• Evaluation of the Broseley Health Technology Pilot

      Mabhala, Mzwandile A.; Bailey, Jan; Davies, Miriam; Enyinna, Chinwe; University of Chester
      This document reports on the evaluation of a health technology pilot, which was delivered by Shropshire Council’s Public Health Team. This service evaluation explored the usability and acceptability of three consumer smart devices in a group of older adults who live within the community. The devices are the “Echo Dot”, “Echo Show” and “Fitness Tracker”. The intention of the evaluation was to identify whether these devices meet the needs of its users, their experiences using the equipment and the impact of having and using this equipment.
    • Evaluation of the CWDC’s support to front line managers project

      Harlow, Elizabeth; Blunt, Gordan; Stanley, Nick; University of Chester ; Gordon Blunt Analytics (2011)
    • Evaluation of village and community halls energy consumption in Cheshire and Warrington

      Hellenbach, Michael; Hunt, Tamara; Alexander, Roy; Hogard, Elaine; Ellis, Roger; University of Chester (University of Chester, 2007-03)
      This report discusses public buildings and environmental education, particulary in relation to energy use and efficiency, attitudes to renewable energy, and institutional problems. A number of recommendations are made.
    • An evaulation study of a pilot group education programme for inflammatory bowel disease

      Sephton, Mark; Kemp, Karen; Ridgway, Victoria; University of Chester; University of Manchester (BMJ Publishing Group, 2015-10-23)
      Background and aims The emphasis for healthcare clinicians to provide adequate diseaserelated education is increasing. Yet little is known about the effect of providing diseaserelated education within inflammatory bowel disease (IBD). Previous studies have demonstrated increased levels of knowledge and satisfaction, but failed to capture any positive effects on the psychosocial elements of living with IBD. The aim of this qualitative study was to evaluate the impact of providing a group patient education programme on the psychosocial elements of living with IBD. Methods The data were obtained through eight semistructured qualitative interviews. Participants were recruited at the education programme using purposive sampling. All the interviews were digital recorded and transcribed. Thematic analysis was used by two independent researchers to analyse the transcripts and agreed emerging themes. Results A global theme of ‘mastery’ was evident within the transcripts. This was underpinned with two core themes of enablement and cooperative learning. The education programme ‘enabled’ the participants in a variety of ways: increased confidence, control, courage and power over their disease. An unexpected core theme of cooperative learning was also identified, with participants describing the overwhelming benefit of interaction with other people who also had IBD. Conclusions This is the first qualitative study to report on the effects of providing a group patient education within IBD. The results identify new and interesting psychosocial elements that existing quantitative studies have failed to identify.
    • Event-related and readiness potentials when preparing to approach and avoid alcohol cues following cue avoidance training in heavy drinkers.

      Stancak, Andrej; Soto, Vicente; Fallon, Nick; Di Lemma, Lisa; University of Chester; University of Liverpool; Universidad Adolfo Ibáñez; University of Sheffield.
      Rationale Cue avoidance training (CAT) reduces alcohol consumption in the laboratory. However, the neural mechanisms that underlie the effects of this intervention are poorly understood. Objectives The present study investigated the effects of a single session of CAT on event-related and readiness potentials during preparation of approach and avoidance movements to alcohol cues. Methods Heavy drinking young adults (N = 60) were randomly assigned to complete either CAT or control training. After training, we recorded participants’ event-related and motor readiness potentials as they were preparing to respond. Results In the CAT group, N200 amplitude was higher when preparing to approach rather than avoid alcohol pictures. In the control group, N200 amplitudes did not differ for approach and avoidance to alcohol pictures. Regarding the late positive potential (LPP), in the CAT group, the negativity of this was blunted when preparing to avoid alcohol pictures relative to when preparing to avoid control pictures. In the control group, the negativity of the LPP was blunted when preparing to approach alcohol pictures relative to when preparing to approach control pictures. There were no effects on motor readiness potentials. Behavioural effects indicated short-lived effects of training on reaction times during the training block that did not persist when participants were given time to prepare their motor response before executing it during the EEG testing block. Conclusions After a single session of CAT, the enhanced N200 when approaching alcohol cues may indicate the engagement of executive control to overcome the associations learned during training. These findings clarify the neural mechanisms that may underlie the effects of CAT on drinking behaviour.
    • Evidence of a Hemophilia Employment Gap: Comparing Data from CHESS US+ and the 2019 Current Population Survey

