• APT study

      Steen, Mary (Florri-Feme, 2009-02-16)
      To evaluate the effectiveness of a a new cooling device (gel pad) with a standard regimen (ice pack) and compare these with a no localised treatment regimen (control). Design: A randomised controlled trial initially based in hospital and then continued in the community. Setting: A Midwifery Unit in the North of England and then in women's own homes. Participants: 450 women who had undergone either a normal or an instrumental delivery that required suturing of an episiotomy or second degree tear. Key Conclusions: This clinical trial confirms earlier findings in a previous study and provides evidence that the use of a specifically designed cooling gel pad is a safe and effective localised method to alleviate perineal trauma without any adverse effects on healing.
    • Are we preparing student nurses for final practice placement

      Morrell, Nicola; Ridgway, Victoria; University of Chester (Mark Allen Healthcare Ltd, 2014-05-21)
      The aims of this research were to illuminate student nurses’ perceptions of preparedness for final practice placement, and to ascertain factors that supported and hindered preparation for final placement practice. This phenomenological qualitative research was carried out in a UK higher education institution (HEI) with eight adult branch student nurses maintaining written diaries for the first 4 weeks of their final 10-week practice placement. Data were then analysed by means of an interpretive phenomenological approach (IPA). Results showed that students felt ill-prepared for placement. Eight clear themes emerged, including: being used as ‘an extra pair of hands’; mentors appearing to treat student practice documentation as unimportant; and high staff expectations. Other themes were: mentor importance; students feeling that they lacked knowledge; and students feeling unsupported and stressed. In conclusion, although students felt that they lacked knowledge and were used as an extra pair of hands, they did show clinical competence.
    • Art therapy with refugee children: a qualitative study explored through the lens of art therapists and their experiences

      Akthar, Zahra; Lovell, Andy; University of Chester (Taylor and Francis, 2018-11-09)
      This article sets out to explore the use of art therapy with refugee children, from the perspective of art therapists and their experiences. Three semi-structured interviews were conducted to gain insights by capturing experiences and stories. Using thematic analysis, five themes were identified: (1) giving voice; (2) rebuilding trust, opening wounds; (3) sharing stories, healing pain; (4) exploring identity, discovering new-self; and (5) understanding art therapy. Upon reflection, two key aspects of art therapy were established, these were identified as: (1) providing refugee children with a safe space to heal and discover new-self, and (2) giving refugee children a voice to express and share stories. Despite the last of the five themes (understanding art therapy) being established as a factor that limits the use of art therapy, this has created an avenue for further research. From the findings, it was concluded that art therapy can be a useful form of psychotherapy for refugee children. Art therapy can provide these children with a safe space to heal, and give them a voice to be heard.
    • Assessing public health need

      Rose, Pat; University of Chester (SAGE, 2008-11-20)
      This book chapter discusses the health needs assessment.
    • Assessment

      Gidman, Janice; University of Chester (SAGE, 2010-10-29)
      This book chapter discusses assessment as an integral part of the learning processes and how to use a variety of assessment strategies to assess professional competence.
    • Assessment and treatment of cutaneous leishmaniasis in the emergency department.

      McGhee, Stephen; Finnegan, Alan; Unversity of Miami; University of Chester
      Cutaneous leishmaniasis is endemic in more than 70 countries worldwide. It is a non-fatal disease caused by the Leishmania parasite that is transmitted to humans via bites of infected female sandflies. Cutaneous leishmaniasis causes skin lesions on areas of exposed skin, such as the face and limbs, which often produce scarring and atrophy. If untreated, cutaneous leishmaniasis can develop into mucocutaneous leishmaniasis, which is potentially life-threatening. Furthermore, patients with cutaneous leishmaniasis commonly experience psychosocial issues such as anxiety, distress, stigma and rejection. Cutaneous leishmaniasis is spreading outside of its traditional endemic areas because of the effects of environmental changes such as urbanisation and climate change. In the UK, healthcare professionals may encounter the disease in migrants from endemic areas, members of the armed forces, tourists and expatriates. Therefore, emergency nurses need to be able to assess and support patients who present with symptoms suggestive of cutaneous leishmaniasis. This article provides an overview of the epidemiology, aetiology, pathophysiology, clinical presentation, diagnosis, treatment and prevention of the disease.
    • Assessment of risk and special observations in mental health practice: A comparison of forensic and non-forensic settings

