• Muscling in on mitochondrial sexual dimorphism; role of mitochondrial dimorphism in skeletal muscle health and disease

      Nye, Gareth; Lightfoot, Adam; Sakellariou, Giorgos; Degans, Hans; University of Manchester, Manchester Metropolitan University (Portland Press, 2017-07-07)
      Mitochondria are no longer solely regarded as the cellular powerhouse; instead, they are now implicated in mediating a wide-range of cellular processes, in the context of health and disease. A recent article in Clinical Science, Ventura-Clapier et al. highlights the role of sexual dimorphism in mitochondrial function in health and disease. However, we feel the authors have overlooked arguably one of the most mitochondria-rich organs in skeletal muscle. Many studies have demonstrated that mitochondria have a central role in mediating the pathogenesis of myopathologies. However, the impact of sexual dimorphism in this context is less clear, with several studies reporting conflicting observations. For instance in ageing studies, a rodent model reported female muscles have higher antioxidant capacity compared with males; in contrast, human studies demonstrate no sex difference in mitochondrial bioenergetics and oxidative damage. These divergent observations highlight the importance of considering models and methods used to examine mitochondrial function, when interpreting these data. The use of either isolated or intact mitochondrial preparations in many studies appears likely to be a source of discord, when comparing many studies. Overall, it is now clear that more research is needed to determine if sexual dimorphism is a contributing factor in the development of myopathologies.
    • Musculoskeletal Disorders in the Workplace: An examination of the underlying causes and contributory risk factors

      Fallows, Stephen; Gellatly, Pamela (University of Chester, 16/05/2018)
      Introduction The incidence of musculoskeletal disorders remain the most common single condition, by incidence, affecting the working population. This remains true even though the apparent historic causation of manual handling, has reduced significantly. Back pain alone has been termed a 20thcentury medical disaster, which has reverberated into the 21stcentury, with 85% of low back pain having no clear clinical diagnosis yet individuals continue to seek a clinical solution. Understanding pain remains as complex as ever with very little evidence to suggest progress. The overall scale and cost of MSDs in the workplace are not easily identifiable as objective and accurate data are rare. Other workplace incidence and costs are either, not recorded or not published, in documents or grey literature, that are generally only accessible to individual organisations on a regular basis. Objectives The epistemology of this thesis is complexity and the extent to which this influences outcomes. The trilogy of complexity considered includes: 1. The issues facing organisations in how they prevent and manage MSDs; 2. The individual’s perspective and what they understand about possible causation, their beliefs, fears and expectations; 3. The interface with clinical and non-clinical practitioners, and whether interventions provided, are beneficial to the individual. Consideration of the multiple perspectives that arise from the various influences affecting the organisation, the employees within that organisation and the practitioners, has been possible by the metaphoric use of a “bricolage” methodology, and suggests that the current medical model is no longer appropriate. Methods A mixed method research design comprising four studies was undertaken. Firstly, a retrospective quantitative study of data (n = 21,092) from benefits provided by four organisations followed by a qualitative case example study (n = 21) of supporting documents and clinical information. These studies then informed the need for a qualitative study (n= 9) symptomatic individuals who participated in a focus group and (n= 6) face-to-face interviews and finally a qualitative study of practitioners involved in the provision of treatment services to the participating organisations. The data from each study informed the others and the data merged with the findings from the literature review and common interventions. Conclusions A disparity was found between what has been identified in literature and what actually is considered in clinical practice. The healthcare industry operates in “silos” and this separation of disciplines is reflected in organisational management. The range of underlying risk factors, evident in modern society, which are affecting or may affect an individual’s future musculoskeletal health are not being addressed by the medical model, and practitioners require training, or need to work in a multidisciplinary team, if they are to improve long-term outcomes. This thesis discusses the complexity of the multifactorial nature of musculoskeletal health, and provides a framework to challenge current practice and promote a fundamental change in the way in we assess, and treat the range of MSDs including a move towards educating individuals to take personal responsibility.
    • Mutational and Structural Analysis of KIR3DL1 Reveals a Lineage-Defining Allotypic Dimorphism That Impacts Both HLA and Peptide Sensitivity