      Asghar, Sohaib; Burke, Tom; Misciattelli, Natalia; Kar, Sharmila; Morgan, George; O'Hara, Jamie (American Society of Hematology, 2020-11-05)
      INTRODUCTION Severe hemophilia A (<1% normal FVIII activity) and B (<1% normal FIX activity) are congenital bleeding disorders characterized by uncontrolled bleeding, either spontaneously or in response to trauma or surgery. Recent commentary has identified a number of patient-important and patient-relevant outcomes that have been understudied, namely the challenges faced by people living with hemophilia to participate in the labor force. The socio-economic impact of hemophilia is comparatively less well understood than clinical outcomes and therapy-related costs. Under-employment and under-utilization have long-term consequences to individuals' job prospects and psychosocial health, as well as an economic cost to the society. The objective of the analysis is to compare labor market participation, among people with severe hemophilia from the US and the general population. This analysis draws on household data derived from the 2019 Current Population Survey (CPS), and on patient-reported data from a patient-centric study conducted in 2019 of people with severe hemophilia, in the US: the 'Cost of Severe Hemophilia Across the US: A Socioeconomic Survey' (CHESS US+). METHODS A patient-centric framework informed the design of CHESS US+ a retrospective (12 months prior to study enrollment), cross-sectional dataset of adults with severe hemophilia in the US. Conducted in 2019, the study used a patient-completed questionnaire to collect data on patient-relevant clinical, economic, and humanistic outcomes. This analysis examines labor market participation (full-time, part-time, unemployed), and corresponding general population data derived from the 2019 Current Population Survey (CPS). Data on the general population were sourced from the 2019 CPS 'Employment status of the civilian noninstitutional population'. Persons 'not in the labor force' in the 2019 CPS and retired persons in CHESS US+ were not included in the analysis. We present data on the civilian labor force, in CHESS US+ and in the 2019 CPS. Results are presented as mean (standard deviation) or N (%). RESULTS Of 356 patients profiled in the CHESS US+ study, 97 (27%) had severe hemophilia B and 257 (73%) had severe hemophilia A. Mean age and weight (kg) of the cohort was 34.99 (12.15) and 85.71 (22.81), respectively. The labor force participation rates of non-retired people with severe hemophilia in CHESS US+ (N = 340) and the general population (161,458) are described in Table 1. Examining aggregate data on employment status observed a higher proportion of people with severe hemophilia in part-time employment (24.4% vs. 15.7%). Differences in the labor force participation of people living with severe hemophilia compared to the general population were most pronounced in the full-time employment rate and the unemployment rate. Compared to 80.7% of the general population (Table 1), only 53.5% of people with severe hemophilia in CHESS US+ had a full-time job. Moreover, the unemployment rate (Table 1) in the 2019 CPS compared with the rate observed in CHESS US+ (3.7% vs. 22.1%) provides a stark contrast in the employment experiences of people living with severe hemophilia relative to the general population. CONCLUSIONS This analysis of CHESS US+ illustrates the impact of severe hemophilia on labor force participation. People with severe hemophilia were more likely than the general population to be unemployed, or in part-time employment. A notable contrast was observed in the rate of full-time employment and unemployment, among the general population compared to people living with severe hemophilia. These data illustrate the need to quantify the impact of hemophilia using a holistic approach that considers the cost of involuntary illness-related part-time and unemployment. Disclosures Asghar: HCD Economics: Current Employment. Burke:HCD Economics: Current Employment; F. Hoffmann-La Roche Ltd: Consultancy; University of Chester: Current Employment. Misciattelli:Freeline: Current Employment, Current equity holder in publicly-traded company. Kar:Freeline: Current Employment, Current equity holder in publicly-traded company. Morgan:HCD Economics: Current Employment; uniQure: Consultancy. O'Hara:F. Hoffmann-La Roche Ltd: Consultancy; HCD Economics: Current Employment, Current equity holder in private company.
    • Evidence-based practice and evidence-informed practice competencies in undergraduate pre-registration nursing curricula: a document analysis at a University in England

