• Obesity and health: Understanding the issues in Pakistani women living in the UK

      Ludwig, Alison F.; Ellahi, Basma; Cox, Peter; University of Chester (British Sociological Association, 2008)
    • The observational analysis of elite coaches within youth soccer: The importance of performance analysis

      Nicolls, Scott B.; Worsfold, Paul R.; University of Chester; Middlesex University; Manchester Institute of Health and Performance (SAGE, 15/11/2016)
      The study investigated the observational capabilities of experienced elite coaches whilst focusing upon soccer specific actions and playing positions within elite youth soccer. Six soccer coaches assessed the performances of 10 youth soccer players (across 8 matches) on their short/long passing, tackling, shooting, heading and dribbling. Analysis was undertaken on an overall, quality and positional grouping basis. Mean observational accuracy was 38.8%, with successful shooting (78.6%) and passing (29.9%) illustrating the range. The limited effective observation of dribbling (37.2%), often considered a separating factor within talent identification, highlights the need for objective measures to aid such processes. Positional grouping analysis elicited 20% more effective observation for unsuccessful compared with successful actions. The poor level of observational accuracy identified herein has significant implications on talent identification assessments devoid of post-performance analyses. The findings reinforce the importance of performance analysis in the provision of highly accurate and comprehensive augmented feedback within the coaching process.
    • Oesophageal stenting: Status quo and future challenges.

      Kaltsidis, Harry; Mansoor, Wasat; Park, Jung-Hoon; Song, Ho-Young; Edwards, Derek William; Laasch, Hans-Ulrich; orcid: 0000-0003-3109-6933 (11/06/2018)
      Oesophageal stents are widely used for palliating dysphagia from malignant obstruction. They are also used with increasing frequency in the treatment of oesophageal perforation, as well as benign strictures from a variety of causes. Improved oncological treatments have led to prolonged survival of patients treated with palliative intent; as a consequence, stents need to function and last longer in order to avoid repeat procedures. There is also increasing need for meticulous procedure planning, careful selection of the device most appropriate for the individual patient and planned follow-up. Furthermore, as more patients are cured, there will be more issues with resultant long-term side-effects, such as recalcitrant strictures due to radiotherapy or anastomotic scarring, which will have to be addressed. Stent design needs to keep up with the progress of cancer treatment, in order to offer patients the best possible long-term result. This review article attempts to illustrate the changing realities in oesophageal stenting, differences in current stent designs and behaviour, as well as the pressing need to refine and modify devices in order to meet the new challenges.
    • Office workers’ experiences of attempts to reduce sitting-time: An exploratory, mixed- methods uncontrolled intervention pilot study

      Dewitt, Stephen; Hall, Jennifer; Smith, Lee; Buckley, John P; Biddle, Stuart J.H.; Mansfield, Louise; Gardner, Benjamin; University of Chester (BMC Springer Nature, 2019-06-25)
      Background: Office workers typically sit for most of the workday, which has been linked to physical and mental ill- health and premature death. This mixed-methods study sought to identify barriers and facilitators to reducing sitting and increasing standing among office workers who received an intervention prototype (the ‘ReSiT [Reducing Sitting Time] Study’). The intervention comprised a sit-stand workstation and tailored advice to enhance motivation, capability and opportunity to displace sitting with standing. Methods: Twenty-nine UK university office workers (aged ≥18y, working ≥3 days per week, most time spent at a seated desk) participated in a 13-week uncontrolled study. They were initially monitored for one-week. In a subsequent face-to-face consultation, participants received sitting time feedback from a prior one-week monitoring period, and selected from a set of tailored sitting-reduction techniques. Quantitative data comprising sitting, standing and stepping time, which were objectively monitored for 7 consecutive days across three post- intervention timepoints, were descriptively analysed. Qualitative data, from semi-structured interviews conducted at 1, 6 and 12-weeks post-intervention, were thematically analysed. Results: Compared to baseline, mean sitting time decreased at weeks 1, 6 and 12 by 49.7mins, 118.2mins, and 109.7mins respectively. Despite prior concerns about colleagues’ reactions to standing, many reported encouragement from others, and standing could be equally conducive to social interaction or creating private, personal space. Some perceived less cognitively-demanding tasks to be more conducive to standing, though some found standing offered a valued break from challenging tasks. Participants prioritised workload over sitting reduction and were more likely to stand after rather than during work task completion. Temporary context changes, such as holidays, threatened to derail newfound routines. Conclusions: Our findings emphasise the importance of understanding workers’ mental representations of their work, and the social functions of sitting and standing in the workplace. Workplace intervention developers should incorporate a pre-intervention sitting time monitoring period, encourage workers to identify personally meaningful tasks and cues for standing, and build organisational support for sitting-reduction. We will use these insights to refine our intervention for self-administered delivery. Trial registration: ISRCTN29395780 (registered 21 November 2016). Keywords: Sedentary behaviour, Workplace, Qualitative, Occupational health
    • On 'Kantian Experimentation' in the health sciences