      O'Connor, Geraldine M.; Vivian, Julian P.; Widjaja, Jacqueline M.; Bridgeman, John S.; Gostick, Emma; Lafont, Bernard A.; Anderson, Stephen K.; Price, David A.; Brooks, Andrew G.; Rossjohn, Jamie; et al. (American Association of Immunologists, 2014-03)
      Killer Ig-like receptors (KIRs) control the activation of human NK cells via interactions with peptide-laden HLAs. KIR3DL1 is a highly polymorphic inhibitory receptor that recognizes a diverse array of HLA molecules expressing the Bw4 epitope, a group with multiple polymorphisms incorporating variants within the Bw4 motif. Genetic studies suggest that KIR3DL1 variation has functional significance in several disease states, including HIV infection. However, owing to differences across KIR3DL1 allotypes, HLA-Bw4, and associated peptides, the mechanistic link with biological outcome remains unclear. In this study, we elucidated the impact of KIR3DL1 polymorphism on peptide-laden HLA recognition. Mutational analysis revealed that KIR residues involved in water-mediated contacts with the HLA-presented peptide influence peptide binding specificity. In particular, residue 282 (glutamate) in the D2 domain underpins the lack of tolerance of negatively charged C-terminal peptide residues. Allotypic KIR3DL1 variants, defined by neighboring residue 283, displayed differential sensitivities to HLA-bound peptide, including the variable HLA-B*57:01-restricted HIV-1 Gag-derived epitope TW10. Residue 283, which has undergone positive selection during the evolution of human KIRs, also played a central role in Bw4 subtype recognition by KIR3DL1. Collectively, our findings uncover a common molecular regulator that controls HLA and peptide discrimination without participating directly in peptide-laden HLA interactions. Furthermore, they provide insight into the mechanics of interaction and generate simple, easily assessed criteria for the definition of KIR3DL1 functional groupings that will be relevant in many clinical applications, including bone marrow transplantation.
    • A Narrative Review on Female Physique Athletes: The Physiological and Psychological Implications of Weight Management Practices

      Alwan, Nura; Moss, Samantha L.; Elliott-Sale, Kisrty; Davies, Ian; Kevin, Enright; Liverpool John Moores University; University of Chester; Nottingham Trent University (Human Kinetics, 2019-06-13)
      Physique competitions are events in which aesthetic appearance and posing ability are valued above physical performance. Female physique athletes are required to possess high lean body mass and extremely low fat mass in competition. As such, extended periods of reduced energy intake and intensive training regimens are utilised with acute weight loss practices at the end of the pre-competition phase. This represents an increased risk for chronic low energy availability and associated symptoms of Relative Energy Deficiency in Sport, compromising both psychological and physiological health. Available literature suggests that a large proportion of female physique athletes report menstrual irregularities (e.g., amenorrhea and oligomenorrhea), which are unlikely to normalise immediately post-competition. Furthermore, the tendency to reduce intakes of numerous essential micronutrients is prominent among those using restrictive eating patterns. Following competition reduced resting metabolic rate, and hyperphagia, are also a concern for these female athletes, which can result in frequent weight cycling, distorted body image and disordered eating/eating disorders. Overall, female physique athletes are an understudied population and the need for more robust studies to detect low energy availability and associated health effects is warranted. This narrative review aims to define the natural female physique athlete, explore some of the physiological and psychological implications of weight management practices experienced by female physique athletes and propose future research directions.
    • The National Bowel Cancer Screening Programme in Cheshire and Merseyside: Perspectives of people with a sensory impairment

      Powell, Katie; Perry, Catherine; Thurston, Miranda; University of Chester, Centre for Public Health Research (University of Chester, 2008-03)
      An report is an exploration into the accessibility of the National Bowel Cancer Screening Programme for those with a sensory impairment. The aim of the research was to explore the experiences, perceptions and understandings of people with a sensory impairment of the first stage of the screening process, from invitation to participate, to completion of a faecal occult blood test.
    • The National Health School Standard: the development of the Cheshire health and education partnership: A case study

      Thurston, Miranda (Centre for Public Health Research, Chester College of Higher Education, 2002-10)
      This project report discusses the question - what is the evidence that the Cheshire healthy schools programme is a 'partnership' based in health and education? The development of the 'partnership' and key achivements and the perceptions of 'partnership working' across the health and education sectors is analysed.
    • The National Healthy Schools Programme: A vehicle for school improvement? Case studies from Cheshire