      Kumah, E; Bettany-Saltikov, J; van Schaik, P; McSherry, R; Teesside University; University of Chester (Elsevier, 2021-03-13)
      Evidence-based practice and evidence-informed practice competencies in undergraduate pre-registration nursing curricula: a document analysis at a University in England Abstract Background In response to the heightened emphasis on incorporating the best available evidence into healthcare decision-making, healthcare training institutions have been actively incorporating Evidence-Based Practice (EBP), and/or Evidence-Informed Practice (EIP) competencies into undergraduate healthcare curricula. However, there is a gap in the scientific knowledge about the actual contents, as well as the extent of integration of EBP and EIP in undergraduate pre-registration nursing programmes. Method A document analysis utilising Rohwer et al.’s (2014) framework was conducted to review and analyse the content of EBP and EIP competencies in the 2018/2019 curriculum of the undergraduate pre-registration nursing programme of a University located in England, United Kingdom. Results Competencies relevant to EBP were included in four nursing modules. However, EIP competencies were not included in the curriculum. Conclusion There is an urgent need for a more structured and holistic way of teaching and assessing EBP competencies through the integration of the principles of EIP, in order to enhance the effective application of evidence into clinical nursing practice.
    • Evidence-informed practice: simplifying and applying the concept for nursing students and academics

      Bettany-Saltikov, Josette; Van Schaik, Paul; McSherry, Robert; Kumah, Elizabeth; University of Chester, University of Teesside
      Abstract Background: Nurses’ ability to effectively apply evidence into practice is a critical factor in the delivery of quality patient care. Evidence-Based Practice (EBP) is recognized as the gold standard for the delivery of safe and effective person-centred care. Yet, after several decades of its inception, nurses continue to encounter difficulties in implementing the concept. Existing models for implementing EBP offer stepwise approaches, nevertheless, certain factors, such as the context of care and its mechanistic nature act as barriers to the effective and consistent implementation of EBP. It is, therefore, imperative that a solution to solving the way in which evidence is applied into practice is found. Evidence-Informed Practice (EIP) is an evolving concept. In recent times, there has been a focus on EIP as an alternative to EBP. This has generated an international debate as to which of the two concepts better facilitate the application of evidence into practice. While several EBP models and educational interventions exist, there is limited research directed towards understanding the concept of EIP and how it facilitates the application of evidence into clinical nursing practice. Aim: This article aims at clarifying the concept of EIP and provides an integrated systems-based model of EIP in facilitating the application of evidence into clinical nursing practice. This is achieved through the application of two nursing case scenarios. Case scenario 1 is about caring for a high-dependent patient and case scenario 2 involves a patient with a low white blood cell count. Method: this article takes the reader through the various factors, elements, and associated systems and processes of the EIP model. Results: The case scenarios detail the various factors and elements of the EIP model and defines how it facilitates the application of evidence into clinical nursing practice. Conclusion: The EIP model provides a framework for nurses (indeed all healthcare practitioners) to deliver clinically effective care, and to be able to defend the processes used and the service provided by referring to reliable evidence. Revised
    • Examination and Validation of a Patient-Centric Joint Metric: "Problem Joint"; Empirical Evidence from the CHESS US Dataset