      Lewis, Stephen J. (2002-05)
      This presentation dicusses various approaches to the definition of health and disease.
    • On the question of questions

      Lewis, Stephen J.; University College Chester (Philo Sophos.com, 2004)
      This article discusses Russell's dictum that "in philosophy, what is important is not so much the answers that are given, but rather the questions that are asked" - posing questions and posing them properly.
    • On the Role of Lyrics in the Music-Exercise Performance Relationship

      Sanchez, Xavier; Moss, Samantha L.; Twist, Craig; Karageorghis, Costas I.; University of Groningen; University of Chester; Brunel University (Elsevier, 27/10/2013)
      Objectives. To examine the role of the musical constituent of lyrics with reference to a range of psychological, psychophysical, and physiological variables during submaximal cycling ergometry. Design. Two-factor (Condition x Time) within-subject counterbalanced design. Method. Twenty five participants performed three 6-min cycling trials at a power output corresponding to 75% of their maximum heart rate under conditions of music with lyrics, same music without lyrics, and a no-music control. Cycling cadence, heart rate, and perceived exertion were recorded at 2-min intervals during each trial. Positive and negative affect was assessed before and after each trial. Results. A significant (p = .006) Condition x Time interaction emerged for cadence wherein participants cycled at a higher rate at the end of the task under music with lyrics. Main effects were found for perceived exertion and heart rate, both of which increased from min 2 through to min 6, and for affect: positive affect increased and negative affect decreased from pre- to post-trials. Conclusions. Participants pedalled faster in both music conditions while perceived exertion and heart rate did not differ across conditions. The inclusion of lyrics influenced cycling performance only at min 6 and had no bearing on the remaining dependent variables throughout the duration of the task. The impact of lyrical content in the music-exercise performance relationship warrants further attention in order that we might better understand its role.
    • One strategy doesn’t fit all: determinants of urban adaptation in mammals

      Santini, Luca; González‐Suárez, Manuela; Russo, Danilo; Gonzalez‐Voyer, Alejandro; von Hardenberg, Achaz; Ancillotto, Leonardo; Radboud University; University of Reading; University of Napoli; Universidad Nacional Autónoma de México; University of Chester (Wiley, 20/12/2018)
      Urbanisation exposes wildlife to new challenging conditions and environmental pressures. Somemammalian species have adapted to these novel environments, but it remains unclear which char-acteristics allow them to persist. To address this question, we identified 190 mammals regularlyrecorded in urban settlements worldwide, and used phylogenetic path analysis to test hypothesesregarding which behavioural, ecological and life history traits favour adaptation to urban environ-ments for different mammalian groups. Our results show that all urban mammals produce largerlitters; whereas other traits such as body size, behavioural plasticity and diet diversity were impor-tant for some but not all taxonomic groups. This variation highlights the idiosyncrasies of theurban adaptation process and likely reflects the diversity of ecological niches and roles mammalscan play. Our study contributes towards a better understanding of mammal association tohumans, which will ultimately allow the design of wildlife-friendly urban environments and con-tribute to mitigate human-wildlife conflicts.
    • Optimising the management of bone disease for coeliac patients in a dietetic-led clinic

      Martin, Kirsty J.; Woodall, Alison; University Hospital Aintree and The Walton Centre NHS Foundation Trust; University of Chester (Science and Education Publishing Co., 2016-06)
      Coeliac disease (CD) is a chronic autoimmune inflammatory condition of the small bowel; the only treatment is lifelong adherence to a gluten free diet (GFD). Adherence to a GFD also minimises the risk of associated conditions such as osteoporosis in CD patients. The present study aimed to evaluate and optimise management of bone disease in CD patients in a dietetic-led clinic. This study was conducted in two parts: study 1 utilised retrospective data to evaluate management of bone disease with reference to British Society of Gastroenterology (BSG) guidelines in 229 CD patients. Based on the results from study 1, study 2 developed a tool to estimate dietary calcium intake in CD patients, which was then trialled on 50 patients. There were no significant differences between the population demographics for study 1 and study 2. 65% of patients had a diagnosis of osteopenia or osteoporosis, in a female predominant population (74.6%). Reported mean dietary calcium intake was over estimated at 1239.6mg/day (SD ± 377.1mg) in study 1 and corrected to 852mg/day (SD ± 264.57mg) using improved methodology (study 2) (p≤0.05). Understanding and compliance with dietary advice correlated positively with GFD (p≤0.001) but not osteoporosis or fracture risk. Overall patients attending the clinic did not meet the BSG recommended calcium intake. However, 30% of patients could meet the 2014 BSG target from oral diet alone. Utilising individual dietary prescriptions and targeted use of calcium supplementation maximised the opportunity to reduce risk of bone disease and improved compliance with BSG recommendations.
    • Orally administered beta-glucan attenuates the Th2 response in a model of airway hypersensitivity

