• The cancer care experiences of gay, lesbian and bisexual patients: A secondary analysis of data from the UK Cancer Patient Experience Survey.

      Hulbert-Williams, Nicholas J.; Plumpton, C.; Flowers, Paul; McHugh, Rhian; Neal, Richard; Semlyen, Joanna; Storey, Lesley; University of Chester; Bangor University; Glasgow Caledonian University; University of Leeds; University of East Anglia; Queen's University (Wiley, 2017-02-27)
      Understanding the effects of population diversity on cancer-related experiences is a priority in oncology care. Previous research demonstrates inequalities arising from variation in age, gender and ethnicity. Inequalities and sexual orientation remain underexplored. Here, we report, for the first time in the UK, a quantitative secondary analysis of the 2013 UK National Cancer Patient Experience Survey which contains 70 questions on specific aspects of care, and six on overall care experiences. 68,737 individuals responded, of whom 0.8% identified as lesbian, gay or bisexual. Controlling for age, gender and concurrent mental health comorbidity, logistic regression models applying post-estimate probability Wald tests explored response differences between heterosexual, bisexual and lesbian/gay respondents. Significant differences were found for 16 questions relating to: (a) a lack of patient-centred care and involvement in decision making, (b) a need for health professional training and revision of information resources to negate the effects of heteronormativity, and (c) evidence of substantial social isolation through cancer. These findings suggest a pattern of inequality, with less positive cancer experiences reported by lesbian, gay and (especially) bisexual respondents. Poor patient-professional communication and heteronormativity in the healthcare setting potentially explain many of the differences found. Social isolation is problematic for this group and warrants further exploration.
    • Cancer experiences in individuals with an intellectual disability: Results from a grounded theory study

      Flynn, Samantha; Hulbert-Williams, Nicholas J.; Hulbert-Williams, Lee; Bramwell, Ros; University of Chester (Wiley, 2015-04-28)
      Increasing numbers of people with an intellectual disability (ID) are diagnosed with cancer, partly due to increased life expectancy. However, there is a paucity of research exploring their cancer experiences.
    • Cancer Experiences in People with Intellectual Disabilities

      Hulbert-Williams, Nick; Hulbert-Williams, Lee; Bramwell, Ros; Flynn, Samantha (University of Chester, 2018-12-20)
      People with intellectual disabilities are increasingly being diagnosed with cancer due, in part, to increases in life expectancy for this population. Despite the growing number of people with cancer and intellectual disabilities, the cancer-related experiences of people with intellectual disabilities are under-researched. Person-centred approaches to research are needed to better understand the needs and psychosocial outcomes of people with cancer and intellectual disabilities. This thesis aims to better understand the cancer-related experiences of people with intellectual disabilities, and the impact on the people who support them. The thesis comprises four related studies: (1) a systematic review of psychosocial experiences of cancer in people with intellectual disabilities; (2) a qualitative study of cancer experiences in people with intellectual disabilities using thematic analysis informed by grounded theory; (3) a survey of UK oncology nurses’ attitudes and care perceptions towards people with intellectual disabilities; and (4) a feasibility study of an intervention to improve healthcare professionals’ perceptions of communicating with people with cancer and intellectual disabilities. Five themes emerged from the ten papers included in the systematic review: delayed diagnosis; information, communication, and understanding; negative psychological consequences; negative physical consequences; and social support. Six of the ten papers included data from the same ethnographic study of 13 people, highlighting a paucity of empirical research regarding the psychosocial cancer experiences of people with intellectual disabilities. The qualitative study indicated that people with intellectual disabilities were often excluded from conversations about their diagnosis, treatment, and ongoing care, and expressed confusion and anxiety about their cancer. Attempts to protect them from distress inhibited communication, but where additional support was offered, participants engaged more meaningfully in their experience and this should, therefore, be encouraged. In the qualitative study, oncology nurses were reported to be important figures in the care of patients with intellectual disabilities. The survey of oncology nurses highlighted that caring for cancer patients with intellectual disabilities may intensify their already difficult role; however, previous experience may ameliorate negative consequences. This sample identified their need for training about communicating with people with intellectual disabilities. The first three studies informed the development of a novel, brief, online, video-based intervention for healthcare professionals working with people with intellectual disabilities and cancer. The feasibility trial of this intervention indicated that there were problems with recruitment, high attrition, and intervention adherence. These problems were, most likely due to participants finding the content and delivery method to be unacceptable. It is clear that the intervention is not feasible in its current format, and that further theoretical and modelling work is needed before the intervention is feasibility tested again ahead of a definitive trial. This body of work has demonstrated that people with intellectual disabilities and cancer face multiple barriers to accessing cancer care, including informative and understandable communication with healthcare professionals. With appropriate support, psychological and physical outcomes can be improved for people with intellectual disabilities and cancer, but caring for people with cancer and intellectual disabilities can be challenging for paid and informal carers, and oncology staff. Difficulties with communication are bi-directional, and improving communication might be an appropriate first step to improving cancer experiences for this population, but developing effective interventions presents numerous feasibility challenges.
    • Cancer patients’ respect experiences in relation to perceived communication behaviours from hospital staff: analysis of the 2012-2013 National Cancer Patient Experience Survey