      Thurston, Miranda (Centre for Public Health Research, University of Chester, 2006-10)
      This project report discusses the relationship between healthy school status and school improvement using case studies of three primary schools at different stages of the involvement with the healthy schools programme.
    • The natural history of the College campus

      Ing, Bruce (Governors of Chester College, 1989)
      This chapter discusses the buildings, gardens, trees, sports fields and the marginal areas of disturbed or undisturbed or undeveloped land on the Chester College campus.
    • The nature and practice of primary physical education: A study of the perceptions of subject leaders

      Green, Ken; Jones, Luke (University of Chester, 2015-09)
      Much of the existing research on primary physical education (PE) has focused on the supposed importance and potential of the subject at this age range, rather than on its actual nature and practice. It is repeatedly claimed within the literature that the development of movement skills during early learning experiences is significant as it lays the foundation for continuing participation in health enhancing physical activity. While much of the existing research has focused on the supposed importance of primary PE, further study in this area expresses concerns about the deficiencies in the preparation of primary generalists to teach the subject; over the quality of learning and teaching within the subject; and over a perceived lack of investment (in the long term) in the primary age phase. In the light of the comparatively limited research relating to primary PE, the reported issues which surround the provision of the subject and the current emphasis on its promotion through the PE and Sport Premium, the study aimed to examine change alongside continuity in what has been identified, rhetorically at least, as an important area of PE. Drawing upon data gathered from one-to-one interviews with 36 subject leaders (SLs), this study sought to describe and explain the nature and practice of primary PE and develop a more adequate understanding of what is actually happening in the name of the subject. The analysis of primary PE was undertaken through the use of a case study of one School Sport Partnership (SSP) in the north-west of England, with the theoretical framework for this study being formed by the figurational sociological perspective. The findings revealed that the most common model for the delivery of PE involved responsibility being shared between the generalist class teacher and either a sports coach or specialist PE teacher. The SLs recognised strengths and weaknesses in all of the three main approaches used. However, while they favoured the use of specialist teachers because of their subject knowledge and expertise, the more prosaic constraints of cost and flexibility meant that the use of coaches had become increasingly popular. Whether or not, the growth of coaches is de-professionalizing the delivery of PE, it certainly appears to be exacerbating any existing tendency to turn primary PE into a pale imitation of the sport-biased curricular of secondary schools. Ironically, the apparent ‘threat’ to the status of PE in the primary curriculum (as well as the status of PE specialists) posed by the growth of coaches in curricular PE in primary schools may well be exaggerated by the primary PE and Sport Premium which appears to have added momentum to a change of direction regarding staffing the subject – towards sports coaches and away from generalist classroom teachers and PE specialists. The data also showed that while the pedagogical approaches adopted in primary PE lessons did include some inclusive and developmentally appropriate methods, the overriding focus was on didactic teaching approaches being used to achieve narrow skills based outcomes. The historical dominance of games, the inclusion of primary teachers in lengthening chains of interdependence with sporting groups and individuals, and the conflation of sport with PE were all thought to have influenced the adoption of a teaching model that is unduly influenced by sport. It was also clear from SLs responses, that the prevalence of teaching methods that bind didactic and skill based pedagogy are unlikely to be challenged by the greater inclusion of sports coaches within primary PE. Finally, the contents of primary PE lessons were shown, by the data, to be dominated by sport and traditional team games; and to be organised around the timings of the major inter-school competitions and tournaments. Overall it was argued that the portents of a future with sports coaches as the main deliverers of primary ‘sport’ lessons are there for all to see, and that this apparent change is best understood by locating the subject leaders of PE in the networks of interdependent relationships that they have with others.
    • Neuromuscular function after exercise-induced muscle damage: Theoretical and applied implications

