• Confidence

      Capper, Carole; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses professional confidence and its association with clinical competence and performance.
    • Conflict resolution for student midwives

      Steen, Mary; University of Chester. (Elsevier, 2011-03)
      Poor working relationships, aggressive behaviour and bullying within the midwifery profession are a common phenomenon, with student midwives reporting that they have either experienced or witnessed this within their clinical or educational environments. There is a need to address this unpleasant phenomenon and one way is to introduce conflict resolution strategies. This article describes and discusses how the Start Treating Others Positively (STOP) model has been adapted to develop an educational workshop to assist student midwives in enhancing and developing skills to manage conflict in their working and learning environments.
    • The consequences of pregnancy and birth for the pelvic floor

      Steen, Mary; Roberts, Taniya; University of Chester (Mark Allen, 2011-11-02)
      This article discusses the anatomy and physiology of the pelvic floor and the important role it plays during childbirth. It will also consider damage that can be caused to the pelvic floor and in the genital/rectal region. Urinary and faecal incontinence, perineal injury (naturally occurring or surgically induced) and haemorrhoids can cause a lot of distress and pain for many women following childbirth. Alleviating the distress and pain associated with these problems is vitally important and will be explored.
    • Considerations for evaluation of public health nutrition interventions in diverse communities

      Ellahi, Basma; University of Chester (Blackwell, 2017-06-02)
      Key messages Knowledge of ethnic groups and in particular their food habits is critical in evaluation Nutritionists should ensure they are culturally competent to work with diverse communities Evaluation of diverse groups requires consideration of language and cultural specific outcomes and literacy issues Identifying the factors that support successful nutrition interventions in diverse groups is challenging without the appropriate tools and measures
    • Constructing and delivering services of support: An Evaluation of the Northwest Post-placement Adoption Support Service.

      Harlow, Elizabeth; Mitchell, Andrew E. P.; Doherty, Pauline; Moran, Paul; University of Chester (University of Chester, 2015-04-01)
      The aims of the Post-placement adoption support services (PPASSs) were to enhance the lives of 40 adopted children by: improving their school attainment; improving their relationships with teachers, peers and family members; building their confidence and well-being; and reducing behavioural difficulties.
    • Constructing the Social, Constructing Social Work

      Harlow, Elizabeth; University of Chester (Routledge, 2017-06-06)
      Over recent times, social work has faced many challenges. This chapter does not focus on these challenges, but takes them into account when giving consideration to the construction of the profession in general, and the welfare regime of which it is a part. In giving consideration to this construction, the meaning of the ‘social’ component of ‘social work’ is deemed to be important to the identity of the profession, along with the socio-economic context from which it emerged, and to which it currently belongs. This theoretical foundation calls into question the essentialism of a fixed professional identity, but it also assumes that there is a body of practice known as social work which, over time has become associated with some prevailing features. A chronological approach to the construction of social work is taken and then a case study is offered. A concluding discussion follows on from the case study.
    • Constructions of meaning and personal identity in the decision-making of community safety professionals

      Ellis, Roger; Hogard, Elaine; Wheeler, Timothy J.; Bendall, Mark; Warren, Jeremy J. (University of Chester, 2010-09)
      This thesis takes an interdisciplinary approach to the study of the impact that constructions of meaning and personal identity have upon the processes of professional decision-making, in the delivery of community safety services. The research draws upon the previous work undertaken in the fields of psychology, sociology, social anthropology, criminology and community safety. The research was composed of five separate studies. Study one was a Delphi exercise to determine consensus of meaning for different community terms in common usage for policy makers, practitioners and academics. The research was able to define consensual meanings for ten of the thirteen terms presented, including crime prevention, crime reduction and community safety. Consensus was not achieved for the terms community engagement, respect and quality of life and suggestions are made which may account for this result. Study two utilised repertory grids to investigate the ways that community safety professionals might construe the decisions that they have to make as part of their duties. Studies three and four utilised bespoke ISA/lpseus instruments, whose structures were informed by the results from Study Two. These instruments were used to further explore the construals and worldviews of a variety of community safety professionals through six process postulates. It was found that whilst an individual's initial job role or gender did not have significant impact upon their professional decision-making, the training that they had received in community safety and the time that they had spent working in the field did have a significant impact upon their professional decision-making. It was also found that the groups of community safety professionals differed in their attitudes towards those members of society who are the target of community safety activity. Study five involved the generation and piloting of a survey instrument whose various sections were designed to validate the findings generated from the previous studies, as well as providing further data on the decision-making processes of those working within community safety. The final chapter presents the Warren Person Process Priority (WaPPP) layered model of decision-making that was derived from the data collected to inform the current thesis. The outer Person layer is defined by the four-way typology derived from the Procedural / Free-form and Cautious / Adventurous bi-polar constructs of identity types that were identified from the ISA/lpseus studies. The middle layer of the model describes a number of different decision-making processes that professionals may follow when making a judgement or coming to a conclusion. The order of the processes was given by the results of the survey pilot. The central portion of the model presents a number of factors that may impact upon professional decision-making, determined from the ethnographic work that informed the ISA/lpseus studies. The order of these factors was determined from the preparatory data collection instrument that was used with the ISA/lpseus studies and confirmed by the results of the survey pilot. Suggestions are made for further research that may expand upon the results presented in this thesis. These include a larger version of the Delphi, with an international panel of experts; correlation of the ISA/lpseus instruments with other validated instruments for the measurement of personality, identity and decision-making and an expansion of the survey pilot.
    • The core conditions of peer mentoring