      Clucas, Claudine; University of Chester (Springer, 2015-10-05)
      Purpose: Respect experiences are poorly understood despite respect being central to professionalism in healthcare and patient well-being, and needed for optimal patient care. This study explores which patient-perceived communication behaviours from hospital staff contribute most to cancer patients’ respect experiences and account for variation in their experience by socio-demographic and clinical characteristics. Methods: Secondary analysis of data from the 2012-2013 National Cancer Patient Experience Survey of 45191 patients with a primary cancer diagnosis treated in English National Health Service trusts providing adult acute cancer services who provided data on experienced respect and dignity. Results: Both autonomy-supportive and caring/emotionally sensitive behaviours were associated with reported respect, although the latter showed stronger associations and accounted for most differences in reports of respect between patient groups. Differences in respect were found by gender, race/ethnicity, age, the presence of long-standing conditions, treatment response, time since first treated for cancer (p<.001), employment and type of cancer (p<.05). Conclusions: The study questions the tendency to conceptualise respect primarily in terms of autonomy-supportive behaviours and shows the relative contribution of autonomy-supportive and caring/emotionally sensitive behaviours in explaining disparities in respect experiences. More attention should be paid to affective communication behaviours from hospital staff to reduce disparities in respect experiences.
    • Care and trust: A new understanding

      Powell, Jason; Chen, Sheying; University of Chester; Pace University (Open Access Text, 2017-12-14)
      The paper is a critical review of the problems and implications of trust and in managing diversity in the British community care system. It is a system in need of strong diversity management in the light of the world economic downturn in recent years. Despite raft of policies on leadership in social care in the UK, the structural issues for why the needs of diverse groups are not met are difficult to understand at particular levels of analysis. The central problem has been lack of ‘trust’. The paper detangles the implications of different forms of trust in order to understand care relations in health contexts.
    • Cargo bikes: Distributing consumer goods

      Cox, Peter; Rzewnicki, Randy; University of Chester ; European Cyclists’ Federation (University of Chester Press, 2015-06-01)
      This book chapter considers the role of human powered vehicles: bicycles and tricycles, in this mundane distribution of consumer goods.
    • Caring for cancer patients with an intellectual disability: Attitudes and care perceptions of UK oncology nurses

      Flynn, Samantha; Hulbert-Williams, Lee; Bramwell, Ros; Stevens-Gill, Debbie; Hulbert-Williams, Nicholas J.; University of Chester and Institute of Psychology, Faculty of Education, Health and Wellbeing, University of Wolverhampton (Elsevier, 2015-05-08)
      Background: Caring for people with cancer or an intellectual disability (ID) is stressful: little is known about the combined impact of caring for cancer patients with an ID, though this is expected to be especially challenging. Method: Eighty-three nurses, working in oncology or a related field (i.e. palliative care) were recruited. Perceptions of caring for patients with and without an ID were measured, alongside potentially confounding information about participant demographic characteristics and perceived stress. Results: Participants felt less comfortable communicating with patients with an ID about their illness (F(1,82) = 59.52, p <0.001), more reliant on a caregiver for communication (F(1,82) = 26.29, p < 0.001), and less confident that the patient's needs would be identified (F(1,82) = 42.03, p < 0.001) and met (F(1,81) = 62.90, p < 0.001). Participants also believed that caring for this patient group would induce more stress, compared with patients without an ID (F(1,81) = 31.592, p < 0.001). Previous experience working with ID patient groups appears to mitigate some perceptions about providing care to this population. Conclusions: Caring for cancer patients with an ID may intensify this, already difficult, role. Through training and knowledge exchange, oncology nurse's confidence in communication, providing appropriate care, and positivity towards this patient group may be improved.
    • A case for taking the dual role of counsellor-researcher in qualitative research