      Burke, Tom; Rodriguez Santana, Idaira; Chowdary, Pratima; Curtis, Randall; Khair, Kate; Laffan, Michael; McLaughlin, Paul; Noone, Declan; O'Mahony, Brian; Pasi, John; et al. (American Society of Hematology, 2020-11-05)
      Introduction Severe hemophilia (FVIII/FIX level <1%) is characterized by spontaneous hemarthrosis leading to progressive joint deterioration and chronic pain in the affected individual. Unless these recurrent hemarthroses can be prevented, e.g. with the use of prophylactic factor replacement therapy, these patients will develop chronic synovitis, pain, and eventually destruction of the joint. Current metrics such as 'Target joint' and other clinical measures of joint morbidity are prevalent and widely accepted. Measures focused solely on bleeding activity, such as the 'Target joint' metric, are arguably becoming less sensitive as current treatment strategies look to significantly reduce or eradicate joint bleeds, though they maintain clinically relevant and complementary to delivery of comprehensive hemophilia care. Key opinion leaders in the haemophilia field have debated the need for a more patient relevant measure of haemophilia-related joint morbidity. 'Problem Joint' (PJ), which is defined as having chronic joint pain and/or limited range of movement due to compromised joint integrity (chronic synovitis and/or haemophilic arthropathy), with or without persistent bleeding was derived through consensus. The objectives of this working group are to examine the usefulness and validity of the PJ metric. Initial research presented here was used to test the sensitivity of PJ as a patient relevant metric with respect to key outcomes for US haemophilia patients. Methods Data on PJs, as well as demographic, clinical and socio-economic variables was captured within the 'Cost of Haemophilia Across Europe: A Socioeconomic Survey' datasets (CHESS: I, II, Paediatric, and US studies). These data contain a total of 992 paediatric (age 1-17) and 2,437 adults (age 18+) with haemophilia from eight European countries and the US. Statistical analysis explored the association of PJ count and location with respect to two key outcomes: quality of life, as measured by an EQ-5D score, and overall work impairment, measured by the Work Productivity and Activity Impairment Questionnaire (WPAI). Those with current inhibitors were excluded from the analysis, and the US cohort comprised the focus of this initial research into the topic. Results The US cohort contained information on 345 people with haemophilia (PwH) and captured adults only, with a mean age of 35 years. Approximately, 43% of PwH had one or more PJs. Lower body PJs were more prevalent than upper body: 40% had one or more lower body PJs vs. 27% upper body. The majority of PJs were located in the ankles, knees and elbows. The relationship between EQ-5D and number of PJs showed a negative trend (see Figure 1): the average EQ-5D score was: 0.81 for those with zero PJs (N=197); 0.79 for those with one PJ (N=24); 0.70 for two PJs (N=29); 0.68 for three PJs (N=24) and 0.49 for those patients with four of more PJs (N=59). Similarly, an increase in number of PJs meant greater work productivity impairment versus no PJs recorded: 30.08% (N=102) vs. 19.51% (N=137), respectively. Discussion Results from the US cohort found that an increase in the number of PJs was associated with an increasing humanistic burden in PwH. The proposed Problem Joint definition takes a holistic viewpoint and provides a patient relevant perspective. Further work is planned to evaluate the appropriateness of the measure, and test the sensitivity in European and pediatric cohorts. Disclosures Burke: HCD Economics: Current Employment; University of Chester: Current Employment; F. Hoffmann-La Roche Ltd: Consultancy. Rodriguez Santana:HCD Economics: Current Employment. Chowdary:Pfizer: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Sobi: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Roche: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Sanofi: Membership on an entity's Board of Directors or advisory committees; Shire (Baxalta): Membership on an entity's Board of Directors