      Whitehead, Elizabeth; Mason, Tom; University of Chester (Blackwell, 2006-10-26)
      This article discusses research into the use of special observations in both forensic and non-forensic psychiatric settings. A comparative approach was adopted to establish if the perceived risk factors leading to the adoption of special observations were similar in both settings. Three groups of nursing staff were requested to assess 30 patients who were placed on special observations. Before this, nurses were requested to rate the risk factors in terms of their severity on a 7-point Likert scale. The rank-ordering analysis revealed a similarity of identified risk factors and anova (one-way, unrelated) and the Jonckheere Trend Test revealed that there were significant differences between the scores in the forensic and the non-forensic settings.
    • Assessment: Physical

      Ridgway, Victoria; University of Chester (Sage, 2008-03-17)
      This chapter examines the need for effective assessment skills in the nursing profession, and argues that the process of assessment is not a one-off activity and that ongoing assessment of patients is needed in order to identify actual and potential problems along with need to prioritise the need against demands on resources. Further consideration is given to the underpinning philosophy of the process of assessment.
    • Assistive Technologies and the Carers of People with Dementia

      Bhattacharyya, Sarmishtha; Benbow, Susan M. (IGI Global, 2016-01)
      Assistive technologies have a role in supporting both formal and informal carers of people with dementia, and in maintaining the independence, and quality of life of both people with dementia and their carers. The authors report a narrative review of the use of technological interventions to empower the carers of people with dementia, and relate this to a model of ageing well. They argue that this highlights the importance of empowering and connecting with carers in order to increase their participation and connection in the care of their relative/client; and conclude that both empowerment and connection contribute to maintaining autonomy and well-being of both carers and people with dementia. Technological interventions should not be used as alternatives to connection. The emphasis in practice should be on empowering and connecting with both carers and people with dementia.
    • Association of apolipoprotein E gene polymorphisms with blood lipids and their interaction with dietary factors

      Shatwan, Israa M.; Winther, Kristian H.; Ellahi, Basma; Elwood, Peter; Ben-Shlomo, Yoav; Givens, Ian; Rayman, Margaret P.; Lovegrove, Julie A.; Vimaleswaran, Karani S.; University of Reading; King Abdulaziz University; University Hospital Denmark; University of Chester; University Hospital of Wales; University of Bristol; University of Surrey (BioMed Central, 2018-04-30)
      Background: Several candidate genes have been identified in relation to lipid metabolism, and among these, lipoprotein lipase (LPL) and apolipoprotein E (APOE) gene polymorphisms are major sources of genetically determined variation in lipid concentrations. This study investigated the association of two single nucleotide polymorphisms (SNPs) at LPL, seven tagging SNPs at the APOE gene, and a common APOE haplotype (two SNPs) with blood lipids, and examined the interaction of these SNPs with dietary factors. Methods: The population studied for this investigation included 660 individuals from the Prevention of Cancer by Intervention with Selenium (PRECISE) study who supplied baseline data. The findings of the PRECISE study were further replicated using 1238 individuals from the Caerphilly Prospective cohort (CaPS). Dietary intake was assessed using a validated food-frequency questionnaire (FFQ) in PRECISE and a validated semi-quantitative FFQ in the CaPS. Interaction analyses were performed by including the interaction term in the linear regression model adjusted for age, body mass index, sex and country. Results: There was no association between dietary factors and blood lipids after Bonferroni correction and adjustment for confounding factors in either cohort. In the PRECISE study, after correction for multiple testing, there was a statistically significant association of the APOE haplotype (rs7412 and rs429358; E2, E3, and E4) and APOE tagSNP rs445925 with total cholesterol (P = 4 × 10− 4 and P = 0.003, respectively). Carriers of the E2 allele had lower total cholesterol concentration (5.54 ± 0.97 mmol/L) than those with the E3 (5.98 ± 1.05 mmol/L) (P = 0.001) and E4 (6.09 ± 1.06 mmol/L) (P = 2 × 10− 4) alleles. The association of APOE haplotype (E2, E3, and E4) and APOE SNP rs445925 with total cholesterol (P = 2 × 10− 6 and P = 3 × 10− 4, respectively) was further replicated in the CaPS. Additionally, significant association was found between APOE haplotype and APOE SNP rs445925 with low density lipoprotein cholesterol in CaPS (P = 4 × 10− 4 and P = 0.001, respectively). After Bonferroni correction, none of the cohorts showed a statistically significant SNP-diet interaction on lipid outcomes. Conclusion: In summary, our findings from the two cohorts confirm that genetic variations at the APOE locus influence plasma total cholesterol concentrations, however, the gene-diet interactions on lipids require further investigation in larger cohorts.
    • Association of apolipoprotein E gene polymorphisms with blood lipids and their interaction with dietary factors