      Byrne, Christopher; Twist, Craig; Eston, Roger; DSO National Laboratories, Republic of Singapore ; NEWI/University of Wales, Bangor ; University of Wales, Bangor (Adis, 2004)
      Exercise-induced muscle damage is a well documented phenomenon particularly resulting from eccentric exercise. When eccentric exercise is unaccustomed or is performed with an increased intensity or duration, the symptoms associated with muscle damage are a common outcome and are particularly associated with participation in athletic activity. Muscle damage results in an immediate and prolonged reduction in muscle function, most notably a reduction in force-generating capacity, which has been quantified in human studies through isometric and dynamic isokinetic testing modalities. Investigations of the torque-angular velocity relationship have failed to reveal a consistent pattern of change, with inconsistent reports of functional change being dependent on the muscle action and/or angular velocity of movement. The consequences of damage on dynamic, multi-joint, sport-specific movements would appear more pertinent with regard to athletic performance, but this aspect of muscle function has been studied less often. Reductions in the ability to generate power output during single-joint movements as well as during cycling and vertical jump movements have been documented. In addition, muscle damage has been observed to increase the physiological demand of endurance exercise and to increase thermal strain during exercise in the heat. The aims of this review are to summarise the functional decrements associated with exercise-induced muscle damage, relate these decrements to theoretical views regarding underlying mechanisms (i.e. sarcomere disruption, impaired excitation-contraction coupling, preferential fibre type damage, and impaired muscle metabolism), and finally to discuss the potential impact of muscle damage on athletic performance.
    • Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity

      Green, Ben; Griffiths, Emily; Almond, Solomon; University of Chester; Public Health England (BioMed Central, 24/01/2016)
      Background: There were at least 31,171 metal-on-metal (MoM) hip implants in the UK between 2003 and 2011. Some of these were subject to failure and widescale recalls and revisions followed. Method This is a presentation of ten cases (mean age 60 years) where we evaluated neuropsychiatric morbidity following metal-on-metal hip implant failure and revision. Implants were ASR total hip replacement (acetabular implant, taper sleeve adaptor and unipolar femoral implants) performed between 2005 and 2009. This case series describes, for the first time, neuropsychiatric complications after revision where there has been cobalt and chromium toxicity. Results Pre-revision surgery, nine patients had toxic levels of chromium and cobalt (mean level chromium 338 nmol/l, mean cobalt 669.4 nmol/l). Depression assessment showed 9 of 9 respondents fulfilled the BDI criteria for depression and 3 of these were being treated. 7 of 9 patients showing short term memory deficit with mean mini mental state examination score of 24.2. The normal population mean MMSE for this group would be expected to be 28 with <25 indicating possible dementia. Conclusions We found neurocognitive and depressive deficits after cobalt and chromium metallosis following MoM implant failure. Larger studies of neurocognitive effects are indicated in this group. There may be implications for public health.
    • Nice to know: impact of NICE guidelines on ketogenic diet services nationwide

      Whiteley, Victoria; Martin-McGill, Kirsty; Carroll, Jennifer; Taylor, Hannah; Schoeler, Natasha; Royal Manchester Childrens Hospital; University of Salford; University of Chester; University of Liverpool; University of Plymouth; Sheffield Childrens Hospital; UCL Great Ormond Street Institute of Child Health (Wiley, 2019-08-20)
      Background In 2012, the National Institute for Health and Care Excellence (NICE) Clinical Guidelines for Epilepsies: Diagnosis and Management (CG137) included, for the first time, ketogenic diets (KDs) as a treatment option for drug‐resistant paediatric epilepsy. The recommendation was made to refer children and young people with epilepsy whose seizures have not responded to appropriate anti‐epileptic drugs to a tertiary paediatric epilepsy specialist for consideration of the use of KDs. We aimed to assess the impact of this change in guidance on the numbers of ketogenic centres and patients following KDs for epilepsy in the UK and Ireland. Methods An online survey was circulated to ketogenic dietitians from the UK and Ireland. The results were compared with similar surveys published in 2000 and 2010. Results The number of centres offering KDs for treatment of epilepsy has risen from 22 in 2000, to 28 in 2010, and to 39 in 2017 (77% overall increase). Seven of these centres accept adult referrals, in comparison to only two centres in 2010. Patient numbers have increased from 101 in 2000 to 754 in 2017. In total, 267 patients are waiting to commence KD at 31 centres. Conclusions Over the last 7 years, the number of patients treated with a KD for epilepsy in the UK and Ireland has increased by 647%, with a 77% increase in the number of centres offering KDs. Despite this rapid growth, there is ongoing demand for patients to be considered for dietary therapy, highlighting the need for continued expansion of KD services nationally.
    • Nicholaus Steno - the blessed (1638-1686)

      Burek, Cynthia V. (Earth Science Teachers' Association, 2005)
      This article discusses the life and career of Nicholaud Steno (1638-1686).
    • Nicotinamide alone accelerates the conversion of mouse embryonic stem cells into mature neuronal populations.

