• Interaction between Metabolic Genetic Risk Score and Dietary Fatty Acid Intake on Central Obesity in a Ghanaian Population

      Alsulami, Sooad; Nyakotey, David; Dudek, Kamila; Bawah, Abdul-Malik; Lovegrove, Julie; Annan, Reggie; Ellahi, Basma; Karani, Santhanakrishnan Vimaleswaran; University of Reading, University of Chester and Kumasi University (MDPI, 2020-07-27)
      Obesity is a multifactorial condition arising from the interaction between genetic and lifestyle factors. We aimed to assess the impact of lifestyle and genetic factors on obesity-related traits in 302 healthy Ghanaian adults. Dietary intake and physical activity were assessed using a 3 day repeated 24 h dietary recall and global physical activity questionnaire, respectively. Twelve single nucleotide polymorphisms (SNPs) were used to construct 4-SNP, 8-SNP and 12-SNP genetic risk scores (GRSs). The 4-SNP GRS showed significant interactions with dietary fat intakes on waist circumference (WC) (Total fat, Pinteraction = 0.01; saturated fatty acids (SFA), Pinteraction = 0.02; polyunsaturated fatty acids (PUFA), Pinteraction = 0.01 and monounsaturated fatty acids (MUFA), Pinteraction = 0.01). Among individuals with higher intakes of total fat (>47 g/d), SFA (>14 g/d), PUFA (>16 g/d) and MUFA (>16 g/d), individuals with ≥3 risk alleles had a significantly higher WC compared to those with <3 risk alleles. This is the first study of its kind in this population, suggesting that a higher consumption of dietary fatty acid may have the potential to increase the genetic susceptibility of becoming centrally obese. These results support the general dietary recommendations to decrease the intakes of total fat and SFA, to reduce the risk of obesity, particularly in individuals with a higher genetic predisposition to central obesity.
    • Social Care Workers’ Experiences of Assessing Parents with Learning Disabilities: An Interpretative Phenomenological Analysis Study Based in the Northwest of England.

      Lovell, Andrew; Constance, Lyndsey J. (University of Chester, 2020-06-26)
      Aims: Qualitative research has identified a number of issues when working with parents with learning disabilities. Pre-conceived ideas, professional discrimination and a high percentage of children living away from the family home have featured heavily in the literature. However, less is known about the assessment process, and how practitioners adapt their skills to assess this parental group. The current study therefore aimed to gain an in-depth understanding of the assessment process, utilising a qualitative approach. The study focused upon the experiences of social care assessors from children’s and adult services, and sought to explore the following: the approach social care workers adopt when assessing parents with learning disabilities; if appropriate knowledge is embedded into practice to assess competently; experiences of the application of the PAMS 4.0; multi-disciplinary approach to assessment, and how this exhibits in practice. Method: Semi-structured interviews were carried out with fourteen frontline social care practitioners from children’s and adult services who had direct experience of assessing parents with learning disabilities. The transcripts of the interviews were analysed using Interpretative Phenomenological Analysis (IPA). Results: The analysis produced four master themes. These were; inadequate knowledge to understand complexities; hierarchy; reasonable adjustments; assessing parental ability. An analysis of these master themes and the related super-ordinate themes is presented. Discussion: The results are considered in light of the experiences of the participants, and how this impacts on the assessment of parents with learning disabilities. The study finds that whilst there is evidence the participants hold pre-conceived ideas, a lack of relevant skills and knowledge as well as an unstructured implementation of the Parenting Assessment Manual 4.0, are both contributing factors. Furthermore, problematic multi-agency working and managerial influences impact on the overall outcomes for parents with learning disabilities and their families.
    • The perceived psychological stressors and coping behaviours in university students, on a pre-registration programme.

