• A child's death: A heuristic exploration of mothers' grief

      Mintz, Rita; Ashton, Gail C. (University of Liverpool (University of Chester), 2006-11)
      The death of a child is one of the most difficult losses that can have complicated, intense and long-lasting effects upon a bereaved parent. This qualitative heuristic study explored the grief experience of mothers after the death of their children, considering how or whether bereaved mothers' world-view was changed, how they rebuilt 'self whilst adapting to a new and changed life and exploring the importance and value of remaining connected to and continuing the bond with their child. Post-traumatic growth was also explored in addition to any existential, spiritual or life changes that resulted during the mothers' grieving. The experience of the researcher, a bereaved mother and counsellor, remained visible within the research, integrating her own personal and professional experience alongside the participants' stories. Data for analysis included interview transcripts with five bereaved mothers together with rich data such as poetry, narratives and photographs. This data was analysed using an inductive approach and Moustakas's (1990) heuristic process of data analysis. The constant comparative method informed this process. The findings not only highlighted the intensity and lifelong process of grief following the death of a child, but also significant changes in world-view, perspective on life and personal values, alongside personal growth and a changed view and altered level of understanding and valuing of people. Significant changes in self and attitudes were described such as a new enthusiasm for living, pride in self, contentment, strength, confidence and a new sense of enrichment, joy and pleasure, alongside the continuing pain of loss and an ongoing relationship with the child. The ways in which child death can be experienced and what can enable bereaved mothers to reconnect and rebuild their lives after such a devastating loss was additionally highlighted. The implications and findings of this study are discussed and potential further areas of study indicated.
    • The complexities of community involvement in Sure Start local programmes: A case study

      Artaraz, Kepa; Stredder, Katrina (University of Liverpool (University of Chester), 2006-10)
      Sure Start is a Government's scheme, the professed aim of which is to provide a positive commencement to life for children through the integration of early education, childcare, health and family support (Sure Start, 2005b). Sure Start Local Programmes (SSLPs) were considered to be a fundamental aspect of this agenda (Sure Start 2005b). At the time of writing, SSLPs were transforming into Children's Centres (Glass, 2005). Strikingly, it has been claimed that the 'involvement' of the 'community', is the fundamental principle of SSLPs (Eisenstadt, 2002). Furthermore, anecdotal evidence suggests that SSLPs are considered to have a relatively unique approach to 'community involvement'. However, what 'community involvement' in SSLPs means in practice is largely unreported. Markedly, research into this area has concentrated on the formal mechanisms of 'community involvement' such as Management Boards and Parents' Forums (Marrow and Malin, 2004; Hassan, Spencer and Hogard, 2006; Briant, 2004; Lomas and Hannon, 2005 and Johnson, 2004). Consequently, this research aimed to explore 'community involvement' across SSLPs more broadly in order to address this identified gap in the literature. This research was fundamentally a case study of a particular SSLP. It utilised focus groups, with both service users and staff members, as a method of data generation. Additionally, it adopted the fundamental principles of a grounded theory approach to data analysis (Charmaz, 2006). The key finding of this research was that both staff and service users perceived the fundamental aspect of 'community involvement' to be the form of relationship developed between them. In particular, the informal nature of this relationship was stressed and highly valued. Thus, it may be considered essential that staff within Children's Centres develop such informal relationships with service users in order for families to access services in the first instance and for the services to be successful in meeting outcomes. In addition, staff within other initiatives and perhaps statutory services could benefit from the development of such informal relationships. A further implication of the high value placed on these informal relationships, is that the mode of measuring 'community involvement' within SSLPs should be altered. A move from measuring the number of 'community' representatives on the Management Board to a more exploratory investigation of the perceived quality of staff-service user relationships would be more useful and relevant. Other findings from this research should be carefully considered for the transition to Children's Centres and perhaps beyond. Areas for potential improvement include the extent to which the 'same few faces' are 'involved' and service users being more thoroughly informed regarding policy changes. More positive aspects of SSLPs which could be taken forward to Children's Centres include, the means of accessing the so called 'hard to reach' through Family Partnership Workers, outreach services, and free services and innovative informal volunteering opportunities, including one off activities and simply 'mucking in'. In addition, there were noticeable differences in the perceptions of different groups of staff members regarding the priority placed on 'community involvement' which should be explored further.
    • Counselling regulation : a qualitative study of the perceptions and experiences of NHS primary care counsellors

