• Development and psychometric testing of the online Adolescent Diabetes Needs Assessment Tool (ADNAT)

      Cooper, Helen; Spencer, Joy; Lancaster, Gillian A.; Titman, Andrew; Johnson, Mark; Lwin, Rebekah; Wheeler, Sarah; University of Chester ; University of Chester ; Lancaster University ; Lancaster University ; Bolton University ; University of Chester ; University of Chester (World Biomedical Frontiers, 2015-01-16)
      World Biomedical Frontiers provides a platform for the exchange of the latest research progress, including strategic and emerging research areas such as diabetes. Their aim is to accelerate understanding of human health and improvetreatment of a variety of human diseases. Our article, published in the Journal of Advanced Nursing, was selected for their web based publication. It provides an abstract plus supplementary information on the research work associated with ADNAT.
    • Development of antenatal education to raise awareness of the risk of relationship conflict

      Steen, Mary; Downe, Soo; Graham-Kevan, Niki; University of Chester ; University of Central Lancashire ; University of Central Lancashire (Redactive Publishing, 2011-06)
      Background: Relationship conflict and abuse occurs in every day life and often starts or escalates during pregnancy with devasting health and well-being consequences, the most severe being loss of life. This paper is the second in a series of two - the first paper described and discussed the first phase of the study, exploring the experiences of participants attending Start Treating Others Positively, a UK, Leeds-based charity. Aim: To explore STOP's participants' views of what could be included in an antenatal parenting education session for expectant parents to enable and empower them to manage emotions and behaviour and prevent any relationship conflict escalating to abuse. Method: An exploratory study involving 20 parents attending sessions organised by STOP. The university's health ethics committee granted approval and the standards recommended by the NHS Research Governance Framework for service users' involvement in research were applied. During December 2007 and January 2008, a schedule of open and closed questions was used to guide interviews. Data analysis were conducted by a thematic analysis that involved the identification of emerging themes. Participants' suggestions of useful exercises and techniques to be included in an antenataleducation programme were recorded. Findings: Four themes emerged from the data: 'Why has nobody thought about it before?', 'Sharing the parenting,' 'learning to listen', 'Creating space for me and for you'. Exercises and techniques for an antenatal education programme were suggested that would increase awareness of the risks of relationship conflict and provide preventative methods. Conclusions: Participants' views and suggestions assisted in the development of a specific session on 'managing emotions, behaviour and any relationship conflict when becoming a parent'. Further research will be undertaken to measure the impact of this newly developed programme for expectant parents.
    • Diet and eating habits of expectant parents and families in Ras Al Khaimah, Emirates: an exploratory study.

      Steen, Mary; Mottershead, Richard; Idriss, Johaina; Parletta, Natalie; Ellahi, Basma; Kumardhas, Vijaya; University of South Australia; Higher Colleges of Technology, Ras Al Khaimah; United Arab Emirates University; University of South Australia; University of Chester; RAK Medical and Health Sciences University (Royal College of Midwives, 2017-06-31)
      Background. Obesity is a problem that has reached epidemic proportions around the globe, attaining an alarming level in Arab Gulf countries. Poor diets and a lack of essential nutrients being consumed by pregnant women has been acknowledged, and it is recognised that parental eating habits and preferences can contribute to the development of unhealthy diets in children. However, there have been no studies exploring diet and eating habits that have targeted expectant parents and their families in the United Arab Emirates (UAE). Aim. To explore the diet and eating habits of expectant parents and their families during pregnancy and test the feasibility of introducing an EatWell Assist workshop and diary, to increase awareness of healthy eating to improve family diet and nutritional status. Method. Participants were recruited from three study sites in Ras Al Khaimah, UAE. Initially, a purposive sample of 20 expectant mothers and 10 expectant fathers were interviewed. Phase 2 of the study recruited 15 expectant mothers and five female family members or close friends to attend on e of three EatWell Assist workshops and complete a diary for four weeks. Thematic analysis of interview transcripts and simple analysis of the structured questionnaire was undertaken. Results. The thematic analysis identified seven main themes for expectant mothers’ current diets and eating habits. These were: knowledge and understanding, eating patterns, fast foods, using supplements, likes and dislikes, body image, influences. Five similar main themes emerged for expectant fathers but the theme, ‘no supplements’, was in contrast to expectant mothers’ ‘using supplements’, and ‘body image’ did not emerge. Overall, the findings demonstrated the workshop evaluations were positive and participants gained knowledge and valued the opportunity to attend. Completing an EatWell food diary enabled expectant mothers to improve their diets and eating habits. Conclusions. Expectant parents’ current diet and eating habits were significantly influenced by the availability of a Western diet as well as traditional foods and cultural eating preferences. There was some improvement in healthy eating behaviours after attending a healthy eating workshop and keeping a daily food diary. Expectant fathers’ work commitments and women’s preferences inhibited opportunities for them to receive healthy eating education. Strategies to engage with expectant fathers need to be implemented and online education options may be worth considering.
    • Dietary assessment in minority ethnic groups: A systematic review of portion size estimation instruments relevant for the UK