      Buck, Gillian; University of Chester (SAGE, 2017-03-21)
      Peer mentoring is an increasing feature of UK criminal justice, yet very little is known about the micro dynamics of this practice. Drawing upon an ethnographic study, this article identifies a number of ‘core conditions’ underpinning the practice, including caring, listening and encouraging small steps. Mentors and mentees highlight these conditions as antidotes to what they often perceive as disconnected, unhearing and technocratic criminal justice practices. Peer mentoring is claimed to release suffering, to unburden the self of grief and to explore new directions, given that mentors ‘genuinely care’ and are tolerant of slip-ups. Respondents offer valuable insight into the experience of being intervened upon and advocate for manageable shifts, which could meaningfully improve services for a range of vulnerable and stigmatized populations. However, the article also introduces tensions, including the expectation of emotional toil for little financial reward and the context of an increasingly results-driven criminal justice system.
    • Cost of non-alcoholic steatohepatitis in Europe and the USA: The GAIN study.

      O'Hara, Jamie; Finnegan, Alan; Dhillon, Harpal; Ruiz-Casas, Leonardo; Pedra, Gabriel; Franks, Bethany; Morgan, George; Hebditch, Vanessa; Jönsson, Bengt; Mabhala, Mzwandile; et al. (2020-07-15)
      Non-alcoholic steatohepatitis (NASH) leads to cirrhosis and is associated with a substantial socioeconomic burden, which, coupled with rising prevalence, is a growing public health challenge. However, there are few real-world data available describing the impact of NASH. The Global Assessment of the Impact of NASH (GAIN) study is a prevalence-based burden of illness study across Europe (France, Germany, Italy, Spain, and the UK) and the USA. Physicians provided demographic, clinical, and economic patient information via an online survey. In total, 3,754 patients found to have NASH on liver biopsy were stratified by fibrosis score and by biomarkers as either early or advanced fibrosis. Per-patient costs were estimated using national unit price data and extrapolated to the population level to calculate the economic burden. Of the patients, 767 (20%) provided information on indirect costs and health-related quality of life using the EuroQOL 5-D (EQ-5D; n = 749) and Chronic Liver Disease Questionnaire - Non-Alcoholic Fatty Liver Disease (CLDQ-NAFLD) (n = 723). Mean EQ-5D and CLDQ-NAFLD index scores were 0.75 and 4.9, respectively. For 2018, the mean total annual per patient cost of NASH was €2,763, €4,917, and €5,509 for direct medical, direct non-medical, and indirect costs, respectively. National per-patient cost was highest in the USA and lowest in France. Costs increased with fibrosis and decompensation, driven by hospitalisation and comorbidities. Indirect costs were driven by work loss. The GAIN study provides real-world data on the direct medical, direct non-medical, and indirect costs associated with NASH, including patient-reported outcomes in Europe and the USA, showing a substantial burden on health services and individuals. There has been little research into the socioeconomic burden associated with non-alcoholic steatohepatitis (NASH). The GAIN study provides real-world data on the direct medical, direct non-medical, and indirect costs associated with NASH, including patient-reported outcomes in five European countries (UK, France, Germany, Spain, and Italy) and the USA. Mean total annual per patient cost of NASH was estimated at €2,763, €4,917, and €5,509 for the direct medical, direct non-medical, and indirect cost categories, respectively. [Abstract copyright: © 2020 The Author(s).]
    • The cost of severe haemophilia in Europe: the CHESS study