      Mitchell, Andrew E. P.; University of Chester (Emerald Publishing, 2020-05-20)
      The purpose was to investigate perceived stressors and coping behaviours in student nurses on a pre-registration programme of study. Stress in student nurses has been identified with decreased emotional well-being and poor academic achievement. The significance of stress and coping behaviours in students during training has implications for education and practice. The present study recruited eighty seven pre-registration student nurses in a cross sectional design. Bivariate and multivariate analyses assessed the differences in field and year of study and the students’ perceived stress and coping behaviours. The findings showed that stress is a significant issue in nurse training. Fifty-three percent of the participants had levels higher than the mean. Interestingly, the present study found that high perceived stress was associated with avoidance behaviours. The most common type of perceived stress and ranked by highest factor were from written assignments and a lack of professional skills and knowledge. Their peer group and everyday life activities were shown as potential ways of coping with stressors. Thus, it seems reasonable to focus support on decreasing avoidant and enhancing stress-reducing behaviours. Psychological stress and coping behaviours must be considered together as perceived stress is bound by the ability to ameliorate stress by managing helpful and unhelpful behaviours. The findings may suggest that a potential benefit could come from the provision of helpful strategies such as peer group support and reduction of avoidant behaviours. Also, there seems to be a need for greater mental health literacy in dealing with stress during training.
    • Understanding minimum and ideal factor levels for participation in physical activities by people with haemophilia: An expert elicitation exercise.

      Martin, Antony P; orcid: 0000-0003-4383-6038; Burke, Tom; Asghar, Sohaib; Noone, Declan; Pedra, Gabriel; orcid: 0000-0002-2023-5224; O'Hara, Jamie (2020-04-08)
      The benefits of physical activity (PA) for people with haemophilia (PWH) may include improvements in joint, bone and muscle health. However, the factor VIII activity level required to avoid a bleeding episode associated with PA is unknown. To elicit the opinion of clinical experts on the minimum level and ideal factor VIII activity ('level') required to avoid a bleeding episode during participation in different types of PA for PWH. Based on the 2017 National Hemophilia Foundation PA descriptions, clinical experts estimated a minimally acceptable and an ideal factor level at which a bleed could be avoided. The uncertainty around estimates was quantified using an approach to construct a probability distribution to represent expert opinion. Minimum and ideal factor level increased with higher risk PA, whether or not joint morbidity was present, as did the experts' uncertainty in their estimates (ie the range between lowest and highest estimates for minimum and ideal levels). Mean minimum levels ranged from 4% to 48% for low to high risk for people without joint morbidity, and from 7% to 47% for those with joint morbidity. For ideal factor levels, corresponding figures were 9%-52% and 12%-64%, respectively. To support a patient-centric outcome, expert opinion indicates that the clinical norm of 0.01 IU/mL (1%) trough level is insufficient. It is anticipated that introducing a more targeted approach to meet the needs of patients who are increasingly physically active will benefit patients further in addition to recent treatment advances. [Abstract copyright: © 2020 John Wiley & Sons Ltd.]
    • The value of embedded secondary-care-based psychology services in rheumatology: an exemplar for long-term conditions

      Barnes, Theresa; Taylor, Lou; Eost-Telling, Charlotte; Joy, Thomas; Countess of Chester Hospital; University of Chester; University of Chester; Cheshire and Wirral Partnership (Royal College of Physicians, 2020-02-29)
      Rheumatoid arthritis is an exemplar long term condition, complicated by pain, disability, co-morbidities and long term medication use. It has significant effects on mobility, work performance, social role, sexual function and relationships. It is commonly associated with fatigue and mood disturbance as a result of complex interactions of physical (disease related) and psychosocial factors. NICE guidance recommends the availability of psychological support for these patients. We have implemented a psychology service for our patients with chronic rheumatological conditions. This study was set up to capture the value of this service.
    • A phenomenological exploration of nursing students’ experience of raising a care concern in clinical practice