      Burg, Ashley R.; Quigley, Laura; Jones, Adam V.; O'Connor, Geraldine M.; Boelte, Kimberly; McVicar, Daniel W.; Orr, Selinda J.; National Cancer Institute-Frederick; University of Alabama at Birmingham; University Dental Hospital, Cardiff and Vale University Health Board; University of Chester; Cardiff University School of Medicine (SpringerOpen, 21/06/2016)
      beta-Glucan is a polysaccharide that can be extracted from fungal cell walls. Wellmune WGP((R)), a preparation of beta-1,3/1,6-glucans, is a dietary supplement that has immunomodulating properties. Here we investigated the effect WGP had on a mouse model of asthma. OVA-induced asthma in mice is characterized by infiltration of eosinophils into the lung, production of Th2 cytokines and IgE. Daily oral administration of WGP (400 microg) significantly reduced the influx of eosinophils into the lungs of OVA-challenged mice compared to control mice. In addition, WGP inhibited pulmonary production of Th2 cytokines (IL-4, IL-5, IL-13), however serum IgE levels were unaffected by WGP treatment. These data indicate that WGP could potentially be useful as an oral supplement for some asthma patients, however, it would need to be combined with therapies that target other aspects of the disease such as IgE levels. As such, further studies that examine the potential of WGP in combination with other therapies should be explored.
    • The osteological use of diagnostic radiographs: Further material for osteoarchaeologists

      Lewis, Stephen J.; Chester College of Higher Education (1996)
      This article discusses the use of radiography in osteoarchaeology.
    • Osteoprotegerin is produced when prostaglandin synthesis is inhibited causing osteoclasts to detach from the surface of mouse parietal bone and attach to the endocranial membrane

      O’Brien, E. A.; Williams, John H. H.; Marshall, Michael J.; Charles Salt Centre, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry ; Chester College ; Charles Salt Centre, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry (Elsevier, 2001-02)
      This article tests the hypothesis that osteoprotegerin (OPG) mediates the inhibition of osteoclast activity that occurs with indomethacin in the mouse calvaria.
    • An overview of extra-curricular education for sustainable development (ESD) interventions in UK universities

      Lipscombe, Bryan P.; Burek, Cynthia V.; Potter, Jacqueline; Ribchester, Chris; Degg, Martin; University of Chester (Emerald, 2008)
      This article explores the extent and type of extra-curricular education for sustainable development-related practice in UK universities and to record opinions about the utility of such work, through a postal questionnaire survey of all UK universities was undertaken in 2006.
    • Oxygen Costs of the Incremental Shuttle Walk Test in Cardiac Rehabilitation Participants: An Historical and Contemporary Analysis

      Buckley, John P.; Cardoso, Fernando, M. F.; Birkett, Stefan T.; Sandercock, Gavin R. H.; University Centre Shrewsbury (Springer, 07/04/2016)
      Background The incremental shuttle walk test (ISWT) is a standardised assessment for cardiac rehabilitation. Three studies have reported oxygen costs (VO2)/metabolic equivalents (METs) of the ISWT. In spite of classic rep- resentations from these studies graphically showing curvilinear VO2 responses to incremented walking speeds, linear regression techniques (also used by the American College of Sports Medicine [ACSM]) have been used to estimate VO2. Purpose The two main aims of this study were to (i) re- solve currently reported discrepancies in the ISWT VO2- walking speed relationship, and (ii) derive an appropriate VO2 versus walking speed regression equation. Methods VO2 was measured continuously during an ISWT in 32 coronary heart disease [cardiac] rehabilitation (CHD-CR) participants and 30 age-matched controls. Results Both CHD-CR and control group VO2 responses were curvilinear in nature. For CHD-CR VO2 = 4.4- e0.23 9 walkingspeed (km/h). The integrated area under the curve (iAUC) VO2 across nine ISWT stages was greater in the CHD-CR group versus the control group (p \ 0.001): & John P. Buckley j.buckley@chester.ac.uk 1 (±86) ml􏰀kg-1􏰀min-1􏰀km􏰀h-1; con- trol = 316 (±52) ml􏰀kg-1􏰀min-1􏰀km􏰀h-1. Conclusions CHD-CR group vs. control VO2 was up to 30 % greater at higher ISWT stages. The curvilinear nature of VO2 responses during the ISWT concur with classic studies reported over 100 years. VO2 estimates for walking using linear regression models (including the ACSM) clearly underestimate values in healthy and CHD-CR par- ticipants, and this study provides a resolution to this when the ISWT is used for CHD-CR populations.
    • Pacing during a cross-country mountain bike mass-participation event according to race performance, experience, age and sex.

