physiochemical and functional properties based on the environmental factors, picking set and age of the tree.
    • The Functionality of “Ogi” – a fermented cereal gruel made in Nigeria, in the Management of Gastrointestinal Disease

      Pickles, Neil; Weili, Li; Olayanju, Adetokunbo T (University of ChesterUniversity of Chester, 2019-04)
      Fermentation is an ancient food processing technique which has over the years had significant impact on food availability, production, economy and health. Fermented corn, ‘ogi’, is a popular meal in South and West African countries and is also traditionally administered to people, especially children, during the incidence of diarrhoea as it is believed to enhance gut health. Various authors have supported the advantageous health functions of fermented corn but have focussed on the possible health benefits that may be derived from the action of the fermentation organisms by investigating their probiotic potentials. Furthermore, in vivo studies have investigated effective functionality of fermented foods and where studies have suggested positive effect of the fermented food intervention, the component of the complex food matrix that may be responsible is often unknown. Though hypothesised, there has been little information on the possible effects of the end products of the fermentation on gut health. Therefore, this thesis aimed to explore the functionality potentials for ‘ogi’, to enhance gut health by investigating the mechanisms through which it may be able to confer the health benefits when consumed. An independent meta-analysis was undertaken to explore and review the analysis of the effectiveness of fermented foods to significantly reduce the duration of diarrhoea. The first experimental study was a comparison between spontaneously fermented vs controlled method of ‘ogi’ production with the aim to explore the possibility of achieving similar end products. The probiotic potential of fermentation organisms and antimicrobial effect of fermentation organisms against E. coli were also investigated. Colonic short chain fatty acids (SCFAs) are known to enhance immune function in the gut. The second experimental study explored the production of SCFAs in fermented corn with the theory that fermented corn may be a dietary source of SCFA and may produce a comparable effect in the gut as the colonic SCFA. It is established that one of the functions of endogenously synthesised nitric oxide (NO) in the body is to enhance immune functions. Therefore, the potential for ‘ogi’ to enhance immune response in the gut by being a dietary source of Nitric Oxide (NO) was explored in the third experimental study. The outcomes of this thesis suggest that it may not be possible to mimic the exact spontaneous fermentation process in a controlled setting. Weissella confuse, Pediococcus pentosaceus and Saccharomyces cerevisiae were the lactic acid bacteria (LAB) and yeast isolated from spontaneously fermented corn using 16S rRNA sequencing. The isolated organisms along with Lactobacillus plantarum were used as starter culture for controlled fermentation. There was a significant difference between the end products of both fermentations. All organisms except W. confuse showed probiotic potential. Acetate was produced during both fermentations but butyrate was produced during spontaneous fermentation only. There was however higher concentration of NO in controlled fermented corn than spontaneous fermentation with nitrate values of 30.54 µM and 23.21 µM and nitrite values of 17.50 µM and 10.11 µM respectively. These suggest that fermented corn may have probiotic potential and may be able to further enhance immune health in the gut by being a dietary source of SCFAs and NO.
    • Genetic analysis of the critically endangered Trinidad Piping guan (Pipile pipile): Implications for phylogenetic placement and conservation strategies

      McDowall, Ian; Hosie, Charlotte A.; Robinson, Louise A. (University of Chester, 2011-11)
      Classified as critically endangered since 1994, the Trinidad Piping guan (Pipile pipile) is an endemic species estimated to number less than 200 individuals. Known to locals of Trinidad as the ‘Pawi’ this bird has been the subject of substantial hunting pressures and much of the species habitat has been destroyed through deforestation. Although officially protected since 1958, occasional recreational hunting of this elusive species still occurs. Due to difficulties locating and capturing the species, no genetic research has previously been performed using samples obtained from Trinidad. All previous research studies have been conducted using biological materials obtained from captive birds outside Trinidad and island data has never been obtained or compared. The genetic diversity of the remaining population was therefore examined through the investigation of mitochondrial haplotypes, pairwise comparison and SNP analysis. With the intention of assisting the protection of this endangered species by the location of remaining areas of habitation, methods of genetic identification were established for the Trinidad Piping guan utilising non-invasive feather samples. Species specific primers were created in the regions of the ND2 and cyt b genes of the mitochondrial genome to identify Pipile pipile. Species detection was further verified with the use of PCR-RFLP of the same gene regions digested with BsaXI, EcoRV and BsrDI. This combined approach allowed the separation of closely related taxa based on single inter-species SNPs. Confirmation of species identification was subsequently performed through the use of forensically informative nucleotide sequencing. The established methodologies were used in the current study to correct the classification of a UK breeding population of Piping guans thought to be Pipile pipile and to identify Trinidad field samples. These detection methods have implications for ecological studies through the location of populations from trace evidence collected in the field. In addition this method could be used to assist Trinidadian police forces in the identification of bushmeats or simply act as a deterrent to hunters. The sequence data obtained in the present study were also used to re-assess the phylogeny of Piping guans. As genetic sequence from a true island bird was previously unstudied, differences between phylogenies created using non-island and island bird data sets were examined. Combined analysis was performed on 1884bp of the ND2 and cyt b genes and placement of Trinidad Piping guan was found to differ from that which has been previously published.