      Mintz, Rita; Jardine, Jacqueline (University of Liverpool (University of Chester), 2007-11)
      The NHS is the largest employer of counsellors in this country and directives from the Department of Health relating to effectiveness, quality control, evidence-based practice and accountability are relevant to their work. NHS counsellors also have to adhere to local policies related to clinical governance and are subject to inspection by statutory bodies. Although at present these issues relate only to the NHS, with the Government's stated intention to regulate the talking therapies, there are possible implications for the wider counselling world, including the voluntary sector. Using data from 6 semi-structured interviews, this study explores primary care counsellors' perceptions and experiences of regulation. The data were transcribed and analysed using the constant comparative method of qualitative analysis. Although this study does not propose any 'universal truths' about the possible impact of statutory regulation, it demonstrates a varied awareness of regulatory issues amongst counsellors and confirms that working within current NHS policies does affect counsellors' practice and how they feel as practitioners. The main finding of the study is that counsellors' creativity appears to be adversely affected by regulatory policies within the NHS, which are experienced as intrusive to the therapeutic endeavour and contribute to low job satisfaction, feelings of isolation and vulnerability, and a sense that something fundamental to counselling is being lost, leading to a desire to work elsewhere. The regulation debate so far in the UK has focused mainly on its practical implementation; this study suggests that the potential impact upon the intra-personal experiences of counsellors is also relevant and one that invites further research.
    • A critical analysis of Karl Jaspers' theory of transendence: And its relevance to the relationship between science and religion

      Deane-Drummond, Celia; Hunt, Andrew N. (University of Liverpool (University of Chester), 2007-07-11)
      The central claim of the thesis is that the thought of the German existentialist Karl Jaspers (1883-1969) articulates a significant approach to the epistemological problems posed by the question of Transcendence. It is arguably a philosophy of special relevance to the ongoing and often competing discourse about existence adumbrated in the 'science and religion' debate. The thesis sets out the key themes of Jaspers that are relevant to the special issues that surround the problem of Transcendence, before critically presenting two contrasting and variant solutions to the philosophical difficulties it poses. An elaboration of Jaspers' cipher theory of Transcendence is believed to be an improvement upon these methodological approaches, is critically outlined as a strategy, and further evaluated against another competing epistemology, that of inference based explanation. The thesis argues that with appropriate qualifications Jaspers provides a compelling account of the human engagement of Transcendence through their otherwise ordinary activity.
    • A critical appraisal of Pierre Teilhard de Chardin's view on the distinctiveness of the human being in the light of evolutionary debate

      Williams, Michael; Rudd, Ann (University of Liverpool (University of Chester), 2006-08)
      A significant contributor to the ongoing debate between science and religion is Pierre Teilhard de Chardin (1881-1955), a French Jesuit priest/theologian and palaeontologist. He perceived evolution to be a working-out of God's purposes in the world. He applies the concept of Darwinian evolution to his own particular notion of human development. Thus he presents a view of the cosmos and humanity's place within it which is original, radical and controversial. His work reflects the thinking of a visionary, a prophet, as well as effecting a synthesis between the biological sciences and Christianity. This dissertation offers a critical appraisal of Teilhard de Chardin's views on human distinctiveness in relation to evolutionary theory of his time and at present. It is a book-based study, in part historical, examining and analyzing both a wide selection of Teilhard's works together with books and journals relative to the period and to the subject. The key questions are: What is it to be human? What distinguishes us from the primates and from the rest of creation? These questions address not only the biological but also the spiritual development of human 'being'. The linking theme is one of emergence - of creativity, of consciousness and spirituality.
    • Effective horse behaviour consultancy: An exploration by means of a social cognition approach