      Griffin, Sile M.; Pickard, Mark R.; Orme, Rowan P.; Hawkins, Clive P.; Williams, Adrian C.; Fricker, Rosemary A.; Keele University; University of Chester; University Hospital of North Staffordshire; University of Birmingham (Public Library of Science, 17/08/2017)
      Vitamin B3 has been shown to play an important role during embryogenesis. Specifically, there is growing evidence that nicotinamide, the biologically active form of vitamin B3, plays a critical role as a morphogen in the differentiation of stem cells to mature cell phenotypes, including those of the central nervous system (CNS). Detailed knowledge of the action of small molecules during neuronal differentiation is not only critical for uncovering mechanisms underlying lineage-specification, but also to establish more effective differentiation protocols to obtain clinically relevant cells for regenerative therapies for neurodegenerative conditions such as Huntington's disease (HD). Thus, this study aimed to investigate the potential of nicotinamide to promote the conversion of stem cells to mature CNS neurons. METHODS: Nicotinamide was applied to differentiating mouse embryonic stem cells (mESC; Sox1GFP knock-in 46C cell line) during their conversion towards a neural fate. Cells were assessed for changes in their proliferation, differentiation and maturation; using immunocytochemistry and morphometric analysis methods. RESULTS: Results presented indicate that 10 mM nicotinamide, when added at the initial stages of differentiation, promoted accelerated progression of ESCs to a neural lineage in adherent monolayer cultures. By 14 days in vitro (DIV), early exposure to nicotinamide was shown to increase the numbers of differentiated βIII-tubulin-positive neurons. Nicotinamide decreased the proportion of pluripotent stem cells, concomitantly increasing numbers of neural progenitors at 4 DIV. These progenitors then underwent rapid conversion to neurons, observed by a reduction in Sox 1 expression and decreased numbers of neural progenitors in the cultures at 14 DIV. Furthermore, GABAergic neurons generated in the presence of nicotinamide showed increased maturity and complexity of neurites at 14 DIV. Therefore, addition of nicotinamide alone caused an accelerated passage of pluripotent cells through lineage specification and further to non-dividing mature neurons. CONCLUSIONS: Our results show that, within an optimal dose range, nicotinamide is able to singly and selectively direct the conversion of embryonic stem cells to mature neurons, and therefore may be a critical factor for normal brain development, thus supporting previous evidence of the fundamental role of vitamins and their metabolites during early CNS development. In addition, nicotinamide may offer a simple effective supplement to enhance the conversion of stem cells to clinically relevant neurons.
    • No difference in satiety or in subsequent energy intakes between a beverage and a solid food

      Almiron-Roig, Eva; Flores, Sonia Y.; University of Washington (Elsevier, 2004-09)
      Energy compensation following the consumption of caloric beverages is said to be imprecise and incomplete. This study compared the relative impact on satiety and energy intakes of the physical form of foods versus the timing of consumption. Thirty-two volunteers (16 men and 16 women), aged 18–35 years, consumed equal-energy preloads (1254 kJ, 300 kcal) of regular cola (710 ml, 24 oz) or fat-free raspberry cookies (87 g, 3 oz) on two occasions each. The preloads were presented either 2 h or 20 min before the test meal. Their principal ingredient was sugar. Participants rated motivational states prior to ingestion and at 30-min intervals. A tray lunch was presented at 12:30 p.m., and food consumption was measured. Regular cola and cookies suppressed hunger ratings equally and no temporal difference in satiety was observed. Cola, but not cookies, resulted in lower ratings of thirst. Energy intakes at lunch were lower when the preload was consumed closer to the test meal (20 min) but was not affected by physical form (liquid vs. solid). Cola, but not cookies, reduced water intakes at lunch. There was no satiety deficit following the ingestion of a beverage as compared with a solid food. The timing of consumption may be more important than the physical form of energy consumed.
    • No Effect of Beetroot Juice Supplementation on 100-m and 200-m Swimming Performance in Moderately-Trained Swimmers.

