• The UK Welfare State System: With Special Reference to the Mental Health Care System

      Taylor, Paul J.; Powell, Jason; University of Chester (Routledge, 2017-01-13)
      This chapter explores the welfare state in the United Kingdom. We critically review its historiography, major institutions and contemporary issues relating to its sustainability. We draw out one feature of the welfare state via an in depth case study: its mental health care system focusing from the legacy of Thatcherism to the present.
    • Ultra-brief non-expert-delivered defusion and acceptance exercises for food cravings: A partial replication study

      Hulbert-Williams, Lee; Hulbert-Williams, Nicholas J.; Nicholls, Wendy; Williamson, Sian; Poonia, Jivone; Hochard, Kevin D.; University of Chester (SAGE, 2017-03-10)
      Food cravings are a common barrier to losing weight. This paper presents a randomised comparison of non-expert group-delivered ultra-brief defusion and acceptance interventions against a distraction control. Sixty-three participants were asked to carry a bag of chocolates for a week whilst trying to resist the temptation to eat them. A behavioural rebound measure was administered. Each intervention out-performed control in respect of consumption, but not cravings. These techniques may have a place in the clinical management of food cravings. We provide tentative evidence that the mechanism of action is through decreased reactivity to cravings, not through reduced frequency of cravings.
    • Unconventional in all respects: same-sex, married and living apart together

      Pratesi, Alessandro; University of Chester (2016-06)
      New, emerging forms of relationships, intimacies and care represent some of the most important challenges facing individuals, society and public policy today. Increasingly, due to work-related geographical mobility, several families and partners live separately and are forced, as such, to entwine love and care relationships at a distance. How far are alternative family models and non-conventional partnering—such as ‘living apart together’ (LAT) couples, same sex couples, solo living persons, or indeed relations ‘beyond the family’, such as friendship—seen as equally valid and entitled? What are their multiple challenges, opportunities and implications? Long distance relationships and caring at a distance may be connected with emotional and psychological exhaustion but also gratification, reward and empowerment; above all, they possess important implications in terms of social justice, equality and citizenship. The expression ‘world families’ (Beck and Beck-Gernsheim, 2014) includes a heterogeneous and tension-filled set of social actors who share in common the potentiality to bridge traditional distinctions between public and private, centre and periphery, national and international, able-bodied and physically/cognitively impaired, heterosexual and homosexual, bypassing dichotomous ideas of inclusion/exclusion which typically characterise the concept of citizenship. This concept resonates with the notion of ‘cultural rights’ described by Pakulski (1997) in terms of a new set of claims including the right to symbolic presence and visibility vs. marginalisation; the right to dignifying representation vs. stigmatisation; and the right to affirmation and propagation of identity vs. assimilation. Among the numerous issues concerning the need to provide different social actors with fair and adequate responses, James (2014) emphasises that of the social and ethical framing of the problem, which requires going beyond unilateral, inflexible and value-neutral definitions of entitlement to rights. More specifically, the author suggests the necessity to ground the ethics of rights to an ethics of care through which fundamental questions of difference/identity, inclusion/exclusion, and mobility/belonging are negotiated. This requires shifting the focus upon the micro level of analysis and looking at the spaces where the situated actions and interactions occur; at the ways, in other words, in which people constantly construct and negotiate their sense of entitlement and belonging. Drawing on recent work on families, relationships, intimacies and caring for distant others and contextualising it within the specific and still unexplored context of LAT same-sex couples, this paper examines the moral, sociological and institutional geographies of these less visible chains of care and affection and their unequally entitled rights and visibility. The literature review of the current state-of-the-art is empirically grounded on self-ethnographic work analysing and discussing the case of a same-sex, transnational, LAT married couple.
    • Unconventional relationships, positive marginalities and citizenship