      Creighton, Emma; Jobling, Ruth (University of Liverpool (University of Chester), 2010-05)
      Behaviour problems are common in domestic horses. It is suggested that the aetiology of these problems may lie in a lack of understanding of horse ethology, in particular learning theory. Horse behaviour consultants offer a vehicle for educating owners and promoting a thorough understanding of these principles which, in turn, will help to resolve behaviour problems and minimise the associated welfare concerns. Where the services provided by horse behaviour consultants are effective they are likely to be promoted. An effective service is dependent on the client's adherence to the advice given and, therefore, this research aimed to establish recommendations to horse behaviour consultants on how to foster adherence to their advice. The established science of human behavioural change has largely been applied in the field of health psychology to indentify predictors of adaptive behaviour. A thorough review of human behavioural change literature identified ten cognitive variables that had the potential to predict adherence to the advice of a horse behaviour consultant. Established self-report questionnaire methodology was adopted to survey an opportunistic sample of 52 clients of horse behaviour consultants before they received the advice (initial cognitive profile), ten days after (changes post-communication) and at three months follow-up (long-term changes). The self-reported responses were validated by telephone. Data were preliminarily analysed using correlation analyses and subsequently multiple regression analyses were used to generate a model for adherence. Of the client's initial cognitive profile, less attribution of the horse's behaviour problem to external factors (r = -0.316) was associated with increased adherence ten days after the communication. Horse behaviour consultants cannot influence what clients come into the process perceiving, however, they are able to influence cognitive variables during the communication. The amount of post-communication change in value of the outcome of adhering to the advice (beta = 0.338) and attribution of the horse's behaviour problem to external factors (beta = 0.309) were significant elements of a multiple regression analysis that explained 23.6% of the variance in adherence ten days after the communication (F2,35= 6.700, p = 0.003). At three months follow-up there were no associations between adherence and the earlier cognitive profiles, but clients who showed a three month increase in positive attitude towards horse behaviour consultants were more likely to adhere long term (r = 0.389). The findings suggest that horse behaviour consultants will benefit clients by demonstrating the effects of the advice early in the communication, so that clients value their efforts to adhere and continue to do so. Horse behaviour consultants may also foster adherence to their advice by developing the client's perception of an external, controllable cause of their horse's behavioural problem, which may build confidence in the client's ability to address the problem.
    • Exploring the views and experiences of early years practitioners with regard to consultation with children under five

      Artaraz, Kepa; Davies, Sarah (University of Liverpool (University of Chester), 2006-10)
      Recent Government agendas have highlighted a need for children to be involved in policy and service design, provision and evaluation, in relation to services they use or which affect them. This has the aim of producing better services, leading to better outcomes for children. No lower age limit of children has been set for participation policies. While consultation with older children has become more usual in children's services, this is not yet the case for younger children. Relevant literature suggests that the attitudes and beliefs of the adults who work with them can be a significant barrier to the participation of young children. This study aimed to explore the current practice and the experiences, perceptions and views of a sample of professionals who work with children under five years old, with regard to consultation with young children. A qualitative research strategy was selected as appropriate for the study. A cross-sectional study design was utilised and potential research participants were identified through a purposive sampling strategy. Semi-structured interviews were conducted with a sample of nine early years practitioners. A grounded theory approach to data analysis was used. In exploring current practice amongst the practitioners the study examined definitions and understanding of consultation, use of consultation, and methods of consultation employed. Findings revealed a number of factors that can influence whether or not practitioners consult with young children. The influencing factors included the views, attitudes and beliefs of practitioners with regard to consultation with young children. In particular, their perceptions of children's competence and their understanding of child development, as well as their views of childhood, were found to be important. Additional factors that could be influential included the aims and focus of the service, the ethos of the setting, training opportunities, and current Government policies and initiatives. Three spheres of influence were discovered in which the different factors could have a varying impact upon practice. These were the spheres of the individual practitioner, the service setting, and the wider policy context. Therefore while training for early years practitioners may be important in introducing consultation with young children, service and setting level influences may also need to be addressed. A possible theoretical model was presented as a means of understanding the views, attitudes and practice regarding consultation with young children among the early years practitioners interviewed for the study. The model suggests that the different factors that can influence whether or not practitioners consult with young children are connected and interrelated. There are policy implications of the findings of this study, in signifying what may need to be in place for the Government drive to consult with young children to work in practice. Future research is recommended to further explore these factors, the nature of the relationships between them and the extent to which they can influence practice.
    • The function of the multidisciplinary team meeting for head and neck cancer: A qualitative analysis