      Cooper, Elizabeth (University of ChesterUniversity of Chester, 2020-01)
      UK pre-registration healthcare students are expected to raise a care concern about unsafe situations whilst in clinical practice. The UK’s NHS is in the midst of a change to an open, honest and transparent culture which responds to a professional’s concern about patient care, to improve safety and prevent harm. Central to this change is improving the experience of registered healthcare professionals whose decision to raise a care concern is influenced by the organisational culture; this can create a difficult moral choice. The experience of nursing students who decide to raise a care concern has received little attention, and this study sought to explore this under-researched area. A literature review was undertaken which identified that the experience of nursing students who had raised a care concern had not been previously examined. To guide this study, Clarke Moustakas’ (1994) transcendental phenomenological methodology was used to explore nursing students’ lived experience of raising a care concern. Ten nursing students with experience of raising a care concern in clinical practice voluntarily participated in the study. Open interviews conducted between December 2016 and October 2017 were audio recorded and transcribed, exposing individual narratives of raising a care concern in clinical practice. The transcripts were analysed to produce a composite description which summarises nursing students’ lived experience, reflecting four themes or essences: 1) patient centred concern; 2) deciding how to act; 3) having emotional strength; and 4) feedback and support. These typify what it is like for nursing students to raise a care concern whilst in clinical practice. The findings were critically examined and suggest that compassion may motivate nursing students to act when faced with an unsafe situation, seeking to stop patient harm and suffering. Recognising this moral motivation, students described the relevance of emotional strength when dealing with the emotionally complex experience of facing difficult situations, with feedback and support providing comfort plus moral and emotional satisfaction. This study also explores the implications for professional practice, specifically the impact upon future teaching and learning approaches to facilitate nursing students’ ability to detect and act upon unsafe situations; providing listening opportunities to support students in clinical practice; and valuing nursing students who raise a care concern as role models and local clinical leaders. Recommendations include a new national campaign to improve the likelihood of nursing students raising care concerns and updating UK professional guidance.
    • Using and developing evidence in health and social care practice

      Chapman, Hazel M.; University of Chester (Sage, 2020)
      [A] Overview This chapter outlines the processes of developing evidence-based practice and carrying out research and highlights the similarities and differences between the two. This chapter aims to increase your skills and motivation in utilising research evidence to improve your practice, introduce you to the process of research and develop your research skills. [A] Learning Outcomes At the end of this chapter you will be able to: • Critique research papers. • Share best practice with your colleagues. • Assist with research in practice. • Develop your research skills with a view to becoming a researcher.
    • Exploring the staff development needs of junior academic middle managers in a Faculty of Health and Social Care during organisational change: A Bourdieusian perspective.

      Evers, Jean L (University of ChesterUniversity of Chester, 2019-12)
      The aim of this study was to gain an in-depth understanding of the personal and professional staff development needs of junior academic middle managers in a Faculty of Health and Social Care during a period of change. The research was undertaken in the North West of England in a post-1992 University, following a reorganisation of the Faculty of Health and Social Care and introduction of new roles. The study adopted an action research methodology and a co-operative inquiry method, which consisted of a co-operative inquiry group of junior academic middle managers who were also co-researchers. The nature of co-operative inquiry is for co -researchers to engage in repeated cycles of reflection and action that generate changes to their professional practice. The study was conducted over a period of one year and during this time multiple data collection methods were utilised to triangulate the evidence. The research findings identified that multiple identities caused conflict between professional and academic roles, negatively impacting on junior academic middle managers during periods of change. During transition, some participants reported difficulty in adapting to complex political reforms, which caused dissonance between their actual and perceived roles in the field. The junior academic middle managers reported that the safe and trusting environment of the co-operative inquiry group enhanced their confidence and enabled them to learn in action and acquire a reflexive approach when undertaking their roles in the newly structured organisation. The study contributes to the existing literature regarding role identity of professional academics in higher education and offers new insights into transition during complex organisational change.
    • The clusters and frequencies of adverse social conditions amongst the homeless people