or advisory committees; Spark: Membership on an entity's Board of Directors or advisory committees; BioMarin: Honoraria; Novo Nordisk: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; CSL Behring: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Chugai: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Freeline: Membership on an entity's Board of Directors or advisory committees, Research Funding; Bayer: Membership on an entity's Board of Directors or advisory committees, Research Funding. Curtis:Bayer: Consultancy; Novo Nordisk: Consultancy; Patient Reported Outcomes, Burdens and Experiences: Consultancy; USC Hemophilia Utilization Group Study (HUGS): Consultancy. Khair:Haemnet: Membership on an entity's Board of Directors or advisory committees; Biomarin: Consultancy; HCD Economics: Consultancy; Novo Nordisk: Consultancy, Membership on an entity's Board of Directors or advisory committees; Medikhair: Membership on an entity's Board of Directors or advisory committees; Sobi: Consultancy, Honoraria, Research Funding, Speakers Bureau; CSL Behring: Honoraria, Research Funding; F. Hoffmann-La Roche Ltd: Honoraria, Research Funding; Takeda: Honoraria, Speakers Bureau; Bayer: Consultancy, Honoraria, Speakers Bureau. Laffan:Shire: Consultancy; LFB: Consultancy; Roche: Consultancy; Sobi: Consultancy; Pfizer: Consultancy; CSL: Consultancy; Pfizer: Speakers Bureau; Bayer: Speakers Bureau; Roche-Chugai: Speakers Bureau; Takeda: Speakers Bureau; Leo-Pharma: Speakers Bureau; Octapharma: Consultancy. McLaughlin:BioMarin: Consultancy; Novo Nordisk: Consultancy, Speakers Bureau; Sobi: Consultancy, Speakers Bureau; Roche/Chugai: Speakers Bureau; Takeda: Speakers Bureau. Noone:European Haemophilia Consortium: Membership on an entity's Board of Directors or advisory committees; Research Investigator PROBE: Research Funding; Healthcare Decision Consultants: Membership on an entity's Board of Directors or advisory committees. O'Mahony:Biomarin: Honoraria, Membership on an entity's Board of Directors or advisory committees; Freeline: Honoraria; UniQure: Honoraria. Pasi:BioMarin: Consultancy, Honoraria, Other: Grants, personal fees, and nonfinancial support; honoraria as member of scientific advisory boards and symposia; uniQure: Other: Grants and nonfinancial support , Research Funding; ApcinteX: Consultancy, Other: Personal fees ; Octapharma: Honoraria, Other: Personal fees and nonfinancial support; honoraria as member of scientific advisory boards and symposia , Speakers Bureau; Novo Nordisk: Honoraria, Other: Personal fees and nonfinancial support; honoraria as member of scientific advisory boards and symposia ; Catalyst Biosciences: Consultancy, Other: Personal fees and nonfinancial support; honoraria as member of scientific advisory boards and symposia; Biotest: Consultancy, Honoraria, Other: Personal fees and nonfinancial support; honoraria as member of scientific advisory boards and symposia; Alnylam (Sanofi): Other: Personal fees and nonfinancial support ; Takeda: Consultancy, Honoraria, Other: Personal fees; honoraria as member of scientific advisory boards and symposia ; Sanofi: Honoraria, Other: Personal fees and nonfinancial support; honoraria as member of scientific advisory boards and symposia, Research Funding; Sigilon: Research Funding; Tremeau: Research Funding; Sobi: Consultancy, Honoraria, Other; Roche: Honoraria, Other; Pfizer: Other. Skinner:Genentech: Consultancy, Honoraria; Spark Therapeutics: Other, Speakers Bureau; Pfizer: Other, Speakers Bureau; Takeda: Honoraria, Research Funding; uniQure: Research Funding; Biomarin: Consultancy, Research Funding; CSL Behring: Research Funding; Freeline Therapeutics: Research Funding; Novo Nordisk: Honoraria, Research Funding; Roche: Honoraria, Research Funding; Sanofi: Honoraria, Research Funding, Speakers Bureau; Sobi: Research Funding; Bayer: Consultancy, Research Funding. O'Hara:HCD Economics: Current Employment, Current equity holder in private company; F. Hoffmann-La Roche Ltd: Consultancy.
    • Experiences of sleep hygiene education as an intervention for sleep problems in children with developmental disabilities: Findings from an exploratory study.