      Almiron-Roig, Eva; Aitken, Amanda; Galloway, Catherine; Ellahi, Basma; MRC Elsie Widdowson Laboratory, Cambridge, UK. Centre for Nutrition Research, University of Navarra, Pamplona, Spain. Faculty of Health and Social Care, University of Chester, Chester, UK (Oxford University Press, 2016-03-14)
      Context: Dietary assessment in minority ethnic groups is critical for surveillance programmes and for implementing effective interventions. A major challenge is the accurate estimation of portion sizes for traditional foods/dishes. Objective: To systematically review published records up to 2014 describing a portion size estimation element (PSEE) applicable to dietary assessment of UK-residing ethnic minorities. Data sources, selection, extraction: Electronic databases, internet sites, and theses repositories were searched generating 5683 titles from which 57 eligible full-text records were reviewed. Data analysis: Forty-two publications aimed at minority ethnic groups (n=20) or autochthonous populations (n=22) were included. The most common PSEE (47%) were combination tools (e.g. food models and portion size lists); followed by portion size lists in questionnaires/guides (19%); image-based and volumetric tools (17% each). Only 17% PSEE had been validated against weighed data. Conclusions: When developing ethnic-specific dietary assessment tools it is important to consider customary portion sizes by sex and age; traditional household utensil usage and population literacy levels. Combining multiple PSEE may increase accuracy but such tools need validating.
    • Dietary intake patterns of South Asian men attending mosques in Burnley, UK

      Ellahi, Basma; Chow, C.; Fitzgerald, Sarah; Dikmen, Derya; University of Chester ; University of Chester ; University of Chester ; Hacettepe University (Webmedcentral.com, 2014-10)
      Objective: To characterise the diet of South Asian males attending mosques in Burnley in order to focus intervention strategies to improve nutrition-related health in the community. Design: Cross sectional survey of Muslim men in Burnley, Lancashire UK. Muslim men (n=141) aged 15-67 years who consented were recruited. Subjects completed a food and health questionnaire and a 24 hour dietary recall (repeated) and provided self-reported anthropometric data. Results: Data revealed significant dietary under-reporting in the sample with a mean value of 78.0% of the estimated average intake (EAR) for energy specific to age group reported. Under-reporting was more likely as the body mass index (BMI) of subjects increased. Similar proportions of total energy were derived from protein but a greater percentage of energy was provided by total fat and a smaller proportion by total carbohydrate when compared with white British males. Saturated fatty acids constituted half the proportion of total food energy yet mono-unsaturated fatty acid intake was low in comparison. All (except the 46-67) year old age group consumed greater than 6g of salt a day. Conclusions: The study identifies several areas with the potential for health improvement. Subjects should reduce total fat intake and redistribute fat intake to more favourable proportions, with more emphasis on monounsaturated fat sources. Further dietary modifications include reducing salt intake and increasing non-starch polysaccharide consumption. Access to mosques for use as a health assessment and promotion environment is an important avenue for ensuring effective communication of messages for Muslims.
    • Digital Mental Health in the Wild: An Adapted Grounded Theory Study