      Mabhala, Mzwandile A. (Oxford University Press (OUP), 2019-11-13)
      Abstract Background A growing body of evidence identifies interconnected social indicators that can lead to homelessness. Several studies identify a catalogue of social disadvantages that starts from childhood and persist throughout the life course that leads to homelessness. Qualitative evidence indicates that their adverse childhood experiences(ACEs) and damage that occurred to them as children had major influences on their ability to negotiate their way through the education system, gain and sustain employment, make appropriate choices of social networks, and form and maintain healthy relationships as adults. However, very little research seeks to objectively investigate these issues. This study aims to use the cross-sectional study to document the cluster and frequency of adverse social conditions amongst the homeless people in North West England in 2019. Methods The study design was cross-sectional. We used IBM SPSS 21, with a significance level set at p &lt; 0.05, CI 95% to analyse the data. Results The mean age was 39.12, range 21-64, 90.5% male. 52%(χ2= 33.4, df = 1, p = 0.001) described their health as poor, 90% (χ2= 61.85, df = 2, p = 0.001) smoked cigarette daily, 83.3% (χ2= 76.4, df = 3, p = 0.001) used drugs daily, 78.6% (χ2= 13.7, df = 1, p = 0.001) saw a doctor in preceding 6 months, 63.4% (χ2= 73.8, df = 3, p = 0.001) left school before age 16; 26.2% (χ2= 37.7, df = 3, p = 0.001) left school at 16, 11.9% (χ2= 33.1, df = 10, p = 0.001) encounterd criminal justice system at the age of 11, 28.6% (χ2= 60.8, df = 8, p = 0.001) had reprimand/caution or conviction at 17. ACES: 57% (χ2= 34.7, df = 3, p = 0.001) experienced humiliation by adults in their household; 54% (χ2= 30.7, df = 3, p = 0.001) threatening behaviour, 50% (χ2= 26.0, df = 3, p = 0.001) physical violence in their household. Conclusions These early stage preliminary results indicate that adverse social circumstances that occur in childhood are disproportionately represented in homeless population. Key messages Homelessness is more complex than the absence of accomodation. Adverse social circumstances that occur in childhood are disproportionately represented in homeless population.
    • Achieving the unimaginable: Health equity in haemophilia

      Skinner, Mark W.; orcid: 0000-0002-0934-0680; Nugent, Diane; Wilton, Pam; O’Mahony, Brian; Dolan, Gerry; O’Hara, Jamie; Berntorp, Erik; orcid: 0000-0002-1337-7195 (Wiley, 2019-11-13)
    • Prophylactic Treatment in People with Severe Hemophilia B in the US: An Analysis of Real-World Healthcare System Costs and Clinical Outcomes

      Noone, Declan; Pedra, Gabriel; Asghar, Sohaib; O'Hara, Jamie; Sawyer, Eileen K; Li, Nanxin (Nick) (American Society of Hematology, 2019-11-13)
      Introduction The treatment paradigm for people with severe hemophilia B in the US typically involves prophylaxis with factor IX (FIX) replacement therapy, the primary aim of which is to provide sufficient FIX levels to reduce the frequency of bleeding events. The clinical benefits of FIX prophylaxis are well understood, however the cost of FIX products as well as costs associated with healthcare resource utilization present a significant burden to the healthcare system. Substantive costs may also accrue in patients who continue to bleed while on prophylaxis, due to the impact on both short and long-term joint-related outcomes. In the absence of existing data in the US, the 'Cost of Hemophilia Across the USA: a Socioeconomic Survey' (CHESS US) study was conducted to establish a population-based estimate of the real-world US healthcare system burden associated with severe hemophilia. Using data drawn from the CHESS US study, this analysis examines the real-world healthcare system costs and clinical outcomes of people with severe hemophilia B on FIX prophylaxis. Methods CHESS US, a retrospective, cross-sectional dataset of adults with severe hemophilia in the USA, gathered information on patient cost via a patient record form. Data on the following parameters are included in this analysis: FIX consumption, annualized bleeding rate (ABR), the presence of one or more chronically damaged joints ("problem joint"), as well as costs associated with annual (prophylactic) factor consumption and hospitalizations (i.e., number of admissions, number of day cases, total inpatient days, and total intensive care unit [ICU] days). All variables report retrospective data of the 12 months prior to enrolment in the study. Results are presented as mean (± standard deviation) or N (%). Results In total, 132 of 576 patients profiled in the CHESS US study had severe hemophilia B. Among them, 77 patients were on FIX prophylaxis, of whom 44 patients reported FIX dosing regimen and were included in the current analyses. Among them, 20 patients were treated with conventional FIX and 24 patients with extended half-life (EHL) FIX products. The cohort has a mean age of 27.64 (± 11.05) and mean weight (kg) of 75.71 (± 13.41). In the last 12 months, the mean number of international units (IU) prescribed for FIX prophylaxis across the full cohort was 257,216 IU (± 213,591), with an associated annual cost of $610,966 (± $495,869). Among patients treated with conventional FIX, mean prescribed FIX was 287,141 IU (± 264,906) at an annual cost of $397,491 (± $359,788), while patients treated with EHL FIX reported a mean prescribed FIX of 232,278 IU (± 160,914) at an annual cost of $788,861 (± $529,258). The cohort reported a mean ABR of 1.73 (± 1.39); 8 (18%) were reported to have a target joint meeting the International Society on Thrombosis and Haemostasis (ISTH) definition; and 11% were reported to have had at least one chronically damaged joint (i.e., problem joint). Healthcare resource utilization associated with bleed events were reported as follows: hospital admissions days [0.18 (± 0.62)]; inpatient days [0.34 (± 1.22)]; and ICU days [0.23 (± 0.86)]. The direct medical cost to the healthcare system was $2,885 (± $7,857; excluding FIX cost) and $614,886 (± $498,839; including FIX cost). Discussion Data from the CHESS US study showed substantial costs and resource utilization among patients with severe hemophilia B receiving FIX prophylaxis, of which the cost of FIX replacement therapy constituted most of the total cost to healthcare system. Although the ABR observed in the analysis population was low, bleed-related hospitalizations comprised a significant non-drug cost to the healthcare system. A proportion of patients also still experienced joint arthropathy. Such substantial clinical and economic burden highlights that unmet needs remain in patients with severe hemophilia B on FIX prophylaxis in the US. Disclosures Noone: HCD Economics: Employment. Pedra:HCD Economics: Employment. Asghar:HCD Economics: Employment. O'Hara:HCD Economics: Employment, Equity Ownership. Sawyer:uniQure Inc.: Employment. Li:uniQure Inc.: Employment.
    • THE METHODOLOGICAL RELEVANCE OF MASS OBSERVATION DATA