      O’Hara, Jamie; Hughes, David; Camp, Charlotte; Burke, Tom; Carroll, Liz; Diego, Daniel-Anibal G.; University of Chester; HCD Economics, Daresbury; The Haeomophelia Society, London; FedHemo, Madrid (BioMed Central, 2017-05-31)
      Background Severe haemophilia is associated with major psychological and economic burden for patients, caregivers, and the wider health care system. This burden has been quantified and documented for a number of European countries in recent years. However, few studies have taken a standardised methodology across multiple countries simultaneously, and sought to amalgamate all three levels of burden for severe disease. The overall aim of the ‘Cost of Haemophilia in Europe: a Socioeconomic Survey’ (CHESS) study was to capture the annualised economic and psychosocial burden of severe haemophilia in five European countries. A cross-section of haemophilia specialists (surveyed between January and April 2015) provided demographic and clinical information and 12-month ambulatory and secondary care activity for patients via an online survey. In turn, patients provided corresponding direct and indirect non-medical cost information, including work loss and out-of-pocket expenses, as well as information on quality of life and adherence. The direct and indirect costs for the patient sample were calculated and extrapolated to population level. Results Clinical reports for a total of 1,285 patients were received. Five hundred and fifty-two patients (43% of the sample) provided information on indirect costs and health-related quality of life via the PSC. The total annual cost of severe haemophilia across the five countries for 2014 was estimated at EUR 1.4 billion, or just under EUR 200,000 per patient. The highest per-patient costs were in Germany (mean EUR 319,024) and the lowest were in the United Kingdom (mean EUR 129,365), with a study average of EUR 199,541. As expected, consumption of clotting factor replacement therapy represented the vast majority of costs (up to 99%). Indirect costs are driven by patient and caregiver work loss. Conclusions The results of the CHESS study reflect previous research findings suggesting that costs of factor replacement therapy account for the vast majority of the cost burden in severe haemophilia. However, the importance of the indirect impact of haemophilia on the patient and family should not be overlooked. The CHESS study highlights the benefits of observational study methodologies in capturing a ‘snapshot’ of information for patients with rare diseases.
    • Cost-effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance

      Radhakrishnan, Muralikrishnan; McCrone, Paul; Lafortune, Louise; Everard, Linda; Fowler, David; Amos, Tim; Freemantle, Nick; Singh, Swaran P.; Marshall, Max; Sharma, Vimal; et al. (Wiley, 2017-08-31)
      Introduction Early Intervention Services (EIS) for psychosis are being implemented, internationally. It is important to learn from established examples and define the components and intensity of services that provide good value for money. This study aims to assess the cost-effectiveness of EIS according to how closely they adhered to the recommendations of the English Department of Health 2001 Policy Implementation Guide (PIG). Methods EIS from the National Eden Study were assessed using a measure of fidelity to the PIG that rated the presence or absence of 64 recommended items relating to team structure and practice. EIS were then classified into three groups: those with fidelity of 75-80 %, 81%-90 %, and 91-95 %. Patient-level resource use and outcomes were measured one year following inception into the service; costs were calculated and combined with quality-adjusted life years (QALYs) gained. Results At a threshold of £20,000 per QALY, the 81-90% fidelity group had a 56.3% likelihood of being the most cost-effective option followed by 75-80% fidelity at 35.8% and 91-95% fidelity group (7.9%). Conclusions The results from England suggest that striving to maximise fidelity may not be warranted, but that dropping below a certain level of fidelity may result in inefficient use of resources.
    • The course of negative symptom in first episode psychosis and the relationship with social recovery

      Gee, Brioney; Hodgekins, Jo; Fowler, David; Marshall, Max; Everard, Linda; Lester, Helen; Jones, Peter B.; Amos, Tim; Singh, Swaran P.; Sharma, Vimal; et al. (Elsevier, 2016-04-28)
      AIMS: To investigate trajectories of negative symptoms during the first 12months of treatment for first episode psychosis (FEP), their predictors and relationship to social recovery. METHOD: 1006 participants were followed up for 12months following acceptance into Early Intervention in Psychosis services. Negative symptom trajectories were modelled using latent class growth analysis (LCGA) and predictors of trajectories examined using multinomial regression. Social recovery trajectories - also modelled using LCGA - of members of each negative symptom trajectory were ascertained and the relationship between negative symptom and social recovery trajectories examined. RESULTS: Four negative symptom trajectories were identified: Minimal Decreasing (63.9%), Mild Stable (13.5%), High Decreasing (17.1%) and High Stable (5.4%). Male gender and family history of non-affective psychosis predicted stably high negative symptoms. Poor premorbid adolescent adjustment, family history of non-affective psychosis and baseline depression predicted initially high but decreasing negative symptoms. Members of the Mild Stable, High Stable and High Decreasing classes were more likely to experience stably low functioning than the Minimal Decreasing class. CONCLUSIONS: Distinct negative symptom trajectories are evident in FEP. Only a small subgroup present with persistently high levels of negative symptoms. A substantial proportion of FEP patients with elevated negative symptoms at baseline will achieve remission of these symptoms within 12months. However, elevated negative symptoms at baseline, whether or not they remit, are associated with poor social recovery, suggesting targeted interventions for service users with elevated baseline negative symptoms may help improve functional outcomes.
    • CPTs’ perceptions of their role satisfaction and levels of professional burnout