      Sutton, Julie E.; Huws, Jaci C.; Burton, Christopher R.; University of Chester and Bangor University (Wiley, 2019-05-16)
      Behavioural sleep problems in children with developmental disabilities that involves advising parents on sleep‐promoting behaviours; however, it is supported by a limited evidence base. Materials and methods: This exploratory study aimed to enhance qualitative understanding and explore stakeholder perceptions about experience, current practice and ideas around the implementation of SHE. Parents of children with developmental disabilities and sleep problems (N = 9) and sleep practitioners (N = 11) took part in semi‐structured interviews and focus groups, and data were thematically analysed. Results and discussion: The analysis identified four parent themes: Beliefs about sleep problems; Getting professional help; Ways of knowing about sleep; and Visions of sleep support. Two practitioner themes were also identified: Sleep service accessibility and Inconsistent sleep support. Conclusion: The findings provide further insight into how parents of children with developmental disabilities experience sleep problems, and how SHE is currently implemented. These have implications for both policy and practice.
    • Experiential and work-based learning

      McLaughlin, Andrea; University of Chester (SAGE, 2010-10-29)
      This book chapter discusses the importance of experience through experiential and work-based learning programmes and how academic credit can be claimed for such experience.
    • An exploration of issues affecting the assessment of social work students on practice placement in England

      Caffrey, Bridget; Fruin, Helen; University of Chester (Whiting and Birch, 2019-05-09)
      This article explores issues affecting assessment of social work students on practice placements in England. The authors have many years of experience in this area of social work and aim to highlight concerns about the complexity of assessment in practice settings. This report draws on research presented by Bailey-McHale and Caffrey (2018) at the 12th International Conference on Practice Teaching and Field Education in Health and Social Work in order to consider student perspectives. These highlight a sense of feeling powerless and judged. This article also explores the wider issues potentially impacting on the assessment of students practice. Acknowledging the challenges of all assessments, we consider how assessment of student practice may be further complicated by factors including the role and demands of universities, the impact of training and support for practice educators and pressures within current social work practice. This commentary highlights longstanding inequalities within social work assessment on placements for some student groups, including BAME students. The authors draw on Brookfield’s (1998) reflective lenses and encourage the social work profession to reflect and consider how current practice might be improved. The authors invite ideas and feedback to stimulate a professional debate and new ideas.
    • An exploration of issues related to nurse led clinics

      Flynn, Sandra D.; Whitehead, Elizabeth; Countess of Chester NHS Foundation Trust ; University of Chester (Elsevier, 2006-05-16)
      This article discusses nurse-led clinics and subsequent problems relating to professional boundaries and role tensions. Other professions may feel uncomfortable with nurse-led clinics and this can lead to distancing and conflict. The article identifies certain issues and discusses ways in which they can be managed in a more constructive manner.
    • Exploring Nigerian obstetricians’ perspectives on maternal birthing positions and perineal trauma

      Diorgu, Faith; Steen, Mary; Keeling, June J.; Mason-Whitehead, Elizabeth; University of Chester (Royal College of Midwives, 2016-05-26)
      Abstract Background. Evidence recommends encouraging expectant mothers to adopt birthing positions that will assist them in having a normal physiological birth. Upright birthing positions have been shown to have good birth outcomes and assist women to give birth normally. However, adopting the lithotomy position with legs flexed and supported with hands has become an entrenched clinical birthing practice in Nigeria and is associated with an increased risk of a routinely performed episiotomy. Hospital protocols have supported this medicalised approach to how women give birth, with little regard to woman-centred care. Nevertheless, Nigerian obstetricians’ perceptions and experiences on birthing position and perineal trauma have received minimal recognition and research. Aim. To explore perceptions and experiences of Nigerian obstetricians regarding maternal birthing position and perineal trauma following childbirth, and to gain insights as to whether obstetricians’ clinical decisions and practice were influenced by evidence. Methods. A descriptive qualitative study was conducted involving a purposive sample of eight obstetricians recruited from two referral hospitals in the Niger Delta region of Nigeria during November 2014. Data were collected using an interview schedule and a thematic analysis was undertaken. Data analysis was guided by Braun and Clarke’s (2006) six-stage thematic framework. Interviews were transcribed in full and categorisation of the data achieved with several in-depth readings of the transcripts. Data saturation was reached with the facilitation of the second focus group interview as no more emerging themes were identified. The study obtained ethical approval from the health and social research ethics committee at the University of Chester in the UK, and also from the study hospitals in the Niger Delta region in Nigeria. Results. Six participants were doctors undertaking obstetric specialist training and two were consultant obstetricians. The following core themes emerged: entrenched practice, lack of insight for evidence, embracing woman-centred care and professional dominance. An overall finding demonstrated a willingness to support mothers in their choices of birthing position and involved reflections on the indications for an episiotomy and incidences of perineal injuries. The findings also indicated that the obstetricians were prepared to consider woman-centred care in relation to birthing position and perineal trauma. Conclusions. This study has enabled some Nigerian obstetricians to reflect upon their perceptions and experiences of their clinical decisions and practices concerning birthing position and perineal trauma. Their current practice was frequently not supported by evidence. However, it emerged that there was a willingness to listen to women and adopt clinical birthing practices and perineal care that would respect choices based on contemporary evidence. Adopting a woman-centred approach would also enable Nigerian midwives working in the two study hospitals to support women to give birth in a position of their choosing and reduce the risk of a routinely performed episiotomy
    • Exploring peer mentoring as a form of innovative practice with young people at risk of child sexual exploitation.