      Mitchell, Andrew; Bergin, Aislinn D. (University of Chester, 2017-12)
      This study explores Digital Mental Health (DMH), referring to the use of digital technologies in mental health, from the perspective of users and system builders – individuals ‘in the wild’. Using an adapted constructive Grounded Theory Methodology (Charmaz, 2014), it qualitatively explores DMH and how it is applied to everyday life. Interviews with users, developers and academics were supported by data collected from extant documents and observations. Findings addressed the complexity of development and use, where differences in priority between the technical and clinical paradigms in development challenged the usability and usefulness for consumers of DMH. Changes implemented within, and the transience of, DMH resources were constructed by users as potentially distressing and difficult for system builders to mitigate. DMH is a new and emerging way to self-manage mental health. However, whilst it provides options, it does not inform as to how to choose and, whilst it supports change, it is not in itself motivating. In understanding the role of DMH it is essential to consider it alongside existing mental health prevention and management. DMH is constructed not as use of a single resource, but rather a toolkit for self-management where resources are used in different ways and at different times. Some will be integral whilst others may be used more occasionally. Many of the participants identified the difficulties and challenges of managing their mental health with only traditional tools and interventions available, and how DMH offered additional ways of doing so. DMH offers users autonomy and a way to explore their experiences in a simulated environment, contributing to its purpose as a supplement to existing mental health provision. Understanding how DMH can supplement the existing treatment and management of mental health is essential. One key area is addressing the opportunities provided by the simulative functions of new technologies and how mobile technologies have enabled these to become part of the everyday lives of so many people. Finally, the concept of Technology-asAdvocate was constructed to identify the ways that technology can help individuals to help themselves. This study recommends that DMH stakeholders invest and conduct further research that bring together clinical, technical and user paradigms to better understand how changes to devices and resources impact users. It positions DMH within the initial stages of help-seeking and addresses its role as one of many tools in the individual’s self-care. It proposes that technology be viewed as supporting self-advocacy and theorises that future technologies, such as personal assistants, be designed to advocate rather than to dictate. It is vital that policymakers recognise the impact of changes for users who find resources that support them in their mental health and apply them within their everyday life.
    • Dignity

      Ridgway, Victoria; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses the concept of dignity in healthcare.
    • Disability studies

      Lovell, Andy; University of Chester (SAGE, 2010-02-15)
      A discussion of the medical and social models of disability in the context of the implications for the individual.
    • The discrepancy between actual and unreported incidents of violence in a learning disability nursing service

      Skellern, Joanne; Lovell, Andy; University of Chester (South West Yorkshire Mental Health NHS Trust and the University of Huddersfield, 2008-10)
      This study reports on research carried out within the Learning Disability Division of a major Mental Health NHS Trust in the North of England, and relates to the discrepancy between the actual number of incidents of violence and aggression and those reported. The literature review demonstrated that violence is a particular issue for nurses, particularly those working in the areas of mental health and learning disability where studies have indicated that as many as one in five may be affected. A questionnaire was distributed to all learning disability nurses currently employed in the Trust, a total of 411, with a response rate in excess of 40%. The study revealed that a discrepancy does exist between actual and reported incidents of violence within the Trust. It confirmed previous claims that the predominant difficulty is cultural, violence being regarded as part of the job and non-reporting primarily revolving around perceptions of incidents being considered 'minor', not worth the time to complete the paperwork. The paper concludes that more work is needed to achieve a united, consistent approach across the NHS, in order that a high quality, accessible service for people with learning disabilities and complex needs can be delivered without violence being considered an acceptable part of the job.
    • Disease prevention

      Massey, Alan; University of Chester (SAGE, 2008-11-20)
      This book chapter discusses disease prevention as a central pillar of public health practice.
    • Diversity

      Bailey-McHale, Julie; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses the concepts of diversity and difference in a healthcare setting.
    • Diversity and equality