      Perry, Catherine; Arya, Arvind K. (University of Liverpool (University of Chester), 2007-10)
      Multidisciplinary team meetings (MDMs) have been shown to be beneficial in the management of patients with cancer. Government recommendations introduced in 2002 suggested that more meetings were needed to take place to optimize cancer care in the UK. Head and neck cancer is a typically heterogeneous disease, and the input of a multidisciplinary team was considered to be vital in order to manage patients properly. This study was aimed at exploring the working of such MDMs through a series of interviews with healthcare professionals who regularly attended them. A large tertiary referral centre for head and neck cancer was the setting of the study. A total of 12 interviews were undertaken. Themes emerged from the data suggesting that there were benefits and problems with the MDM. There were benefits to team working, communication, information gathering, patient care, planning and decision reassurance. The problems identified included time constraints, excessive radiological workload, cost implications and loss of nurse led meetings. There was little contribution by certain allied heath professionals (AHPs) who found the atmosphere generated by medical staff combative. There was little time available to discuss non-medical issues. Patient care was not affected because social issues were discussed at a clinic following on from the MDM. Some Consultants questioned the ability of the MDM to come up with suitable treatment plans for patients, and preferred to make decisions in the clinic. The study's findings could help improve the working of the MDM in head and neck cancer. The issues of non-contribution should be addressed as should time and financial resources. A different set up of the MDM may be beneficial or by having an addition MDM per week. Further studies are needed to fully explore these issues, and to implement changes to improve head and neck cancer services in the UK.
    • A gluten-free diet as a normal way of life: Adherence to gluten-free diet among people with coeliac disease and the role of specialist follow up

      Ford, David; Pender, Fred; Fallows, Stephen; Britcut, Elizabeth K. (University of Liverpool (University of Chester)Wirral University Teaching Hospital NHS Foundation Trust, 2009-08)
      Strict adherence to a gluten-free diet is the only known treatment for coeliac disease and is believed to reduce the risk of serious complications such as malignancy. Regular follow up has been associated with better dietary adherence in this group. This thesis examines adherence to a gluten-free diet among people with coeliac disease with a particular emphasis on specialist follow up. The research presented in the thesis comprises a qualitative study, conducted using a grounded theory method, and a questionnaire study. The questionnaire focussed particularly on specialist follow up and aimed to compare people who attended follow up with those who had defaulted. Data for the qualitative study was collected by means of semi-structured interviews. Thirty interviews were carried out. Interview transcripts were analysed and the findings used to develop a model of dietary adherence. The experience of coeliac disease and of implementing a gluten-free diet was seen to be a social one. At the centre of the model was the concept of dietary adherence as the incorporation of the gluten-free diet into normal life. The model illustrates the factors which were found to facilitate or inhibit the adoption of a strict gluten-free diet as part of normal life. Findings from the qualitative study were used to inform a postal questionnaire. Three hundred and four questionnaires were distributed and 214 returned giving a response rate of 70%. A higher response rate (78%) was obtained from regular clinic attenders than non-attenders (43%). Non-attenders (n=29) were less likely than attenders (n=185) to report their needs had been met at their out-patient appointments. This suggests that a service which better meets the needs of this group may result in better attendance and this may in turn improve dietary adherence and possibly influence long term health. This research suggests a number of ways in which health professionals may better support people with coeliac disease. These include understanding the social aspects of coeliac disease, providing practical and factual information that is useful to the individual and allowing adequate time for patients to discuss their concerns.
    • The landscape, heritage and society of St Michael's churchyard, Shotwick

