• Safeguarding and qualitative research

      Jones, Alun; Steen, Mary; University of Chester (Elsevier, 2013-01-07)
      Qualitative research is a potent method used by researchers to gain an insight and understanding into the thoughts, feelings, views and experiences of both patient’s and healthcare professionals. The narrative data offered through conversational methods of qualitative research can provide rich and deep descriptions of healthcare and so act as a guide to further research or offer different views and considerations for professional practice. Nonetheless, safeguards are a paramount issue particularly if studies involve inexperienced researchers.
    • Screening and public health

      Mabhala, Mzwandile A.; University of Chester (SAGE, 2008-11-20)
      This book chapter discusses general criteria for a screening programme, appraisal and quality control, and the criteria for the evaluation of screening.
    • Screening, Diagnosis, and Management of Patients With Alcohol Use Disorders at Bwindi Community Hospital, Uganda.

      Kuule, Yusufu; Dobson, Andrew E.; Harries, Anthony D.; Mutahunga, Birungi; Stewart, Alex G.; Wilkinson, Ewan (2018-05-24)
      Introduction: The harmful use of alcohol is a growing global public health concern, with Sub-Saharan Africa at particular risk. A large proportion of adults in Uganda consume alcohol and the country has a high prevalence of alcohol use disorders (AUD), almost double that for the African region as a whole. Bwindi Community Hospital, in rural western Uganda, recently introduced a program of screening, diagnosis and management of AUD and we assessed how this worked. Methods: This was a cross-sectional study in three departments (out-patients, adult in-patients and sexual & reproductive health) of Bwindi Community Hospital assessing numbers of patients screened, diagnosed and treated with AUD between January 2014 and June 2017. Data sources included the hospital electronic data base and departmental case files. Frequencies and proportions are reported and odds ratios used to compare specific factors associated with medical interventions. Results: Altogether, 82,819 patients attended or were admitted to hospital, of whom 8,627 (10.4%) were screened and 273 (3.2%) diagnosed with AUD. The adult in-patient department recorded the largest number with AUD (n = 206) as well as a consistent increase in numbers in the last 18 months of the study. Of those with AUD, there were 230 (84%) males, 130 (48%) aged 36-60 years, and 131 (48%) with medical non-alcohol related diagnostic categories. Medical/supportive interventions included guidance and counselling to 168 (62%), community social support to 90 (33%), mental health service referrals for 75 (27%), detoxification for 60 (22%) and referral to Alcoholics Anonymous for 41 (15%). There were 36 (15%) patients who received no medical/supportive interventions, with significantly higher proportions in patients with surgical alcohol-related disease and pregnancy-related conditions (P < 0.05). Conclusion: Bwindi Community Hospital has implemented a program for AUD in three departments, with most individuals screened and managed in the adult in-patient department. While a variety of interventions were given to those with AUD, 15% received no intervention and this deficiency must be addressed. Program performance could improve through better screening processes, ensuring that 100% of those with AUD receive a medical/supportive intervention and raising public awareness.
    • Self-administered Homeopathy part 2: A follow up study

      Steen, Mary; Calvert, Jan; Leeds Teaching Hospitals NHS Trust (Mark Allen Publishing, 2007-06-01)
      This paper discusses a follow up study that used a semi-structured interview technique to further explore the experiences of women and their partners following the use of a specifically chosen homeopathic kit that included ten remedies that were self-administered.The interview data demonstrated that women and several birth partners experienced positive emotional, psychological and physical benefits from using the kit of homeopathic remedies. Implications: Self administered homeopathic remedies have the potential to promote a women-led approach to childbirth and an active supportive role for the birth partner. The findings will form the foundations to undertake further research in this field.
    • Service user and carer involvement

      Williams, Terry; Phipps, Dianne; Forum for Carers and Users of Services in Cheshire and Merseyside ; University of Chester (SAGE, 2010-10-29)
      This book chapter discusses partnerships between users/carers and higher education.
    • Serving within the British army: research into mental health benefits

      Finnegan, Alan; Finnegan, Sara; McGee, Paula; Srinivasan, Mike; Simpson, Robin; University of Chester (Mark Allen Group, 2011-10-28)
      The mental health (MH) of soldiers remains extremely newsworthy and is regularly featured in high profile media forums that focus on post-traumatic stress disorder. However, the authors feel that there are distinct benefits to serving within the Army, and that it provides effective occupational medical, MH and welfare support. This research study explores potential benefits and stressors of being in the Army and provides an overview of Army mental health services (AMHS) through the perspectives of AMHS personnel, 84% of which were nurses. The study indicated that the Army can provide a protective community, sharing a bond based on common values and experiences. The Army can provide soldiers with career opportunities that are not available in civilian life, and there are opportunities to develop an employment profile, enhanced by internal and external educational training, and encapsulated within a progressive career pathway. The Army can also be seen to offer an escape route, preventing soldiers entering a life of crime, and supplying the stable family these soldiers had never experienced. The provision of leadership, within an environment where soldiers are valued and stigma is not tolerated can potentially shield against MH problems.
    • Sexual health in mental health practice

      Bates, Jo; University of Chester (SAGE, 2013-01-15)
      This book chapter aims to consider the concept of sexual health; identify some of the most prevalent sexually transmitted infections; discuss contraceptive methods; and explore the role of the mental health practitioner in facilitating good sexual health.
    • Sexual Violence on Public Transportation: A Threat to Women’s Mobility in Bangladesh

      Mazumder, Hoimonty; Pokharel, Bishant (Informa UK Limited, 2018-07-06)
    • Sexuality

      Baldwin, Moyra A.; Woodhouse, Jan; University of Chester (SAGE, 2011-01-01)
      This book chapter discusses palliative care and meeting sexuality needs.
    • Sexually transmitted infections among Rohingya refugees in Bangladesh.