      Eost-Telling, Charlotte L; Kingston, Paul; Taylor, Louise; Bailey, Jan (Oxford University Press (OUP), 2019-11-08)
      Abstract The Mass Observation Project, established in 1937, documents the lives of ordinary people living in the UK, and explores a wide range of social issues. The Project distributes a set of written questions (“Directives”) to a panel of 500 members of the British public (“Observers”) three times each year; “Observers” respond in writing. From the initial commissioning of a “Directive” to data becoming available for analysis takes between four to six months. This approach offers researchers an opportunity to capture in-depth qualitative data from individuals with a range of demographic backgrounds who live across the UK. As there are no word limits on “Observers’” responses and they remain anonymous, a “Directive” often yields rich, high-quality data. Additionally, compared with alternative methods of collecting large volumes of qualitative data from a heterogeneous population, commissioning a “Directive” is cost-effective in terms of time and resource.
    • THE HEALTH IMPACT OF SCAMS

      Bailey, Jan; Kingston, Paul; Taylor, Louise; Eost-Telling, Louise (Oxford University Press (OUP), 2019-11-08)
      Abstract This presentation will offer new and alternate insights into ‘scams’ and the health effects of fraud on older people. It reports data captured from a Mass Observation Project “Directive” focusing on scams and their impact on individuals. Eighty “Observers’” aged 50 and over responded to the “Directive”. Responses indicate that falling victim to a scam may have negative impacts on individuals’ mental wellbeing, self-esteem and relationships with others. Data analysis also identified that fear of victimisation can also affect individuals, resulting in worry, anxiety and maladaptive coping strategies. Offering a sociology of health perspective, we will focus is on these health impacts of scams and the legitimisation of the issue as a socio-political problem. We will also highlight additional important areas for consideration, such as the absence of a common understanding of the concept and nomenclature of ‘scam’, and the ‘vagaries of scams’ by presenting a typology of scams.
    • PERCEPTIONS OF DEMENTIA

      Kingston, Paul; Taylor, Louise; Eost-Telling, Charlotte; Bailey, and Jan (Oxford University Press (OUP), 2019-11-08)
      Abstract This paper considers narratives of 143 respondents (“Observers”) to a Mass Observation Project Directive exploring individuals’ perceptions of dementia. Perceptions of dementia held by “Observers” with experience of dementia and those without differed sharply. “Observers” with experience of dementia offered insight into living with and caring for a person with dementia, and the impact this had on their lives and personal relationships. Whereas, “Observers” with no direct experience of dementia focused more on common disease symptoms such as memory loss and reflected idealised views of care. “Observers” often feared being diagnosed with dementia themselves. This suggests education to facilitate care planning and ameliorate fears held by the public is required.
    • PERSONAL NARRATIVES OF AGING.