      Shatwan, Israa M.; Winther, Kristian H.; Ellahi, Basma; Elwood, Peter; Ben-Shlomo, Yoav; Givens, Ian; Rayman, Margaret P.; Lovegrove, Julie A.; Vimaleswaran, Karani S.; Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research (ICMR), Department of Food and Nutritional Sciences, University of Reading, Reading, UK, RG6 6AP, UK; Food and Nutrition Department, Faculty of Home Economics, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Endocrinology and Metabolism Odense University Hospital Denmark; Faculty of Health and Social Care, University of Chester, Chester, CH1 1SL, UK; Department of Epidemiology, Statistics and Public Health, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK; Population Health Sciences, University of Bristol, Bristol, BS8 2PS, UK; Institute for Food, Nutrition and Health, University of Reading, Earley Gate, Reading RG6 6AR, UK; Department of Nutritional Sciences Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK. (BMC, 2018-04-30)
      Abstract Background: Several candidate genes have been identified in relation to lipid metabolism, and among these, lipoprotein lipase (LPL) and apolipoprotein E (APOE) gene polymorphisms are major sources of genetically determined variation in lipid concentrations. This study investigated the association of two single nucleotide polymorphisms (SNPs) at LPL, seven tagging SNPs at the APOE gene, and a common APOE haplotype (two SNPs) with blood lipids, and examined the interaction of these SNPs with dietary factors. Methods: The population studied for this investigation included 660 individuals from the Prevention of Cancer by Intervention with Selenium (PRECISE) study who supplied baseline data. The findings of the PRECISE study were further replicated using 1,238 individuals from the Caerphilly Prospective cohort (CaPS). Dietary intake was assessed using a validated food-frequency questionnaire (FFQ) in PRECISE and a validated semi-quantitative FFQ in the CaPS. Interaction analyses were performed by including the interaction term in the linear regression model adjusted for age, body mass index, sex and country. Results: There was no association between dietary factors and blood lipids after Bonferroni correction and adjustment for confounding factors in either cohort. In the PRECISE study, after correction for multiple testing, there was a statistically significant association of the APOE haplotype (rs7412 and rs429358; E2, E3, and E4) and APOE tagSNP rs445925 with total cholesterol (P=4x10-4 and P=0.003, respectively). Carriers of the E2 allele had lower total cholesterol concentration (5.54± 0.97 mmol/L) than those with the E3 (5.98± 1.05 mmol/L) (P=0.001) and E4 (6.09± 1.06 mmol/L) (P=2x10-4) alleles. The association of APOE haplotype (E2, E3, and E4) and APOE SNP rs445925 with total cholesterol (P=2x10-6 and P=3x10-4, respectively) was further replicated in the CaPS. Additionally, significant association was found between APOE haplotype and APOE SNP rs445925 with low density lipoprotein cholesterol in CaPS (P=4x10-4 and P=0.001, respectively). After Bonferroni correction, none of the cohorts showed a statistically significant SNP-diet interaction with lipid outcomes. Conclusion: In summary, our findings from the two cohorts confirm that genetic variations at the APOE locus influence plasma total cholesterol concentrations, however, the gene-diet interactions on lipids require further investigation in larger cohorts.
    • Attachment theory and schools

      Harlow, Elizabeth; University of Chester (2018-01-11)
      The implications of attachment theory are becoming more relevant to the work of schools. This article looks at the research and signposts a range of resources, training and support.
    • Attachment Theory: Developments, Debates and Recent Applications in Social Work, Social Care and Education