      Pratesi, Alessandro; University of Chester (Universitat Oberta de Catalunya, 2018-07-31)
      Long distance relationships and caring at a distance may be connected with emotional and psychological exhaustion but also gratification, reward and empowerment; above all, they possess important implications in terms of social justice, equality and citizenship. The expression ‘world families’ (Beck and Beck-Gernsheim, 2014) includes a heterogeneous and tension-filled set of social actors who have in common the potential to bridge traditional distinctions between public and private, centre and periphery, national and international, able-bodied and physically/cognitively impaired, heterosexual and homosexual, bypassing dichotomous ideas of inclusion/exclusion which typically characterise the concept of citizenship. These families represent a group of very different social actors, including couples of mixed cultures and ethnicities, low-paid migrant workers, skilled migrant workers, asylum seekers, refugees, distant families, etc. who challenge our culturally homogenous understanding of family and society and are defined therefore as ‘pioneers of cosmopolitanism’ and cultural diversity. Drawing on recent work on families, relationships, intimacies and caring for distant others and contextualising it within the specific and still unexplored context of Living Apart Together (LAT) same-sex couples, this article examines the moral, sociological and institutional geographies of these less visible chains of care and affection and their unequally entitled rights and visibility. The literature review is combined with auto-ethnographic work analysing and discussing the case of a married, same-sex, transnational, Living Apart Together (LAT) couple. This article suggests that by looking at what happens at the level of emotion-based, micro-situated interactions we can get some crucial insights into the changing nature of families, intimacies and relationships and their multiple implications in terms of social inclusion, entitlement to rights/citizenship and social change. It is a form of relational, emotion-based and micro-situated social inclusion and entitlement to rights/citizenship which is occurring, on a daily basis, in the interstices of people’s interactions even when such change still meets several obstacles at the structural, political and institutional level.
    • Undermining position effects in choices from arrays, with implications for police lineups

      Palmer, Matthew; Sauer, James; Holt, Glenys; University of Tasmania; University of Chester (American Psychological Association, 2017-03)
      Choices from arrays are often characterized by position effects, such as edge-aversion. We investigated position effects when participants attempted to pick a suspect from an array similar to a police photo lineup. A reanalysis of data from 2 large-scale field studies showed that choices made under realistic conditions—closely matching eyewitness identification decisions in police investigations—displayed edge-aversion and bias to choose from the top row (Study 1). In a series of experiments (Studies 2a–2c and 3), participants guessing the location of a suspect exhibited edge-aversion regardless of whether the lineup was constructed to maximize the chances of the suspect being picked, to ensure the suspect did not stand out, or randomly. Participants favored top locations only when the lineup was constructed to maximize the chances of the suspect being picked. In Studies 4 and 5, position effects disappeared when (a) response options were presented in an array with no obvious center, edges, or corners, and (b) instructions stated that the suspect was placed randomly. These findings show that position effects are influenced by a combination of task instructions and array shape. Randomizing the location of the suspect and modifying the shape of the lineup array may reduce misidentification.
    • Understanding Aging

      Powell, Jason; University of Chester (Nova Science Publishers, 2013-05-19)
      An examination of major theories of ageing and relevance to social policy and professional practice.
    • Understanding Illness, Crisis and Loss

      Powell, Jason; University of Chester (Sage, 2014-07-01)
      This issue of the Journal brings together a number of important articles on illness, crisis, and loss. This issue shines light on illness, crisis, and loss as central forces shaping our personal experiences, social life, and order. The articles all, in one way or another, draw on various disciplines relating to education, sociology, philosophy, and psychology to provide different perspectives on the interrelationships of illness, crisis, and loss, showing how they contribute to social change and how the meanings of illness, crisis, and loss are generated to serve social functions but used to make sense of personal narratives in contemporary society.
    • Understanding old age and victimisation: a critical exploration

      Powell, Jason; Wahidin, Azrini; University of Chester; Nottingham Trent University (Emerald, 2008-06-14)
      The purpose of paper is to shine light on the under‐theorised relationship between old age and victmisation. In classical criminological studies, the relationship between “age”, victimisation and crime has been dominated by analysis of younger people's experiences. This paper aims to address this knowledge deficit by exploring older people's experiences by linking it to the social construction of vulnerability.
    • Understanding risk and old age in western society

      Powell, Jason; Wahidin, Azrini; Zinn, Jens; University of Chester; Kent University; Kent University (Emerald, 2007-01-05)
      The purpose of this paper is to explore the concept of “risk” in relation to old age. Part of this reflexive response to understanding risk and old age is the importance of recognising self‐subjective dimensions of trust, biographical knowledge and resources.
    • Understanding self-respect and its relationship to self-esteem