      Fleet, Doreen; DasGupta, Mari; Reeves, Andrew; Burton, Amy; University of Staffordshire; University of Chester (Taylor & Francis, 2016-08-03)
      There is ongoing debate about whether the challenges of practice-based research in counselling, with clients’ discourses providing the raw data, can be overcome. This article begins by considering the argument of whether taking a dual role of counsellor-researcher within case study research is a legitimate qualitative approach. A case example using sand-tray in short-term therapy with adults from a pluralistic perspective is provided to demonstrate how the challenges of the dual role can be managed to produce effective research findings. It is suggested that this approach closes the gap between research and practice to produce findings that are highly relevant to the counselling context. The ethical considerations of taking a dual role of counsellor-researcher are considered, and opportunities and challenges when adopting this approach are identified.
    • Cashing in on curiosity and spectacle: The forensic patient and news media

      Morley, Sharon; Taylor, Paul J.; University of Chester (Taylor & Francis, 2016-05-24)
      Health and social care professionals are gatekeepers to, and custodians of, confidential service user information. In the United Kingdom (UK), police investigations have unveiled cases of payments being made to public service officials by journalists in return for service user information. The purpose of this discussion is to investigate such cases in the context of high security forensic care. This paper provides a discussion drawing upon two UK-based case studies of prosecutions of public service workers relating to the sale of confidential information. The analysis presented here illuminates upon the salient and connected issues at work that have led to the transgression of legal obligations and professional responsibilities/principles of confidentiality. A fuller reading of the context in which these transgressions occur, and motivations that exist, may well serve to inform policy, training, guidance or vigilance in relation to the preserving of service user information in the future.
    • Catchment asymmetry in Tabernas Desert (Almería, Spain)

      Lazaro, R.; Calvo-Cases, A.; Rodriguez-Caballero, E.; Arnau-Rosalén, E.; Alexander, R.; Rubio, C.; Cantón, Y.; Solé-Benet, A.; Puigdefábregas, J.; Estación Experimental de Zonas Aridas (CSIC), Almería, Spain; Inter-University Institute for Local Development, Department of Geography, Universitat de València. Spain; School of Science & Environment, Manchester Metropolitan University, United Kingdom; Department of Geography & International Development, Univ. of Chester, UK; Departamento de Agronomia, Universidad de Almería, Spain
      Abstract and e-Poster presented at Geoecology and Desertification, from physical to human factors. International Symposium in memory of Prof Juan Puigdefabregas (EcoDesert) Almería, February 2019.
    • Celebrity ambassador/celebrity endorsement – takes a licking but keeps on ticking

      Proctor, Tony; Kitchen, Philip J. (Informa UK Limited, 2018-01-25)
    • Chain reaction: interviewing interviewers. Positionality and qualitative research

      Pratesi, Alessandro; Runswich-Cole, Katherine; Manchester Metropolitan University (2010-07)
    • The challenge of relational referents in early word extensions: Evidence from noun-noun compounds

      Snape, Simon; Krott, Andrea; University of Chester; University of Birmingham
      Young children struggle more with mapping novel words onto relational referents (e.g., verbs) compared to non-relational referents (e.g., nouns). We present further evidence for this notion by investigating children’s extensions of noun-noun compounds, which map onto combinations of non-relational referents, i.e. objects (e.g., baby and bottle for baby bottle), and relations (e.g., a bottle FOR babies). We tested two- to five-year-olds’ and adults’ generalisations of novel compounds composed of novel (e.g., kig donka) or familiar (e.g., star hat) nouns that were combined by one of two relations (e.g., donka that has a kig attached (=attachment relation) versus donka that stores a kig (=function relation)). Participants chose between a relational (shared relation) and a non-relational (same colour) match. Results showed a developmental shift from encoding non-relational aspects (colour) towards relations of compound referents, supporting the challenge of relational word referents. Also, attachment relations were more frequently encoded than function relations.
    • Changes to the dispersive characteristics of soils along an evolutionary slope sequence in the Vera badlands, southeast Spain: Implications for site stabilisation

      Faulkner, Hazel; Alexander, Roy; Wilson, B. R.; University of Middlesex : University of Chester : University of New England, Australia (Elsevier, 2003-01-01)
    • Channel pattern of proglacial rivers: topographic forcing due to glacier retreat

      Marren, Philip M.; Toomath, Shamus C.; University of Melbourne (Wiley, 2014-02-14)
      Glacier retreat leads to changes in channel pattern during deglaciation, in response to changing water, sediment and base level controls. Recent ongoing retreat at Skaftafellsjökull, Iceland (c. 50m per year since 1998) has resulted in the formation of a sequence of river terraces, and several changes in river channel pattern. This paper compares widely used models of river channel pattern against the changes observed at Skaftafellsjökull. Doing this reveals the role of topographic forcing in determining proglacial channel pattern, whilst examining the predictive power and limitations of the various approaches to classifying river channels. Topography was found to play a large role in determining channel pattern in proglacial environments for two reasons: firstly, glacier retreat forces rivers to flow through confined moraine reaches. In these reaches, channels which theory predicts should be braided are forced to adopt a single channel. Secondly, proximal incision of proglacial rivers, accompanied by downstream aggradation, leads to changes in slope which force the river to cross channel pattern thresholds. The findings of this work indicate that in the short term, the majority of channel pattern change in proglacial rivers is due to topographic forcing, and that changes due to changing hydrology and sediment supply are initially relatively minor, although likely to increase in significance as deglaciation progresses. These findings have implications for palaeohydraulic studies, where changes in proglacial channel pattern are frequently interpretedas being due to changes in water or sediment supply. This paper shows that channel pattern can change at timescales faster than hydrological or sediment budget changes usually occur, in association with relatively minor changes in glacier mass balance.
    • Channel-specific daily patterns in mobile communication