      Buck, Gillian; Lawrence, Angela; Ragonese, Ester; University of Chester; Liverpool John Moores University (Oxford University Press, 2017-09-02)
      Peer-led approaches hold unique and innovative potential as a response to child sexual exploitation (CSE), yet little is known about such approaches in this field. This study aims to increase understanding by listening to young people using one such service. Qualitative methods were adopted in an attempt to understand how young people make sense of peer mentoring, data were collected through self-completion booklets, interviews and a focus group, and analysed using thematic analysis and Gilligan’s listening guide (see Kiegelmann, 2009). Given the small and local sample, the findings presented are not representative; rather they provide a snapshot, which enables us to consider the approach with this client group and the broader implications for peer-led practices. Peer mentoring emerges here as a method which may have emotional, practical and inter-personal benefits for young people facing multiple vulnerabilities. It also, importantly, reaches young women from hidden populations, who are often missing from, or missed by, support services. The article concludes by reflecting on the dilemmas associated with peer-led work and by outlining suggestions made by young people themselves, in the hope that inherent strengths in the approach can be recognised and embedded.
    • Exploring Preceptorship Programmes: Implications for Future Design

      Taylor, Louise; Ellerton, Annie; Eost-Telling, Charlotte; University of Chester (John Wiley & Sons Ltd, 2018-11-15)
      • Aims and objectives: To review and analyse current preceptorship programmes within NHS trusts in the North West of England. To evaluate the pedagogic rigour of the programme and suggest recommendations to inform the future design of preceptorship programmes. • Background: Enhancing the retention of newly qualified staff is of particular importance given that the journey from a new registrant to a competent healthcare professional poses a number of challenges, for both the individual staff member and organisations. • Design: A mixed methods evaluative approach was employed, using online questionnaires and content analysis of preceptorship documentation. • Methods: Forty-one NHS trusts across the North West region employing newly qualified nurses were invited to participate in the completion of an online questionnaire. In addition, preceptorship programme documentation was requested for inclusion in the content analysis. This study utilised the SQUIRE (Standards for Quality Improvement Reporting Excellence) guidelines. • Results: The response rate for the questionnaire was 56.1% (n=23). Eighteen trusts (43.9%) forwarded their programme documentation. Findings highlighted the wide variation in preceptorship programmes across the geographical footprint. • Conclusions: There were instances of outstanding preceptorship and preceptorship programmes where there was a clear link between the strategic vision, i.e., trust policy, and its delivery, i.e. preceptorship offering. There was no one framework that would universally meet the needs of all trusts, yet there are key components which should be included in all preceptorship programmes. Therefore, we would encourage innovation and creativity in preceptorship programmes, cognisant of local context. Relevance to clinical practice: The significant shortage of nursing staff in England is an ongoing issue. Recruitment and retention are key to ameliorating the shortfall, and formal support mechanisms like preceptorship, can improve the retention of newly qualified staff. Understanding current preceptorship programmes is an important first step in establishing the fundamental building blocks of successful preceptorship programmes and enabling the sharing of exemplary good practice across organisations.
    • Exploring Public Perceptions and Understanding of Dementia: Analysing Narratives from the Mass Observation Project