      Clucas, Claudine; University of Chester (Sage, 2019-10-21)
      The concept of self-respect has received little attention in the psychological literature and is not clearly distinguished from self-esteem. The present research sought to empirically investigate the bases of self-respect by manipulating adherence to morals together with interpersonal appraisals, or task-related competence, in hypothetical scenarios (Studies 1a and 1b) and a situation participants relived (Studies 2 and 3). Participants’ levels of state self-respect and self-esteem were measured. Studies 1-3 found main effects of adherence to morals on self-respect, with self-respect mediating the effect of adherence to morals on self-esteem, but little support for competence and interpersonal appraisals directly influencing self-respect. Self-respect uniquely contributed to anticipated/felt self-esteem alongside competence or interpersonal appraisals. The pattern of results supports the conceptualisation of self-respect as a component of self-esteem associated with morally principled conduct, distinct from performance and social self-esteem. The findings have implications for our understanding of self-esteem and moral behaviour.
    • Understanding the Voluntary Sector: Critical Success Factors – A Case Study

      Powell, Jason; University of Chester (Nova Science Publishers, 2012-10-23)
      One of the key issues in recent times in England is the inter-relationship between voluntary organizations and sustainability. It is very tempting to view voluntary agencies rather like very fragile black boxes adrift on a turbulent sea and at the mercy of powerful social, economic and political pressures. The direction of their journey and their very survival is determined by critical success factors. Although the spate of studies have undoubtedly advanced the state of knowledge about voluntary organizations, very little is known about the internal composition and operation of the black boxes and even less about the way in which internal factors interact within the external world. This book examines the factors that impinge upon opening and understanding the black box such as governance and quality, leadership, workforce, performance, partnerships and finance and funding.
    • Unequally entitled citizens: towards a micro-situated and emotion-based model of social inclusion

      Pratesi, Alessandro; University of Chester (Franco Angeli Editore, 2018)
      This paper illustrates a micro-situated and emotion-based model of social inclusion aimed to overcome current limitations of the concept of citizenship. A growing number of critical theorisations of care work, intimacy and citizenship from feminist, multicultural and global perspectives support the argument that nonconventional forms of intimacy and care represent an opportunity to explore possible sites of resistance against macro-structural forces while at the same time avoiding marginalisation. The theoretical contribution illustrated in this paper discusses the extent to which a micro-situated and emotion-based model of social inclusion can be applied to several types of unequally entitled citizens in different cultural contexts. Its overall objective is developing new perspectives to understand the relationship between individuals, local communities and political institutions and to grasp useful insights into how people across the globe resourcefully “do citizenship” and social inclusion through care practices and the emotional dynamics revolving around them. In other words, to explore and understand how new, creative ways to define citizenship and social inclusion can be activated at the local level of micro-interactions even when forms of institutional exclusion and racism persist at a structural and political level. The new perspective on citizenship and social inclusion emerging from the proposed theoretical model challenges common assumptions on the problematic nature of migration and reframes this latter as an integral part of the process of human, social and economic development.
    • The unidirectional relationship of nightmares on self-harmful thoughts and behaviors

      Hochard, Kevin D.; Heym, Nadja; Townsend, Ellen; University of Chester ; Nottingham Trent University ; University of Nottingham (American Psychological Association, 2015-03-01)
      Understanding the direction of the predictive relationship between nightmares and suicidal behaviors is important to model its underlying mechanisms. We examine the direction of this relationship and the mediating role of negative affect. A fixed interval diary study obtained pre-sleep and post-sleep measures of affect, nightmares, and self-harmful thoughts and behaviors (SHTBs) from 72 university students (88.9% female). The results show predictive utility of nightmares on SHTBs - indicating a four-fold increased risk of SHTBs. Additionally, results support the suggestion of a unidirectional predictive influence (of nightmares on likelihood of SHTBs but not vice versa). Moreover, post-sleep negative affect partially mediated the relationship between nightmares and post-sleep SHTBs. This empirically validates assumptions of directionality for future models.
    • Universal BRCA1/BRCA2 testing for ovarian cancer patients is welcomed, but with care: How women and staff contextualise experiences of expanded access