      Hossain, Md M.; Sultana, Abida; Mazumder, Hoimonty; Munzur-E-Murshid (2018-07)
    • Siblings of Adults with Learning Disabilities: An Empirical Study

      Gant, Valerie; University of Chester (Social Work and Society, 2018-01-01)
      Adult siblings are frequently providers of care for their brother or sister with a learning disability* and many take on many levels of responsibility, which often lasts for decades. The majority of research focusing on siblings of people with learning disabilities comes from the perspective of those aged under 18. This paper draws on the work of Rawson (2012) and Pompeo (2009) to focus attention on adult siblings. This study, examined the relationships adult siblings have with their brother or sister with a learning disability. Fourteen participants were involved, in-depth interviews were conducted to gather data that was thematically analysed. The findings revealed that siblings want to be involved in the life of their brother or sister and to be seen as next of kin by professionals when their parents have died, but yet are unsure how best to approach this prospect. Based on these findings, implications for practitioners are discussed.
    • Simulated learning and objective structured clinical examinations

      McLaughlin, Andrea; University of Chester (SAGE, 2010-10-29)
      This book chapter discusses the benefits and challenges of simulated learning and how such learning can be assessed.
    • Sleep hygiene education and children with developmental disabilities:findings from a co-design study

      Sutton, Julie E.; Huws, Jaci C.; Burton, Christopher R.; University of Chester; Bangor University (SAGE publications, 2019-01-17)
      This qualitative study develops a programme theory demonstrating the complexity embedded in sleep hygiene education (SHE) as an intervention to improve sleep problems in children with developmental disabilities. In co-design workshops, eight parents and six sleep practitioners deliberated themes developed from findings of an earlier exploratory study of stakeholder perceptions of SHE. A SHE tool underpinned by programme theory was developed evidenced by midrange theories of change. Analytical themes were developed to explain the programme theory and the complexities of a successful SHE intervention: the need to legitimize children’s sleep problems and consider the nature of customization, knowledge sharing, health expectation and impact of sleep service rationing and gaming strategies on implementation success. Policy and practice implications include a need to raise the public profile of children’s sleep problems and promote parental involvement in intervention implementation. Further research is needed to test out this theory-driven framework for evaluating SHE.
    • The Social and Health Inequalities Agenda

      Mabhala, Mzwandile A.; University of Chester (McGraw-Hill / Open University Press, 2014-10-01)
      How much the health and well-being of individuals and populations can be improved depends upon understanding the wider determinants of health and the social and health inequalities agenda. This chapter aims to build on the concepts introduced in chapter one and to explore the differences in health outcomes globally and across the UK. This will be achieved through an examination of up-to-date policy and publications such as Fair Society, Fair Lives – The Marmot Review (Department of Health [DH] 2010), Closing the Gap in a Generation (World Health Organization [WHO] 2008b), and The Impact of Inequality (Wilkinson 2005). Health outcomes can be measured, but how can health inequalities be reduced and health and well-being improved? What are the economic implications of impaired health, and how can strategic planning improve health and reduce inequalities?
    • Social conditions of becoming homelessness: qualitative analysis of life stories of homeless peoples

      Mabhala, Mzwandile A.; Asmait, Yohannes; Griffith, Mariska; University of Chester; Mount Sanai Healthcare System, New York, University of Chester (BioMed Central, 2017-08-22)
      Background It is increasingly acknowledged that homelessness is a more complex social and public health phenomenon than the absence of a place to live. This view signifies a paradigm shift, from the definition of homelessness in terms of the absence of permanent accommodation, with its focus on pathways out of homelessness through the acquisition and maintenance of permanent housing, to understanding the social context of homelessness and social interventions to prevent it. However, despite evidence of the association between homelessness and social factors, there is very little research that examines the wider social context within which homelessness occurs from the perspective of homeless people themselves. This study aims to examine the stories of homeless people to gain understanding of the social conditions under which homelessness occurs, in order to propose a theoretical explanation for it. Method Twenty-six semi-structured interviews were conducted with homeless people in three centres for homeless people in Cheshire North West of England. Results The analysis revealed that becoming homeless is a process characterised by a progressive waning of resilience capacity to cope with life challenges created by series of adverse incidents in one’s life. The data show that final stage in the process of becoming homeless is complete collapse of relationships with those close to them. Most prominent pattern of behaviours participants often describe as main causes of breakdown of their relationships are: 1. engaging in maladaptive behavioural lifestyle including taking drugs and/or excessive alcohol drinking 2. Being in trouble with people in authorities. Conclusion Homeless people describe the immediate behavioural causes of homelessness, however, the analysis revealed the social and economic conditions within which homelessness occurred. The participants’ descriptions of the social conditions in which were raised and their references to maladaptive behaviours which led to them becoming homeless, led us to conclude that they believe that their social condition affected their life chances: that these conditions were responsible for their low quality of social connections, poor educational attainment, insecure employment and other reduced life opportunities available to them.
    • The social construction of stigma in health care settings