      Moss, Samantha L.; Francis, Ben; Calogiuri, Giovanna; Highton, Jamie (15/12/2018)
      This study describes pacing strategies adopted in an 86-km mass-participation cross-country marathon mountain bike race (the 'Birkebeinerrittet'). Absolute (km·h ) and relative speed (% average race speed) and speed coefficient of variation (%CV) in five race sections (15.1, 31.4, 52.3, 74.4 and 100% of total distance) were calculated for 8182 participants. Data were grouped and analysed according to race performance, age, sex and race experience. The highest average speed was observed in males (21.8 ± 3.7 km/h), 16-24 yr olds (23.0 ± 4.8 km/h) and those that had previously completed >4 Birkebeinerrittet races (22.5 ± 3.4 km/h). Independent of these factors, the fastest performers exhibited faster speeds across all race sections, whilst their relative speed was higher in early and late climbing sections (Cohen's d = 0.45-1.15) and slower in the final descending race section (d = 0.64-0.98). Similar trends were observed in the quicker age, sex and race experience groups, who tended to have a higher average speed in earlier race sections and a lower average speed during the final race section compared to slower groups. In all comparisons, faster groups also had a lower %CV for speed than slower groups (fastest %CV = 24.02%, slowest %CV = 32.03%), indicating a lower variation in speed across the race. Pacing in a cross-country mountain bike marathon is related to performance, age, sex and race experience. Better performance appears to be associated with higher relative speed during climbing sections, resulting in a more consistent overall race speed.
    • Palliative opioid use, palliative sedation and euthanasia: reaffirming the distinction.

      Schofield, Guy; Baker, Idris; Bullock, Rachel; Clare, Hannah; Clark, Paul; Willis, Derek; Gannon, Craig; George, Rob (2019-06-20)
      We read with interest the extended essay published from Riisfeldt and are encouraged by an empirical ethics article which attempts to ground theory and its claims in the real world. However, such attempts also have real-world consequences. We are concerned to read the paper's conclusion that clinical evidence weakens the distinction between euthanasia and normal palliative care prescribing. This is important. Globally, the most significant barrier to adequate symptom control in people with life-limiting illness is poor access to opioid analgesia. Opiophobia makes clinicians reluctant to prescribe and their patients reluctant to take opioids that might provide significant improvements in quality of life. We argue that the evidence base for the safety of opioid prescribing is broader than that presented, restricting the search to palliative care literature produces significant bias as safety experience and literature for opioids and sedatives exists in many fields. This is not acknowledged in the synthesis presented. By considering additional evidence, we reject the need for agnosticism and reaffirm that palliative opioid prescribing is safe. Second, palliative sedation in a clinical context is a poorly defined concept covering multiple interventions and treatment intentions. We detail these and show that continuous deep palliative sedation (CDPS) is a specific practice that remains controversial globally and is not considered routine practice. Rejecting agnosticism towards opioids and excluding CDPS from the definition of routine care allows the rejection of Riisfeldt's headline conclusion. On these grounds, we reaffirm the important distinction between palliative care prescribing and euthanasia in practice. [Abstract copyright: © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.]
    • Parents as sex and relationship educators: A local evaluation of Speakeasy 4 Parents

      Perry, Catherine; Ward, Fiona; Thurston, Miranda; University of Chester, Centre for Public Health Research (University of Chester, 2008-06)
      This was a small scale-study designed to evaluate the effectiveness of the Speakeasy 4 Parents course in improving participants’ knowledge, skills and confidence to communicate and discuss sex and relationship issues with their children. A predominantly qualitative approach was adopted. There is evidence in this study that the Speakeasy 4 Parents courses run at Children’s Centres in Cheshire have been effective, from the perspectives of parents attending the courses and professionals facilitating them.
    • Passive heat maintenance after an initial warm-up improves high intensity activity during an interchange rugby league match simulation protocol.