      Gaunt, Peter; Greatorex Roskilly, Vanessa J. (University of Liverpool (University of Chester), 2005-10)
      This dissertation examines the history and heritage of St Michael's Churchyard in the Wirral parish of Shotwick. It explores in particular the effect topographical features and historical events have had on the churchyard's development. Stylistic variations in memorials are analysed to identify chronological trends. The lifestyle of churchyard occupants is also discussed, with the spotlight focusing specifically on the Whaley, Roberts and Maddock families; parish curates; and RAF pilots killed in the final months of the Second World War. Information has chiefly been derived from memorials recorded during numerous visits to the churchyard itself, and from primary and secondary sources held by Cheshire and Chester Archives and Local Studies, in particular maps, parish registers and their transcripts, churchwarden's accounts, wills, reports of coroner's inquests, school log¬books, tithe apportionments, charters and church correspondence. Relevant information has been extracted from Cheshire County Council's Sites and Monuments Record, and material held by the War Graves Commission and the RAF Museum at Hendon has also contributed to the exposition. Data from all these sources has been collated and analysed to extrapolate parochial trends, and much supporting material discussed in the body of the dissertation is included in the Appendices as verification.
    • Physiological responses to six weeks unsupervised walking exercise in patients with intermittent claudication

      Sykes, Kevin; Edwards, Paul; Morris, Mike (University of Liverpool (University of Chester), 2005-03)
      Objective: It is well established that exercise training improves walking distance in patients with intermittent claudication. However the physiological mechanisms responsible for explaining these increases are not fully understood. The aim of this study was to investigate the physiological mechanisms and to provide a rationale as to why patients with intermittent claudication improve pain free and maximum walking distances following a programme of unsupervised exercise. Methods: 10 claudicants with a mean age of 70 years (± 9.84) were studied. Pain free walking distance (PFWD), maximum walking distance (MWD), heart rate (HR), microalbuminuria, ankle brachial pressure index (ABPI), respiratory exchange ratio (RER), C>2 uptake and lactate were measured. Patients performed a graded treadmill protocol at baseline and following six weeks of an unsupervised exercise programme. The exercise programme consisted of patients performing 1 hour of walking per day above and beyond their normal daily activities. Patients were monitored by the use of an exercise diary, pedometer and a weekly phone call. Results: MWD improved by 5% although this difference was not found to be significant. Positive differences were also observed in ABPI (5.5%) and resting lactate levels (10%), once again these differences were not found to be significant. No differences were observed between heart rate, RER and C>2 uptake. A significant difference was observed in PFWD (p = 0.02), Microalbuminuria levels at rest (p = 0.03) and post exercise (p = 0.01), lactate levels at rest (p = 0.0005) and 6 minutes (p = 0.001) post a graded treadmill protocol. Conclusions: Exercise training improves walking distances in claudicants and reduces post exercise lactate levels. Exercise has a significant effect on two of the physiological variables measured (Microalbuminuria and post exercise lactate) and a positive effect on ABPI and resting lactate although no significant difference was found. This could possibly be due to a number of limitations in this study including small sample size (n = 10), the exercise programme was too short and also unsupervised. It is still unclear how exercise improves walking distances in claudicants and further research is required to investigate this.
    • A qualitative exploration of the impact of personal development in counselling training on the student counsellor's significant relationships: Should counsellor training come with a stronger warning or more support?

      Le'Surf, Anne; Collins, Karen A. (University of Liverpool (University of Chester), 2008-11)
      A small scale qualitative research study set out to explore the impact of the personal development element of counsellor training on the student counsellors’ significant relationship. Six qualified counsellors shared their own experiences of training, and the impact it had on their relationships, in a semi-structured, one to one interview. The data gathered was subjected to a form of grounded theory. The study concluded that the personal development element does have an impact on students’ relationships; some survived and others ended. Whilst this was generally perceived by the participants as positive, the study found a number of factors, resulting from personal development in counselling training, which did contribute to various stresses being placed on the participants’ relationships.
    • The relationship between Samuel Wilberforce and William Ewart Gladstone, 1835-73, with special reference to contemporary religious issues