      Haydock, Deborah; Mannix, Jean; Gidman, Janice; University of Chester (Community Practitioner, 2011-05-19)
      This paper reports on a multi-method research project that explored perceived role satisfaction and professional burnout among community practice teachers (CPTs) while facilitating postregistration education and caseload management. A bespoke Satisfaction Questionnaire and the Maslach Burnout Inventory (Educators) were completed by 23 participants to elicit quantitative and qualitative data. Findings are presented in relation to three themes – aspects of the CPT role leading to satisfaction, aspects leading to dissatisfaction or burnout, and ways to enhance satisfaction and reduce burnout. The majority of CPTs were satisfied with their current role. A number of factors were elicited that affected participants’ perceived satisfaction. Respondents scored low levels of burnout overall, with high levels of personal accomplishment and low levels of depersonalisation. The relationship between participants’ satisfaction and their levels of burnout was not found to be statistically significant. However, mean scores on the emotional exhaustion subscale indicate moderate levels of emotional exhaustion. The paper concludes with recommendations to improve the support provided by employers and partner universities for CPTs.
    • 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.
    • Crisis management

      Barton, Janet; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses factors that lead to a crisis and the principles of crisis management.
    • Critical analysis of the Armed Forces Covenant Fund Trust Aged Veterans Fund

      Di Lemma, Lisa C G; orcid: 0000-0001-9161-1779; Finnegan, A; orcid: 0000-0002-2189-4926; Howe, S (BMJ Publishing Group, 2021-03-30)
      Background: Relatively little research is available regarding the specific needs of older military veterans and the services introduced to support them. In 2016, the Armed Forces Covenant Fund Trust launched the Aged Veterans Fund (AVF), to understand the impact that military service may have on ageing, and to support initiatives targeting their health and well-being. This fund was financed for 5 years and included 19 UK portfolio projects. Method: The paper presents a retrospective evaluation on the processes and impact of the AVF, with the intent of informing policy, educational services, service providers and stakeholders of the lessons learnt. The inclusion criteria was veterans and their families aged 65 years of age or over. In 2019, data were drawn from documentary evidence related to the programmes. Qualitative analysis were performed on 78 eligible sources and 10 themes were identified. Results: Programmes were rolled out via collaborative partnerships referrals, focusing on person-centred or skill-exchange approaches. Challenges were encountered, such as capacity and timelines issues. A limited amount of associated cost-savings was observed, even if examples of sustainability and high satisfaction were reported. Evidence was found of programmes boosting health and well-being outcomes, in raising awareness, and in positively impacting on clinical practice, such as re-admission rates. Conclusion: The AVF programmes were successful in their intent to provide support to older veterans and their families. The findings provide indicators of the next steps required for the support of ageing veterans. Further investigation of the cost-effectiveness of age-friendly veterans’ services is needed.
    • Critical thinking

      Harlow, Elizabeth; University of Chester (SAGE, 2012-11-12)
    • Cultural change in a learning disability secure service: The role of the ‘toggle’ group

      Astbury, Geoff; Lovell, Andy; Mason, Tom; Froom, Katy; University of Chester ; University of Chester ; University of Chester ; 5 Boroughs Partnership NHS Foundation Trust, Warrington (2011-04-01)
      This paper reports the findings of a study into the management of change within a learning disability service in transition from medium to low security status. The relationship between the service culture and resistance to change was a key consideration. A focus group approach was utilized with eight professionals from a range of disciplines meeting on six separate occasions, and the data was subsequently subject to thematic analysis. The study findings revealed markedly different perceptions of the response of the staff team to the implementation of change, with three groups adopting markedly different identities and allegiances. A dynamic group, embracing change and showing initiative, a strategically resistant group, and a third group, the ‘toggle’, swaying towards one of the other two groups according to changing circumstances. The paper concludes that the toggle group were extremely influential with regard to the implementation of change, and may be of significance in analysis of strategies of resistance.
    • Curriculum models and design

      Gidman, Janice; University of Chester (SAGE, 2010-10-29)
      This book chapter discusses curriculum design, and philiosophies of education and learning theories.
    • Curriculum planning and development

      Bryan, Ann; University of Chester (SAGE, 2010-10-29)
      This book chapter discusses the major influences on curriculum planning and development; stakeholder involvement in curriculum planning and development; mapping and benchmarking; and validation and on-going currency.