      Fairbank, Matthew; Highton, Jamie; Twist, Craig; University of Chester (Lippincott, Williams & Wilkins, 01/01/2019)
      This study examined using passive heat maintenance to maintain core temperature after a warm-up and its effect on first half running performance in rugby players. Thirteen male rugby players completed this randomized crossover study. Tympanic temperature was taken before a warm-up and then after a further 15 minutes passive recovery either with (PHM) or without (CON) a passive heat maintenance garment. Participants then completed 23 min of the rugby league match simulation protocol (RLMSP-i). Differences in tympanic temperature were unclear between CON and PHM before (35.7 ± 1.3 cf. 36.0 ± 1.1oC; ES = 0.20) and during exercise (34.5 ± 0.1 cf. 35.2 ± 0.1oC; ES = 0.26-0.35). High-intensity running (ES = 0.27) and peak sprint speed were higher (ES = 0.46-0.56) during the PHM compared to the CON trial. Time spent above 20 W.kg-1 also increased in the first quartile of PHM compared to CON trial (ES = 0.18). All other between trial comparisons of performance were unclear. HRmean (ES = 0.38) was higher in PHM compared to CON, while differences in RPEmean (ES = -0.19) were unclear. There are small to large increases in high intensity work performed during a playing bout when rugby players wear a PHM garment after a warm-up. Rugby players should consider PHM during extended periods of time between a warm-up and starting a match.
    • Patients’ Perspectives of Oral and Injectable Type 2 Diabetes Medicines, Their Body Weight and Medicine-Taking Behavior in the UK: A Systematic Review and Meta-Ethnography

      Psarou, Aikaterini; orcid: 0000-0002-0447-4452; email: kpsarou@yahoo.co.uk; Cooper, Helen; Wilding, John P. H. (Springer Healthcare, 17/08/2018)
      AbstractThe aim of this review is to identify peoples’ perspectives of their glucose-lowering and anti-obesity drugs in relation to diabetes and weight control and to explore how these views affect medication adherence. Theoretical perspectives associated with medicine-taking behavior are also explored. The systematic review was based on a meta-ethnography of qualitative studies identified through a search of 12 medical and social science databases and subsequent citation searches. The quality of all studies was assessed. Sixteen studies were included with data from 360 UK individuals. No relevant studies were identified which focused on anti-obesity and non-insulin injectable drugs. The review revealed that the patients’ perspectives and emotional state were influenced by starting and/or changing to a new glucose-lowering medicine. These were also influenced by prior medication experience, disease perceptions and interactions with clinicians. Despite reports of positive experiences with and positive perceptions of medicines, and of participation in strategies to regain life control, medication non-adherence was common. Accepting glucose-lowering medicines impacted on the individual’s perception of lifestyle changes, and it was notable that weight loss was not perceived as a strategy to support diabetes management. Synthesis revealed that more than one theory is required to explain medicine-taking behavior. New insights into the underlying factors of poor adherence and the specific practical issues identified in this review can help in the development of patient-centered interventions.Funding: Diabetes UK.
    • Patterns of behaviour, group structure and reproductive status predict levels of glucocorticoid metabolites in zoo-housed ring-tailed lemurs, Lemur catta.

      Smith, Tessa E.; McCusker, Cara; Stevens, Jeroen M. G.; Elwood, Robert W.; University of Chester; Queens University of Belfast; Centre for Research and Conservation, Royal Zoological Society of Antwerp, Belguim (Karger Publishing, 30/01/2016)
      In ring-tailed lemurs, Lemur catta, the factors modulating hypothalamic-pituitary-adrenal (HPA) activity differ between wild and semi-free-ranging populations. Here we assess factors modulating HPA activity in ring-tailed lemurs housed in a third environment: the zoo. First we validate an enzyme immunoassay to quantify levels of glucocorticoid (GC) metabolites in the faeces of L. catta. We determine the nature of the female-female dominance hierarchies within each group by computing David’s scores and examining these in relation to faecal GC (fGC). Relationships between female age and fGC are assessed to evaluate potential age-related confounds. The associations between fGC, numbers of males in a group and reproductive status are explored. Finally, we investigate the value of 7 behaviours in predicting levels of fGC. The study revealed stable linear dominance hierarchies in females within each group. The number of males in a social group together with reproductive status, but not age, influenced fGC. The 7 behavioural variables accounted for 68% of the variance in fGC. The amounts of time an animal spent locomoting and in the inside enclosure were both negative predictors of fGC. The study highlights the flexibility and adaptability of the HPA system in ring-tailed lemurs.