      Olsen, Veronica; Taylor, Louise; Whiteley, Kirsty; Ellerton, Annie; Kingston, Paul; Bailey, Jan; University of Chester (Sage, 2019-07-10)
      Over 850,000 people living in the United Kingdom have been diagnosed with dementia, yet knowledge about this condition amongst the general population remains relatively poor. Many studies have evaluated the level of public knowledge and understanding about dementia from a research and professional service perspective, however none have considered this condition from the perspective of the wider public. In this preliminary overview, we analyse and describe high level narratives collected from 143 respondents to a dementia Directive commissioned to the Mass Observation Project. These narratives present a perspective on the public knowledge and understanding about dementia not previously considered, where respondents have written openly about their own experiences, and reflected on their perception of the wider public’s knowledge and understanding about dementia. This unique perspective importantly enhances our knowledge about the public’s understanding and awareness of dementia, and informs the main areas of public concern found in the analysis: care responsibilities, impact on relationships, and fears about developing dementia.
    • Exploring the emotional experience of lean

      Taylor, Siobhan; McSherry, Robert; Cook, Susy; Giles, Emma; Coventry University; University of Chester; Shrewsbury and Telford Hospital NHS Trust; Teesside University
      Purpose – This research aims to contribute to the literature on Lean implementation in healthcare by studying the emotional experiences of the relevant actors related to a Rapid Process Improvement Workshop (RPIW) in a UK healthcare context. The purpose of this study was to go beyond what people think about Lean and towards an exploration of their subjective, emotional and “feeling” experience and whether that emotional experience influenced Lean implementation. Design/methodology/approach – A phenomenological and symbolic interactionist qualitative case study was undertaken. Data related to participants’ emotional experience were collected through non-participant observation and semi-structured interviews. Data were analysed using thematic network analysis. Findings – This paper provides novel insights into the emotional experience of Lean as experienced through an RPIW. The findings reveal that participation in an RPIW is much more than a technical process. It influences how people feel about themselves, is based on relationships with others, and requires mental, physical and emotional effort. All of these factors influence engagement with, initiation of and sustainability of the RPIW. Research limitations/implications – A new conceptual framework for the planning and implementation of RPIWs has been developed. However, because of the chosen research approach, the results may lack generalisability. Therefore, researchers are encouraged to test the framework and proposed practice implications. Originality/value – Despite emotions being an integral part of individual and social everyday life, emotional experience has not been studied in relation to Lean. This study is the first to explore emotions in relation to Lean, with implications for practice as to how RPIWs are managed with a new framework for implementation being proposed.
    • Exploring the health status of older persons in Sub Saharan Africa

      Audain, Keiron A.; Carr, Michelle; Dikmen, Derya; Zotor, Francis B.; Ellahi, Basma; University of Zambia; University of Chester; Hacettepe University; University of Health and Allied Science; University of Chester (Cambridge University Press, 2017-05-10)
      Sub-Saharan Africa has traditionally had a low life expectancy due to the onslaught of the HIV epidemic, high levels of chronic diseases, injuries, conflict and undernutrition. Therefore, research into public health concerns of older persons has largely been overlooked. With a growing population, the roll-out of antiretroviral treatment, and the effects of globalisation; Sub-Saharan Africa is experiencing an increase in the number of people over 50 years of age as well as an increase in the prevalence of non-communicable diseases. The aim of this review is to highlight available research on the health status of older persons in Sub-Saharan Africa, and to identify the current gaps that warrant further investigation. A literature search was conducted across multiple databases to identify studies in Sub-Saharan Africa on older persons (aged 50 years and older) related to health indicators including nutritional status, non-communicable diseases and HIV burden. Whilst it was concluded that older persons are at an increased risk of poor health, it was also determined that significant gaps exist in this particular area of research; namely nutrient deficiency prevalence. Resources should be directed towards identifying the health concerns of older persons and developing appropriate interventions.
    • Expression of inducible nitric oxide synthase in cultured smooth muscle cells from rat mesenteric lymphatic vessels

      Robertson, Deborah A. F.; Hughes, Gwen A.; Lyles, Geoffrey A.; University of Chester (Roberston) (Blackwell, 2004-09)