      Aledavood, Talayeh; Lopez, Eduardo; Roberts, Sam G. B.; Reed-Tsochas, Felix; Moro, Esteban; Dunbar, Robin I. M.; Saramäki, Jari; University of Chester (Springer International Publishing, 2016-05)
      Humans follow circadian rhythms, visible in their activity levels as well as physiological and psychological factors. Such rhythms are also visible in electronic communication records, where the aggregated activity levels of e.g. mobile telephone calls or Wikipedia edits are known to follow their own daily patterns. Here, we study the daily communication patterns of 24 individuals over 18 months, and show each individual has a different, persistent communication pattern. These patterns may differ for calls and text messages, which points towards calls and texts serving a different role in communication. For both calls and texts, evenings play a special role. There are also differences in the daily patterns of males and females both for calls and texts, both in how they communicate with individuals of the same gender vs. opposite gender, and also in how communication is allocated at social ties of different nature (kin ties vs. non-kin ties). Taken together, our results show that there is an unexpected richness to the daily communication patterns, from different types of ties being activated at different times of day to different roles of channels and gender differences.
    • Chapter 5 Film: Using secondary data as a mechanism to support student learning

      Lafferty, Moira E.; University of Chester (Routledge, 2017-05-02)
      INTRODUCTION This chapter introduces readers to the concept of using feature films as a method for seminar tasks, formative and summative assessment within the social sciences. Drawing on personal experiences, reflection and student feedback examples are given as to how feature films have been used in a final year undergraduate sport psychology module. I begin by charting my own journey discussing how I came to use feature films in assessment. I identify the key literature which provided the evidence base for the task development and review the benefits and caveats to such an approach. Finally, along with a flow chart to help guide those who may wish to use the technique I comment on some future uses of the approach within assessment.
    • Characterising beach intertidal bar systems using multi-annual LiDAR data

      Miles, Andrew; Ilic, Suzana; Whyatt, Duncan; James, Mike R.; University of Chester; Lancaster University (Wiley, 2019-02-05)
      Intertidal bars are common in meso-macrotidal low-to-moderate energy coastal environments and an understanding of their morphodynamics is important from the perspective of both coastal scientists and managers. However, previous studies have typically been limited by considering bar systems two-dimensionally, or with very limited alongshore resolution. This paper presents the first multi-annual study of intertidal alongshore bars and troughs in a macro-tidal environment using airborne LiDAR data to extract three-dimensional bar morphology at high resolution. Bar and trough positions are mapped along a 17.5 km stretch of coastline in the northwest of England on the eastern Irish Sea, using eight complete, and one partial, LiDAR surveys spanning 17 years. Typically, 3 – 4 bars are present, with significant obliquity identified in their orientation. This orientation mirrors the alignment of waves from the dominant south-westerly direction of wave approach, undergoing refraction as they approach the shoreline. Bars also become narrower and steeper as they migrate onshore, in a pattern reminiscent of wave shoaling. This suggests that the configuration of the bars is being influenced by overlying wave activity. Net onshore migration is present for the entire coastline, though rates vary alongshore, and periods of offshore migration may occur locally, with greatest variability between northern and southern regions of the coastline. This work highlights the need to consider intertidal bar systems as three-dimensional, particularly on coastlines with complex configurations and bathymetry, as localised studies of bar migration can overlook three-dimensional behaviour. Furthermore, the wider potential of LiDAR data in enabling high-resolution morphodynamic studies is clear, both within the coastal domain and beyond.
    • #Cheshirehunger: Understanding Emergency Food Provision in West Cheshire

      Spencer, Alec; Ogden, Cassandra A.; Battarbee, Lynda; West Cheshire Foodbank, University of Chester, Trussell Trust (2015-03-01)
      A report exploring the use of foodbanks and the reasons behind their use, within the West-Cheshire region.
    • Chester College site and setting

      Hargreaves, Clifford (Governors of Chester College, 1989-01-01)
      This book chapter discusses the site of Chester College, covering building and land developments.