      Esen, Ozcan; Nicholas, Ceri; Morris, Mike; Bailey, Stephen J (14/11/2018)
      Dietary nitrate supplementation has been reported to improve performance in kayaking and rowing exercise which mandate significant recruitment of the upper body musculature. Since the effect of dietary nitrate supplementation on swimming performance is unclear, the purpose of this study was to assess the effect of dietary nitrate supplementation on 100-m and 200-m swimming freestyle time-trial (TT) performance. In a double blind, randomized crossover design, ten moderately-trained swimmers underwent two separate 3-day supplementation periods, with a daily dose of either 140 mL nitrate-rich (BRJ; ~800 mg/d nitrate) or nitrate-depleted (PLA) BRJ. Following blood sampling on day 3, the swimmers performed both 200-m and 100-m freestyle swimming TTs, with 30 min recovery between trials. Plasma nitrite concentrations was greater after BRJ relative to PLA consumption (432 ± 203 nmol/L, 111 ± 56 nmol/L, respectively, p = 0.001). Systolic BP was lowered after BRJ compared to PLA supplementation (114 ± 10, 120 ± 10 mmHg, respectively p = 0.001), but time to complete the 200-m (BRJ: 152.6 ± 14.1 s, PLA: 152.5 ± 14.1 s) and 100-m (BRJ: 69.5 ± 7.2 s, PLA: 69.4 ± 7.4 s) freestyle swimming TTs were not different between BRJ and PLA (p > 0.05). While 3 days of BRJ supplementation increased plasma nitrite concentration and lowered blood pressure, it did not improve 100-m and 200-m swimming TT performance. These results do not support an ergogenic effect of nitrate supplementation in moderately-trained swimmers, at least for 100-m and 200-m freestyle swimming performance.
    • ‘No pain, no gain’: former elite female gymnasts’ engagements with pain and injury discourses

      Tynan, Ruby; McEvilly, Nollaig; University of Chester (Taylor & Francis, 11/05/2017)
      This paper investigates former elite female gymnasts’ views and experiences of pain and injury. The purpose of the study was to examine how participants engaged with pain and injury discourses and interrogate the ways in which certain knowledge and practices had become dominant. A Foucaultian theoretical framework underpinned the study, making use of Foucault’s work on discourses, power and resistance. Data were generated through semi-structured interviews with seven former elite gymnasts. By analysing the participants’ talk through poststructural discourse analysis, three themes were identified. Firstly, participants’ persistence through pain and injury was due to the desire to compete. Secondly, participants differentiated between ‘good pain’ and ‘bad pain’. Thirdly, participants had a higher tolerance for pain than for injury. This research raises questions about the dominance of a ‘no pain, no gain’ discourse, and the ways in which gymnasts may develop an uncritical acceptance of particular ‘truths’ surrounding pain and injury.
    • Non-invasive tools to quantify hypothalamic-pituitary function in lion-tailed macaques (Macaca silenus)

      Skyner, Lindsay J.; Smith, Tessa E.; University College Chester (Karger, 2004)
    • Norwegian youngsters’ perceptions of physical education: Exploring the implications for mental health

      Røset, Linda; Green, Ken; Thurston, Miranda; University of Chester (Taylor & Francis, 2019-06-24)
      Improving young people’s mental health has become a priority for policy-makers in Norway as elsewhere. Although the evidence is limited, physical activity has been identified as having a role in mental health promotion with school physical education (PE) typically being presented as a suitable setting. Few studies, however, have explored young people’s perceptions and experiences of PE and the possible consequences for their mental health – the departure point for this paper. We approach this issue sociologically by focusing on the processes through which PE is enacted. Qualitative data were generated by 31 focus groups involving 148 youngsters from the 10th grade (15–16-year-olds) in eight secondary schools in Norway. The overarching theme to emerge was that PE was valued by the students for what it was not as much as what it was. The appeal of PE often lay in being different and a break from ‘normal’ school lessons and, at the same time, an opportunity for informal social interaction and strengthening social bonds. Enjoyment of PE – even among those with limited sporting competence – was understood as giving rise to cathartic benefits and an antidote to their increasingly academic, routinized and performance-oriented school lives. However, processes relating to the organization, delivery and assessment of lessons meant that these benefits were sometimes compromised for some young people. We conclude that as far as the mental health of young people is concerned, the best justificatory defence for PE becomes physical recreation as a solution to (academic) schooling rather than PE as education.
    • Not just making babies: A Darwinian perspective

      Lewis, Stephen J.; Chester College of Higher Education (2009-11-25)