      Swift, Roger; Whitehouse, Graham (University of Liverpool (University of Chester), 2010-12)
      This thesis examines the private and public relationship between Samuel Wilberforce and William Ewart Gladstone, who became great friends between 1835 and 1873. Wilberforce (1805-1873), who became Bishop of Oxford in 1845, was an outstanding preacher and diocesan, an effective speaker in parliament, and the best known Anglican clergyman of his time. Gladstone (1809-1898), who became Liberal prime minister on four occasions, was the most fervently religious prime minister of the Victorian period. The thesis is divided into two parts. Part One examines the nature and development of the private friendship between Wilberforce and Gladstone. Chapter One describes their early lives and the start of their friendship in the mid-1830s. The two men had much in common; they both came from devoutly Evangelical backgrounds, yet both became High Churchmen; both their fathers were Tory Members of Parliament, and both went to Oxford University. Chapter Two examines the consolidation of their friendship from the 1840s until Wilberforce's death in 1873. It shows their mutual respect and admiration, and enjoyment of one another's company. Their friendship reflected sympathetic and empathic responses to various family crises, including the defection of some of Wilberforce's relatives to Roman Catholicism, and the deaths of close friends and relatives. Wilberforce's ambitions for promotion were thwarted, but Gladstone was able to appoint him to the venerable bishopric of Winchester in 1869. Gladstone was clearly distraught by Wilberforce's sudden death in 1873 and fulsomely eulogised his friend. Part Two examines the public relationship between Wilberforce and Gladstone, with particular reference to contemporary religious issues in which they shared a mutual interest. Chapter Three examines the response of Wilberforce and Gladstone to problems faced by the Church of England during the mid-Victorian period, including the divisions between Evangelicals and High Churchmen, Tractarianism, Ritualism, the Broad Church and various other doctrinal disputes. On these and other issues the two friends frequently acted in tandem. Wilberforce and Gladstone both argued with the protagonists of Darwinism in the debate on Evolutional Theory, which challenged Christian belief. Chapter Four examines the views of Gladstone and Wilberforce on the difficult relationship between Church and State during the mid-Victorian period, and explores, by reference to the Hampden controversy, the Gorham Judgement, the re-establishment of Convocation and Papal Aggression, the extent to which they were mutually supportive. Finally, Chapter Five considers the parliamentary roles of Wilberforce and Gladstone regarding ecclesiastical legislation, where they frequently co-operated in the promotion of, and support for measures including the development of an independent Colonial Church and regulation of the Anglican clergy. Whilst Gladstone's aim to disestablish the Church of Ireland was initially opposed by Wilberforce, he came to accept it as a decision of the electorate and was instrumental in persuading the English and Irish bishops not to oppose the legislation promoting disestablishment in 1869. The parliamentary co-operation between Wilberforce and Gladstone also extended to some social legislation, including the question of divorce and the extension of elementary educational provision in 1870. In summary, this original thesis offers the first detailed examination of the relationship between Samuel Wilberforce and William Gladstone - a relationship hitherto largely ignored by historians - and argues that theirs was a true and enduring friendship which equated with Aristotle's criteria forphilia, despite differences in their personalities and occasional differences of opinion, and which also extended to mutual co-operation and support in their public lives.
    • The role of heat shock proteins in colorectal diseases