      Shipman, Hannah; Flynn, Samantha; MacDonald-Smith, Carey; Brenton, James; Crawford, Robin; Tischkowitz, Marc; Hulbert-Williams, Nicholas J. (2017-05-24)
      Decreasing costs of genetic testing and advances in treatment for women with cancer with germline BRCA1/BRCA2 mutations have heralded more inclusive genetic testing programs. The Genetic Testing in Epithelial Ovarian Cancer (GTEOC) Study, investigates the feasibility and acceptability of offering genetic testing to all women recently diagnosed with epithelial ovarian cancer (universal genetic testing or UGT). Study participants and staff were interviewed to: (i) assess the impact of UGT (ii) integrate patients’ and staff perspectives in the development of new UGT programs. Semi-structured interviews were conducted with twelve GTEOC Study participants and five members of staff involved in recruiting them. The transcripts were transcribed verbatim and analyzed using Interpretative Phenomenological Analysis. There are two super-ordinate themes: motivations and influences around offers of genetic testing and impacts of genetic testing in ovarian cancer patients. A major finding is that genetic testing is contextualized within the broader experiences of the women; the impact of UGT was minimized in comparison with the ovarian cancer diagnosis. Women who consent to UGT are motivated by altruism and by their relatives’ influence, whilst those who decline are often considered overwhelmed or fearful. Those without a genetic mutation are usually reassured by this result, whilst those with a genetic mutation must negotiate new uncertainties and responsibilities towards their families. Our findings suggest that UGT in this context is generally acceptable to women. However, the period shortly after diagnosis is a sensitive time and some women are emotionally overburdened. UGT is considered a ‘family affair’ and staff must acknowledge this.
    • Unmet needs in young adults with a parent with chronic illness: a mixed method investigation and measure development study.

      Nicholls, Wendy; Patterson, Pandora; McDonald, Fiona; Hulbert-Williams, Nicholas J. (Wiley, 2016-05-10)
      Rationale: Given the high number of young adults caring for a family member, and the potential for adverse psychosocial outcomes, there is a need for a screening tool, with clinical utility, to identify those most vulnerable to poor outcomes and to aid targeted interventions. Objectives: (i) To determine whether current knowledge from cancer literature regarding young carers is generalisable to chronic conditions and, therefore, whether an existing screening tool could be adapted for this population. (ii) To develop a measure of unmet needs in this population and conduct initial psychometric analysis. Design: This was mixed-methods: interviews in study one informed measure development in study two. Inclusion criteria were: having a parent with a chronic condition, and being aged 16-24 years. In study 1, an interpretative phenomenological analysis was conducted on interviews from seven young adults (age range 17-19 years). Study 2 explored factor structure, reliability and validity of the Offspring Chronic Illness Needs Inventory (OCINI). Participants were 73 females and 34 males (mean ages 18.22, SD = 1.16; 18.65, SD = 1.25). Main Outcome Measures: OCINI, Depression Anxiety and Stress Scale, and the Adult Carers Quality of Life Scale. Results: Interviews communicated that the impact of their parent’s condition went unacknowledged and resulted in psychosocial, support and informational needs. An exploratory principal axis analysis of the OCINI yielded five factors. Significant and positive correlations were found between unmet needs and stress, anxiety, and depression, and inversely with quality of life. Conclusions: The scale has applications in clinical settings where these young people, who are at risk of negative psychological outcomes, may be assessed and unmet needs targeted appropriately.
    • Unmet psychosocial needs and their psychological impact in haematological cancer survivors

      Swash, Brooke; Bramwell, Ros; Hulbert-Williams, Nicholas J.; University of Chester (Wiley, 2015-04-28)
    • Unmet psychosocial needs in haematological cancer: A systematic review

      Swash, Brooke; Hulbert-Williams, Nicholas J.; Bramwell, Ros; University of Chester (Springer Verlag, 2014-01-25)
      A systematic review of key online databases and psycho-oncology journals was conducted to identify papers that formally assessed unmet psychosocial needs in adults with a diagnosis of haematological cancer.
    • The Unmet Psychosocial Needs of Haematological Cancer Patients and their Impact upon Psychological Wellbeing