      Mason-Whitehead, Elizabeth; University of Chester (SAGE, 2010-10-29)
      This book chapter discusses equality and diversity, and widening participation in higher education.
    • Diversity in ageing, reductive welfare and potential new ways of utilising ethics in social work with Older People

      Carey, Malcolm; University of Chester (Routledge, 2019-01-15)
      This chapter examines some ethical and political challenges generated by the increasingly complex needs of an ageing society upon social work. It concentrates on the UK as a case study and critically evaluates related age-graded policies and practices relating to social work and care. The chapter includes a discussion of the on-going tensions between social diversity within an ageing society and the shrinking of formal care provision, alongside the impact of professional codes of ethics.
    • Do health consultations for people with learning disabilities meet expectations? A narrative literature review

      Chapman, Hazel M.; Lovell, Andy; Bramwell, Ros; University of Chester (Wiley, 2018-04-06)
      Aim: To explore the benefits and disadvantages of annual health checks for people with learning disabilities, including: • What are the rationales and outcome measures for health checks? • How well do health checks meet the needs of people with learning disabilities? • What areas does research in this topic need to focus on in the future? Background Health consultations are an interpersonal activity that influence health outcomes and attitudes towards self and health professionals for people with learning disabilities. Annual health checks have been introduced to improve health inequalities for people with learning disabilities Method A narrative literature review of health care for people with learning disabilities was undertaken to evaluate health care for this population, and specifically the outcomes from annual health checks. Findings: While annual health checks have made some improvements in terms of health outcomes, attendance for appointments is still low, provision is variable and experiences of health checks for people with learning disabilities are under-researched. Conclusions: Service-user-led research into their health experiences is needed. Research into the attitudes and experiences of health professionals in relation to people with learning disabilities is needed. Health care inequalities are only being partially addressed – improvement is needed in terms of service user experience and engagement.
    • Does integrated health and care in the community deliver its vision? A workforce perspective

      Wain, Linda Marie; University of Chester
      Purpose –The purpose of this paper is to explore and capture workforce perceptions, experiences and insights of the phenomena of integrated care (IC) in a community health and care NHS trust in England; including whether there are any associated factors that are enablers, barriers, benefits or challenges; and the level of workforce engagement in the process of integrated health and care. Design/methodology/approach – A qualitative design based on an interpretivist research paradigm was used with a purposive sampling technique. Five in-depth semi-structured interviews were conducted with community nursing, social workers and allied health professionals. Colaizzi’s (1978) descriptive phenomenological seven-step method was applied to analyse data, with the emergence of 170 significant statements, 170 formulated meanings and 8 thematic clustering of themes to reveal 4 emergent themes and 1 fundamental structure capturing the essential aspects of the structure of the phenomenon IC. Findings – This study revealed four interdependent emergent themes: (1) Insight of IC and collaboration: affording the opportunity for collaboration, shared goals, vision, dovetailing knowledge, skills and expertise. Professional aspirations of person-centred and strength-based care to improve outcomes. (2) Awareness of culture and professionalism: embracing inter-professional working whilst appreciating the fear of losing professional identity and values. Working relationships based on trust, respect and understanding of professional roles to improve outcomes. (3) Impact of workforce engagement: participants felt strongly about their differing engagement experience in terms of restructuring and redesigning services. (4) Impact of organisational structure: information technology (IT) highlighted a barrier to IC as differing IT platforms prevent interoperability with one system to one patient. Shared positivity of IC, embracing new ways of working. Originality/value – This study proposes considerations for future practice, policy and research from a local, national and global platform, highlighting the need for any IC strategy or policy to incorporate the uniqueness of the “voice of the workforce” as a key enabler to integration developments, only then can IC be a fully collaborative approach.
    • Does preceptorship support newly qualified midwives to become confident practitioners?