      Williams, John H. H.; Skellern, Luke I. G. (University of Liverpool (University of Chester), 2008-10)
      Introduction: This thesis examines the roles of Hsp10, Hsp60, and Hsp7O in colorectal diseases, in particular Inflammatory Bowel Disease, Colonic Polyps, and Colorectal Cancer. HSPs are reported to be elevated in a number of human diseases, including autoimmune diseases and cancers. On a daily basis the colon is exposed to a number of harsh stresses, including fermentation of foodstuffs as well as a high bacterial load. These stresses are thought to possibly induce the expression of HSPs in colonic mucosal cells, where it is thought that they may influence cellular function. HSPs are known to regulate apoptosis and coordinate certain immune functions that may provide either beneficial or detrimental effects depending upon the situation. Deranged apoptosis and inappropriately coordinated immune responses, possibly as a consequence of HSP activity, are thought to be implicated in the pathogenesis of some colorectal diseases. This project aims to find correlations in the concentration of a number of important HSPs in colorectal mucosa with colorectal diseases to enhance our knowledge of the roles that HSPs might play in pathogenesis of inflammatory bowel disease, colorectal polyps and colorectal cancer. Methods: 81 subjects were recruited prior to colonoscopy or sigmoidoscopy and consented to the removal of blood and colorectal mucosal biopsies for the purpose of this study. Colonic mucosal biopsies were analysed for protein levels of Hsp70 by ELISA, in addition the mRNA expression of HsplO, Hsp60 and Hsp70 was quantified by RT-PCR in colonic mucosal specimens. A further 20 patients were venesected so that whole lysed blood could be analysed by flow cytometry to determine the cellular localisation of Hsp70 concentration in neutrophils, monocytes and lymphocytes, to understand the involvement of Hsp70 in the coordination of immune responses appropriate to colorectal diseases. Kruskal-Wallis, Mann-Whittney, and Linear regressional analysis were performed to determine statistical significance. Results: Endoscopic appearance and pathological diagnosis separated the 81 patients into the following groups: normals (n = 42), inflammatory lesions (n = 23), polyps (n = 10), and colorectal cancer (n = 6). Hsp70 protein expression appears to be most elevated in normal mucosa, while lower levels are measured in inflammatory lesions and polyps, and minimal levels seen in colorectal cancer specimens (P-value = 0.447). A similar pattern is seen in the levels of Hsp70 mRNA expression, again with lowest levels measured in the colorectal cancer specimens (P-value = 0.528). The gene expression of both HsplO (P-value = 0.977) and Hsp60 (P-value = 0.245) is raised in inflammatory and polypoid lesions, but as with Hsp70, is lower in colorectal cancer specimens than in healthy colonic mucosa. Too few patients with colorectal disease were evident among the 20 patients for whom blood was sampled for flow cytometry therefore statistical significance was not achieved. The percentage of neutrophils and monocytes expressing Hsp7O was maximal in the colorectal cancer patient and lowest among healthy patients, however the average concentration of Hsp70 on these cells was lower in the colorectal cancer patient than healthy patients. Discussion: Pathological group sizes were a representation of the epidemiology of colorectal diseases and hence some sample sizes, particularly the colorectal cancer group, were too small to obtain significant conclusions. Further work with larger groups is therefore required to build upon the results of this pilot study. Contrary to what was predicted, high levels of Hsp70 in healthy bowel mucosa may be a cytoprotective mechanism ensuring the survival of the cell. In contrast, cells with lower levels of Hsp70 may be more likely to undergo spontaneous mutations this could explain lower Hsp70 levels measured in the pathological groups. Alternatively, low levels of Hsp70 in the pathological groups could be due to active secretion as part of a 'danger signal' by these cells to mount an effective immune response.
    • Social and cultural construction of obesity among Pakistani Muslim women in North West England

      Ellahi, Basma; Cox, Peter; Ludwig, Alison F. (University of Liverpool (University of Chester), 2012-04)
      Higher rates of obesity, Type 2 diabetes and coronary heart disease are observed in British Pakistani women compared to the general UK population. This qualitative research explored the links between the participant’s understanding of health risks related to obesity, body image and dietary patterns in a cohort of first- and second-generation Pakistani women, living in Greater Manchester, England. Pakistani women act as gatekeepers to family nutrition and health. The research aims to inform promotion strategies, focusing on healthier changes, and to create increased levels of awareness of the strategies. Beyond South Asian [SA] languages, effective and ethnically appropriate approaches are essential to reach these goals. Research outcomes can no longer just be interesting or show potential, as they ought to contribute to improving women’s health and advice public health professionals when making relevant recommendations. Qualitative techniques, using focus groups and one-to-one interviews, with 55 women, were recruited from the Pakistani community via snowballing and cold calling at community and resource centres. The participants were either active in their local communities or were deemed “hard to reach” in relation to accessibility. The interviews were conducted in the participants’ homes or at the venues. Third-person fictitious vignettes were used to stimulate and promote discussion. A series of vignettes were intended to resonate with the participant’s own lives. The interviews were audio-recorded, transcribed then analysed. One researcher as a community insider and the other as an outsider, along with sociological analysis, reflected upon then coded the data. Using ethnography and an interpretive, phenomenological framework, allowed for data description and interpretation of an emerging understanding. The rich data uncovered issues relating to faith, family and broader socio-cultural influences, all of which had an impact on daily life and in particular to food choices. Despite an acknowledgement of obesity in themselves and around them, there appeared to be a lack of awareness linking obesity to health outcomes. The participants in both generations turned to and, in part, relied upon both traditional food and western health beliefs. As an outcome of the data analysis, a multi-directional theoretical model was developed specifically for this group of women in Manchester, called the Health Action Transition (HAT) model. The HAT model is intended to be used as a working tool in a clinical setting to aid in understanding of the Pakistani women’s socio-cultural structures and to provide a framework for recommendations relating to health promotion for these women.
    • Study skill use, motivation and the efficacy of the "mind map" technique