      Swash, Brooke (University of Chester, 2015-01)
      Unmet psychosocial needs indicate a desire for additional support in cancer patients, having a direct clinical utility in directing the provision of supportive care. There is evidence in wider cancer groups that unmet needs relate to psychological wellbeing but this relationship has yet to be fully explored and factors that may explain or moderate this relationship yet to be examined. There has been little investigation of type or prevalence of unmet need in haematological cancer patients, however, haematological cancers are noteworthy for their high levels of associated distress. Understanding causality of distress is key to the effective implementation of supportive care services. This thesis aimed to highlight the unmet needs most relevant to haematological cancer patients and to explore their impact upon psychological wellbeing. This thesis comprises four interconnected research studies: a systematic review exploring existing knowledge of unmet needs; a qualitative exploration of patient experiences of unmet needs and their impact; a quantitative questionnaire study of unmet need and psychological wellbeing in newly diagnosed haematological cancer patients, placing a special emphasis on the difference between active treatment and watch and wait regimes; and, a second quantitative questionnaire study that explores unmet need, psychological wellbeing, and psychological flexibility as a potential moderator in their relationship in a sample of haematological cancer survivors. This thesis demonstrates a relationship between unmet need and psychological wellbeing in haematological cancer patients. Fear of recurrence, concerns about loved ones, being able to do the things you used to, and a need for information were all found to be of relevance. The qualitative study highlighted that patients feel that, as haematology patients, they are distinct from other cancer patients which impacts upon the perceived acceptability of support services and specific barriers to the accessing of support services are presented. Significant correlations between unmet need and key psychological outcomes such as anxiety, depression and quality of life were observed in both quantitative studies. In addition, the concept of psychological flexibility was found to moderate the relationship between unmet need and psychological wellbeing in haematological cancer survivors. This work has clear implications for both future research and clinical practice. Unmet needs assessment has the potential to be used as a screening tool for overall psychological wellbeing, a way to stratify and understand the specific causes of distress and poor quality of life for this patient group. In the UK, on-going support for cancer patients diminishes at the end of treatment, these findings suggest that further support is needed in order to meet the psychological needs of cancer survivors. Further research is needed to further explore the role of psychological flexibility in cancer-related distress: interventions that target psychological flexibility have the potential to improve both unmet need and distress.
    • Unmet psychosocial supportive care needs and psychological distress in haematological cancer survivors: The moderating role of psychological flexibility.

      Swash, Brooke; Bramwell, Ros; Hulbert-Williams, Nicholas J.; University of Chester; University of Cambridge; University of Chester; University of Chester (Elsevier, 2017-02-17)
      Background The period immediately after the end of cancer treatment is a time when supportive care for the cancer patient decreases; this is known to increase risk of psychological distress and poor wellbeing. While there is broad recognition that unmet psychological and supportive care needs correlate with psychological wellbeing, little is understood about the factors that influence this relationship. This study explores the role of psychological flexibility, with a particular focus on its potential moderating role between unmet needs and psychological distress in haematological cancer survivors. Materials and Method Haematological cancer survivors were recruited for this cross-sectional study through two major UK blood cancer charities. Participants (n=91) were all over the age of 16 and had been diagnosed with any sub-type of haematological cancer more than 18 months previously. Participants completed self-report questionnaires assessing unmet psychological and supportive care needs (SCNS SF34), anxiety and depression (HADS), quality of life (EORTC QLQ-C30) and psychological flexibility (AAQ II). Results High levels of both unmet need and distress were present in the sample, indicating on-going care needs for these cancer survivors. Statistically significant correlations between unmet needs, psychological flexibility and all outcome variables (anxiety, depression, quality of life) were found. Using regression analysis based on Hayes’ methodology (Hayes, 2013), psychological flexibility was found to act as a moderator between unmet need and distress in four out of 15 models; specifically, the statistical relationship between need and distress emerged only when levels of psychological flexibility were at average level or above. Discussion Haematological cancer survivors have on-going supportive care needs that persist well beyond the end of active treatment. Unmet needs can, in turn, increase levels of anxiety and depression, and reduce quality of life in this patient group. The understanding offered by our data that psychological flexibility plays a moderating relationship between need and psychological distress creates opportunities for the development of theoretically-informed interventions to reduce both unmet need and distress in cancer patients. As such, these findings support the growing emphasis on Acceptance and Commitment based interventions for cancer patients.
    • Unpacking performativity: a case study of patriarchy and the elderly in China

      Powell, Jason; Cook, Ian; University of Chester; Liverpool John Moores University (Emerald, 2006-07-11)
      Performativity, we suggest, offers productive insights into the processes of subjection and the nature of power relations that may be usefully incorporated into studies of the elderly in China.