      Mason, Tom; Mason-Whitehead, Elizabeth (Chester Academic Press, 2006)
      This book chapter discusses stigma in health care settings from the perspective of social constructivism.
    • Social exclusion and stigma

      Whitehead, Elizabeth; University of Chester (SAGE, 2008-11-20)
      This book chapter discusses categorising stigma, understanding stigma from a perspective of affective psychology, and working towards social inclusion.
    • Social Justice and Global Perspectives on Health Improvement and Well-being

      Mabhala, Mzwandile A.; University of Chester (McGraw-Hill/ Open University Press, 2014-10-01)
      This chapter critically defines social justice. It openly declares that its analysis of social justice is situated within a particular political position, and explains why that position is taken in relation to public health and inequalities in health. It proposes that, in a just society, the primary function of the state should be to produce policies that enable all members of society to have fair and genuine access to opportunities to obtain the social goods that determine health and well-being. It goes on to critically review the literature on three differing theories of social justice – the libertarian, utilitarian, and egalitarian philosophies – particularly their fundamental claims regarding equality and fairness in the distribution of privilege and deprivation. It notes that egalitarian theories are consistent with the social justice principles of equality and fairness, on the understanding that egalitarian philosophy proposes an equal distribution of social goods; and as the evidence suggests that health inequalities are rooted on an uneven distribution of social goods, egalitarian theories are proposed as a suitable approach for addressing inequalities in health. Furthermore, evidence shows that egalitarian approaches, which place more emphasis on health – as opposed to healthcare or access to health services – provide a better solution to the social injustice of health inequalities. This chapter uses examples from the UK, South Africa and elsewhere to explain why egalitarian social justice principles provide a perfect fit with the practice of public health policy. It also justifies why health, as opposed to healthcare, has special moral importance for social justice in health inequalities; and argues that, if health and social policies are to have any chance of reducing health inequalities they will have to pay more attention to health rather than health services.
    • Social recovery therapy in combination with early intervention services for enhancement of social recovery in patients with first-episode psychosis (SUPEREDEN3): a single-blind, randomised controlled trial

      Fowler, David; Hodgekins, Jo; French, Paul; Marshall, Max; Freemantle, Nick; McCrone, Paul; Everard, Linda; Lavis, Anna; Jones, Peter B.; Amos, Tim; et al. (Elsevier, 2017-12-11)
      Background - Provision of early intervention services has increased the rate of social recovery in patients with first episode psychosis; however, many individuals have continuing severe and persistent problems with social functioning. We aimed to assess the efficacy of early intervention services augmented with social recovery therapy in patients with first-episode psychosis. The primary hypothesis was that social recovery therapy plus early intervention services would lead to improvements in social recovery. Methods - We did this single-blind, phase 2, randomised controlled trial (SUPEREDEN3) at four specialist early intervention services in the UK. We included participants who were aged 16–35 years, had non-affective psychosis, had been clients of early intervention services for 12–30 months, and had persistent and severe social disability, defined as engagement in less than 30 h per week of structured activity. Participants were randomly assigned (1:1), via computer-generated randomisation with permuted blocks (sizes of four to six), to receive social recovery therapy plus early intervention services or early intervention services alone. Randomisation was stratified by sex and recruitment centre (Norfolk, Birmingham, Lancashire, and Sussex). By necessity, participants were not masked to group allocation, but allocation was concealed from outcome assessors. The primary outcome was time spent in structured activity at 9 months, as measured by the Time Use Survey. Analysis was by intention to treat. This trial is registered with ISRCTN, number ISRCTN61621571. Findings Between Oct 1, 2012, and June 20, 2014, we randomly assigned 155 participants to receive social recovery therapy plus early intervention services (n=76) or early intervention services alone (n=79); the intention-to-treat population comprised 154 patients. At 9 months, 143 (93%) participants had data for the primary outcome. Social recovery therapy plus early intervention services was associated with an increase in structured activity of 8·1 h (95% CI 2·5–13·6; p=0·0050) compared with early intervention services alone. No adverse events were deemed attributable to study therapy. Interpretation - Our findings show a clinically important benefit of enhanced social recovery on structured activity in patients with first-episode psychosis who received social recovery therapy plus early intervention services. Social recovery therapy might be useful in improving functional outcomes in people with first-episode psychosis, particularly in individuals not motivated to engage in existing psychosocial interventions targeting functioning, or who have comorbid difficulties preventing them from doing so.