      Taylor, Louise; Bailey, Jan; Kingston, Paul; Eost-Telling, Charlotte (2019-11-08)
      AbstractThis presentation reflects on self-written narratives from respondents to a mass observation directive, focusing on the experiences of growing older. Narrative methods are theoretically and methodologically diverse, and are helpful in social research to understand events or happenings in human lives. This data presents accounts from a heterogeneous sample in the form of self-penned responses. These experience-centred narratives bring stories of personal understanding into being by means of the first person description of past, present, future or imaginary experiences. This presentation will focus on the findings with reference to physical and mental impacts, both real and anticipated. We will also explore themes arising from the data including gender differences, age-cohort effects and stigma. The data can be used to inform Health and Social Care education and practice, particularly in co-producing appropriate person-centred services with older people.
    • Queering Blackpool: An Ethnographic Study

      Owens, Allan; Moran, Paul; Eadon-Sinkinson, Helen (University of ChesterUniversity of Chester, 2019-11)
      This research explores the notion of identity in relation to drag queens in the seaside town of Blackpool in the North West of England. What I describe is how this complex form of identity is composed not only from the appropriation and cultural manipulation of gendered tropes, in terms of behaviours, dress, and attitudes; but how identity is also composed from the socio-cultural place of Blackpool within the Northwest of England; and from specific genres of entertainment as they manifest in this sea-side town, which suffers from a high level of deprivation. The research employs qualitative data collection methods to build an understanding of how identity is created whilst exploring the ethnographic structure and representation of the town of Blackpool which is reflected in the analysis of the film through an autoethnographic lens. It becomes autoethnographic as it is my personal reaction to the research. I wanted to analyse my findings in terms of a qualitative visual ethnography and critical reportage, which takes the form of a short film which was an appropriate way to present the visual and socio-cultural representations of the data. Blackpool’s identity has been shaped by its raucous history. Early examples of dancing, drunken behaviour and prostitution at the Raikes Garden in the 1870s are documented by Walton (1998) as well as fairground style attractions and a rising number of cheap drinking establishments to cater for the influx of holidaymakers; all of which were difficult to police. Advertising the resort’s entertainment attracted more working-class visitors creating a more downmarket holiday resort which continues to this day. The working-class history of the town gives the resort a particular kind of focus. It also means that the town is vulnerable; it is vulnerable to economic market change, problems of poverty, and unemployment. Therefore, this thesis seeks to discuss the question: how is Blackpool’s social history reflected in both the town and drag performance spaces? This thesis uses the theory of Bakhtin’s Carnival (1984) to highlight certain aspects of the film in order to present the research through an appropriate theoretical lens as well as appropriate supporting literature throughout. I felt it appropriate to use Bakhtin, since even at the level of a superficial joke, Bakhtin’s work is located in celebration, freedom, holiday and the superficial preoccupations of historic and contemporary Blackpool. More significantly perhaps Bakhtin was interested in how the world, in these contexts, can be turned upside down, and what it means for order and identity to be essentially forms of performativity, a theme central to my own work around identity and place with respect to Blackpool. Due to the nature and disclosure of some participants I decided to present the data through the form of a film. Through the initial interview process, it became apparent that some identities needed to be hidden as a means of protecting both the participants and their families as sensitive details were 11 discussed, however their stories still needed to be told. To both explore and mitigate the problems that I have mentioned, visual ethnography seemed to offer both a solution and an interesting way to convey meaning that would otherwise be lost in text. By presenting the data in this way I am creating characters. This becomes unavoidable, rather like the drag queen performers who create characters, therefore I am paralleling that. By creating the characters that are heard and deliberately filming various aspects of Blackpool, I was able to join both person and place to create a visual means that represents the journey and exploration that I went through as a researcher and which further presents the data, as self and other, in the most appropriate way. When I use the word ‘trans,’ I am referring to transvestites, transsexuals and transgender people. Throughout this written part of this thesis, I will refer to the visual aspect as ‘the film.’
    • Workplace Health and Well-Being