      Hayes, Peter; Alexander, Roy; Shuttleworth, Joanne (University of Liverpool (University of Chester), 2005-06)
      The last decade has seen a considerable increase in the number of students entering Higher Education, coupled with this a lowering of entry requirements in terms of qualifications. This climate demands attention to study skill training, with particular emphasis on those students with problematic studying patterns (Entwistle et al, 1996). The present study was made up of two parts: the first part of the study used a questionnaire to investigate motivation and the frequency of use of study skills, the second part of the study involved an experiment to measure the efficacy of a study skill. The Study Skill Questionnaire was devised to examine differences according to gender, year of study, whether the students had taken a break in their study, degree type and main subject of study. The questionnaire also examined the relationship between academic motivation and study skill use. The results showed that in particular, mature students are considerably more motivated than their peers; however, they use the same techniques with the same frequency as their colleagues. The second part of the study continued to investigate a study skill's efficacy in an attempt to arm these motivated students with a superior learning technique. The mind map study skill was chosen for investigation. After some initial difficulty with task bias, the study showed that there was no significant difference between a self-selected technique (i.e. the study technique the student normally uses) and the mind map technique. Although this implies that the Mind Map Technique is not a superior study technique, other explanations may be possible. It could be that the technique cannot be mastered in a single session and that practice is required. It could be also possible that mind mapping only works for certain types of learners following the findings of Pask and Scott (1972; cited in Richardson, 1983). Future research could examine such possibilities.
    • Swettenham: A rural township in East Cheshire, 1660-1770

      McGuicken, Rachel; Richards, Peter W. (University of Liverpool (University of Chester), 2005-10)
      This dissertation aims to describe the buildings, landscape, population and economy of the township of Swettenham between the years 1660 and 1770 using mainly the primary sources available. Firstly there is a description of the landscape and population in general terms - the landscape's appearance, land use, pattern of settlement, overall population trends and patterns. This includes consideration of how old the landscape described might be. Moving away from the general to the particular, consideration is then given to the standards of living and way of life of the individuals, the type of agriculture they practised and the buildings in which they lived. Where possible, reference is made to evidence from the lives of individuals to support and illustrate these themes. The results show that Swettenham was a relatively self-contained community in terms of its agricultural economy and contact beyond the parish boundary. The population was fluid, with movement into and out of the parish throughout the period, but social habits were slow to change.
    • Young people's perceptions of their experience of counselling in a school setting: A qualitative study

      Le'Surf, Anne; Bassett, Linda (University of Liverpool (University of Chester), 2007-10)
      This study examines young peoples’ experiences of counselling in a school setting. Five young people who received counselling in their school were interviewed individually and their responses analysed using the constant comparative method. The results highlight four particular areas that would be helpful to address if a school were considering setting up a counselling service. The findings emphasise the importance young people place on autonomy around the disclosure of the fact they are attending counselling, as well as the actual content of counselling sessions. They suggest that many young people would prefer to have counselling in their school, rather than at another venue. The young people interviewed identify certain qualities in the counsellor that facilitate an effective counselling relationship, and finally how many of their peers were unaware of the nature and existence of a counselling service in their school. The relevance of the outcomes to the effective counselling of young people are discussed.