      Harlow, Elizabeth; University of Chester
      Attachment theory may be considered controversial given that some of its foundational principles are contested. Not only this, it is currently being developed by insights from neuroscience, another perspective that academics have subjected to critique. Nevertheless, at the beginning of the twenty-first century in England and the United Kingdom in general, there has been a renewed interest in its explanation of child development, as well as its application in schools, social care settings and the practice of professionals such as social workers and teachers. This paper outlines the core principles of attachment theory, acknowledges some of the criticisms, then traces the ways in which the theory has been developed over time. The theory is then illustrated with a description of the ways in which it is being applied in the training of foster carers, the provision of support to adoptive parents and in the school environment.
    • Attributes of palliative caring

      Baldwin, Moyra A.; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses the attributes of palliative care which include developing a therapeutic relationship between the carer and cared-for, as well as professional colleagues.
    • Autobiographical memory response to a negative mood in those with/without a history of depression

      Mitchell, Andrew E. P.; University of Chester (AEPress, 2015-09-17)
      In this study, we investigated the accessibility of overgeneral autobiographical memories (OGM) and specific memories by observing the effects of induced negative mood state on the characteristics of memory recall in those with and without a previous history of a depression. The Sentence Completion for Events from the Past Test (SCEPT) was used to assess OGM. The effects of previous history of depression (without history or with previous history of depression) and self-reported mood (pre or post negative mood induction) on autobiographical recall was shown in a mixed factor design. A significant interaction was observed between time and group in their effects on general memories (F(1, 32) = 5.06, p = .03) and specific memory (F(1, 32) = 4.88, p = .03), such that the previous history of depression group experienced a larger increase in general memory and a larger reduction in specific memory from pre to post manipulation.
    • Autonomy

      McCarthy, Jill; University of Chester (Sage, 2008-03-17)
      This chapter examines the concept of autonomy within the health care profession, which involves consideration of the moral and legal implications. The chapter also discusses the practicalities of autonomy when it is not always possible for the patient to exercise their autonomy because of an inability to communicate or act independently.
    • Barriers facing social workers undertaking direct work with children and young people with a learning disability who communicate using non-verbal methods.’

      Prynallt-Jones, Katherine A.; Carey, Malcolm; Doherty, Pauline; University of Chester (Oxford University Press, 2017-03-03)
      Abstract: This paper analyses data drawn from a small group of qualified social workers’ specialising in work with disabled children who communicate using non-verbal methods. While a number of studies have criticised social services for neglecting disabled children, this paper re-evaluates evidence from the standpoint of a small group of experienced practitioners. Three substantive themes are explored which include: problems faced by practitioner’s communicating with children and young people; barriers to direct work; and positive engagement or use of creative methods. Among other findings, the paper highlights the complexity of communication techniques when seeking to accommodate diverse service user and carer needs, as well as creative responses used by practitioners despite significant barriers that include limited available training, technology and financial resources. Despite policy initiatives and legal requirements emphasising the importance of direct work and participation with disabled children, the conclusion reiterates the narrow focus of current risk-averse social work around disability, as well a need for additional resources and training to improve relationships, communication and meaningful support for children and young people that meet basic legal requirements.
    • Beating the blues with pleasurable activity

      Mitchell, Andrew E. P.; University of Chester (Philip Allan, 2019)
      In this article Chartered Psychologist, Andrew Mitchell explains how behavioural activation (BA) can be used to treat depression
    • Behavioural and neurochemical responses evoked by repeated exposure to an elevated open platform

      Storey, J.; Robertson, Deborah A. F.; Beattie, J. E.; Reid, I. C.; Mitchell, S.; Balfour, David J. K.; University of Chester (Robertson) (Elsevier, 2011-01-18)
      This article investigated the changes in 5-HT release and turnover in the hippocampus evoked by acute and repeated exposure to an inescapable stressor, an elevated open platform, and compared them to the changes evoked in the frontal cortex.
    • Behavioural learning theories

      Lovell, Andy; Unversity of Chester (SAGE, 2010-10-29)
      This book chapter discusses the emergence of behaviourism and behaviour learning theory.