      Massey, Alan; University of Chester (Springer Nature, 2019-10-01)
      The problems related to the process of industrialisation such as biodiversity depletion, climate change and a worsening of health and living conditions, especially but not only in developing countries, intensify. This chapter looks at the role of workplaces in the drive for global sustainability through the World Health Organisations healthy workplace framework
    • Elderly Persons Health and Wellbeing

      Ridgway, Victoria; University of Chester (2019-10-01)
      This chapter considers older persons’ health and wellbeing. As the world population changes there are global challenges to ensure that health and social care systems, individuals, communities and countries meet the needs of older people so that they are empowered to lead active and connected later lives. However, these opportunities are heavily dependent on two fundamental characteristics that of good health and wellbeing and healthy ageing. The conceptualisation of ‘being old or older’ first needs to be considered. The use of 65 as a parameter to measure old age is a political and social construct. Baar et al. (2014) for example noted the tendency to use 60 to 65 as the entrance point to old age and although useful to establish understanding writers in the field of gerontology have argued against such use. Culturally older age can occur from 50 upwards (Baar et al. 2014) as consequence of poor health, education, financial situation and environment and there is no typical older person (World Health Organisation (WHO) 2018a). Other authors have defined no age categorisation boundaries but have referred to a third and fourth age. The third age being conceptualised as a life period full of opportunity and good health and wellbeing, whilst the fourth age is perceived as a period of decline, increasing dependency and ultimately death (Higgs and Gilleard 2015). Therefore, being older is difficult to define and for this chapter 60 will be used as a ‘marker of old age’. There are two lenses from which society view and perceive older people, first by some they are considered a burden, a drain on resources and are less valued. Alternatively, older people are considered wise, dependable individuals who contribute to society, local communities and family life. The increasing older demographic has both immense potential for society but also comes with challenges. This chapter will explore population growth, perceptions of ageing, health and wellbeing in later life, factors that negate against healthy ageing and will end with preventive strategies
    • Politicisation or Professionalisation? Exploring divergent aims within UK voluntary sector peer mentoring

      Buck, Gillian; University of Chester (Wiley, 2019-09-04)
      Meaningful ‘user involvement’ is an established aim of social work practice, and increasingly, an aspiration of criminal justice, yet there are unique challenges to participatory work within punitive contexts. Drawing upon a study of peer mentoring in the voluntary sector, this article unveils some core tensions related to (ex)service user involvement in criminal justice. Interviews with mentors, mentees, and key stakeholders, along with direct observations of practice, reveal that respondents often see their work as personal-political, emphasising the value of lived expertise and of collective action to address limiting social conditions. Simultaneously, however, mentoring is framed nationally and shaped locally by more established aims to correct, improve, and manage, individual ‘offenders’. There is, therefore, a fundamental tension between processes of politicisation, or coming together to assert a user voice and affect social change; and professionalisation, wherein mentors are co-opted into forms of practice they often critique.
    • The criminal justice voluntary sector: concepts and an agenda for an emerging field

      Tomczak, Philippa; Buck, Gillian; University of Nottingham; University of Chester (The Howard League and John Wiley & Sons Ltd, 2019-09-04)
      Volunteers and voluntary organisations play significant roles pervading criminal justice. They are key actors, with unrecognised potential to shore up criminal justice and/or collaboratively reshape social justice. Unlike public and for-profit agents, criminal justice volunteers and voluntary organisations (CJVVOs) have been neglected by scholars. We call for analyses of diverse CJVVOs, in national and comparative contexts. We provide three categories to highlight distinctive organising auspices, which hold across criminal justice: statutory volunteers, quasi-statutory volunteers and voluntary organisations. The unknown implications of these different forms of non-state, non-profit justice involvement deserve far greater attention from academics, policymakers and practitioners.