      Black, Sophie E.; University of Chester (British Journal of Midwifery, 2018-12-05)
      Aim: The aim of this literature review is to analyse the literature in order to answer the research question of ‘does preceptorship for newly qualified midwives support them to become competent and confident practitioners?’ Methods: Using a systematic review process, literature was searched for and using an inclusion/exclusion criteria either eliminated or deemed appropriate to use. There were six pieces of relevant literature that met the inclusion criteria. Themes were derived from the chosen pieces of literature via thematic analysis and analysed. Results: The themes derived from the literature consisted of two main themes; a named lead for the preceptorship programme was beneficial and the time that midwives had to complete the programme was insufficient. Three sub-themes were also identified as important consisting of; feedback and reflection, supernumerary time and ability of the preceptor. Conclusion: There is an evident lack of primary research into newly qualified midwives, preceptorship and gaining competence and confidence. More primary research is needed to assess this notion. In addition, preceptors also need to be trained to ensure they have the right attributes to adequately support, teach and assess junior midwives.
    • Does the Association between Depressive Symptomatology and Physical Activity Depend on Body Image Perception? A Survey of Students from Seven Universities in the UK

      El Ansari, Walid; Stockton, Christine; Phillips, Ceri; Mabhala, Mzwandile A.; Stoate, Mary; Adetunji, Hamed; Deeny, Pat; John, Jill; Davies, Shân; Parke, Sian; et al. (MDPI, 2011-01-25)
      This cross-sectional study assessed the association between depression and PA in university students of both genders and the role of body image perception as a potential effect modifier. Undergraduate students (N = 3706) from seven universities in the UK completed a self-administered questionnaire that assessed sociodemographic information; a range of health, health behaviour and health awareness related factors; the modified version of Beck’s Depression Inventory (M-BDI); educational achievement, and different levels of physical activity (PA), such as moderate PA (at least 5 days per week moderate exercise of at least 30 minutes), and vigorous PA (at least 3 days per week vigorous exercise of at least 20 minutes). Only 12.4% of the sample achieved the international recommended level for moderate PA, and 33.1% achieved the recommendations for vigorous PA. Both moderate and vigorous PA were inversely related to the M-BDI score. Physically active students, regardless of the type of PA, were significantly more likely to perceive their health as good, to have higher health awareness, to perform strengthening exercises, and to be males. The stratified analyses indicated that the association between depression and PA differed by body image. In students perceiving their body image as ‘just right’, moderate (>4th percentile) and high (>5th percentile) M-BDI scores were inversely related to vigorous PA. However, in students who perceived their body image as ‘overweight’, the inverse association was only significant in those with high M-BDI scores. We conclude that the positive effect of PA on depression could be down modulated by the negative impact of a ‘distorted’ body image on depression. The practical implications of these findings are that PA programmes targeting persons with depressive symptoms should include effective components to enhance body image perception.
    • Domestic violence: A multi-professional approach for healthcare practitioners

      Keeling, June J.; Mason, Tom; University of Chester (Open University Press, 2008-05-01)
      This book takes a multi-agency approach to domestic violence and looks at a large range of issues that impact on those working in the health and social care fields. It begins with identification of situations where abuse may occur, including intimate partner violence, child and adolescent abuse, same-sex violence and elderly abuse. The book considers the commonalities for survivors of abuse - such as the right to feel safe and protected from violence - and evaluates how health and social care professionals can work towards a positive outcome for all of the individuals involved.
    • Drug action: The therapeutic effect

      Robertson, Deborah A. F.; University of Chester (Mark Allen Publishing, 2017-05-13)
      Abstract In this article in the series of ‘bite sized’ pharmacology, we will look at the concept of drug action- the therapeutic effect of the medications we give. It is important that prescribers are aware of factors that can affect drug action and the time to onset of and subsequent duration of the desired therapeutic effect. We will look at factors that affect these two important areas of drug action. Knowledge of these factors can assist the prescriber when deciding on doses and dose schedules to ensure that patients receive their medications at the correct dosing, by the correct route and in the right formulation to ensure optimum therapeutic effect. It also helps the prescriber understand why dose adjustments are made or some drugs are avoided in patients with hepatic or renal impairment.
    • Drug calculations in Alzheimer's disease and anxiety

      Khan, Nahim; University of Chester (2015-07-02)
      The article uses a case study to give examples of calculations that may be encountered with patients who have Alzheimer's dementia and benzodiazepines