• Feme pad: Out of the ice age and into the new millennium

      Steen, Mary; Leeds Teaching Hospitals NHS Trust (Mark Allen Publishing, 2000-05-03)
      Explains the principles behind and use of the Feme Pad, a new cooling gel pad designed to alleviate perineal pain and reduce swelling following delivery.
    • Fieldwork and the practical implications for completing qualitative research in the British Armed Forces

      Finnegan, Alan; University of Chester (British Medical Journal, 2014-01-09)
      This article provides direction regarding the practical implications of undertaking qualitative research within the British Army, and in particular the Defence Medical Services (DMS). Qualitative researchers must gather sufficient data to answer their research question, and guidance on using DMS healthcare professionals as the research sample is offered, including dealing with the 'gatekeepers' who control access, and the principles for creating a conducive environment to gather reliable data. Data collection is often through intensive interviewing where communication skills and personal awareness are vital to a successful study. Aids to a productive study include memo writing and listing factors that may later provide an insight into how the interviewees characterise and describe particular activities, events and groups. Guidance is offered to develop an interview schedule with questions related to each other in a seamless, meaningful way. Both the researcher's and participant's conscious and unconscious biases must be acknowledged. In this narrow and specialist field, DMS researchers need extensive knowledge of clinical practice and the military's distinctive language, characterised with nuances and abbreviations. These words portray meanings and perspectives that signpost the participants' view of their empirical world. Early identification, without having to seek clarification, means that the researcher can examine hidden assumptions in the sample's own language
    • Final Report of the Evaluation of the Self-Directed Support Pilot

      Eost-Telling, Charlotte; University of Chester
      In recent years personalisation and the individualisation of health and social care have become key drivers of change. The process was initiated by the previous Labour government, and the new Coalition government has sought to accelerate the shift through policy documents, continued consultation and practical guides [1-7]. Personalisation in learning and physical disability services is becoming well established, however mental health services have been slow to take up the agenda and offer Personal Budgets to service users. Stockport Metropolitan Borough Council (SMBC), together with Pennine Health Care NHS Trust, are working to address this and implemented a pilot study to explore the possibilities for self directed support and Personal Budgets within Stockport mental health services.
    • Financial aspects for patients and carers

      Woodhouse, Jan; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses the financial burden that an illness may bring and how health care practitioners can help.
    • Finding the Forgotten: Motivating Military Veterans to Register with a Primary Healthcare Practice

      Finnegan, Alan; Jackson, Robin; Simpson, Robin; University of Chester; NHS Bury Clinical Commissioning Group; Ministry of Defence Deanery (Oxford University Press, 2018-05-09)
      Introduction: In the UK, primary healthcare practices choose from a series of Read codes to detail certain characteristics onto a patient's medical documentation. One of these codes is for military veterans indicating a history relating to military service. However, veterans are poor at seeking help, with research indicating that this code is only applied in 7.9% of cases. Clinical staff have a clear role in motivating veterans to declare their ex-Forces status or register with a primary healthcare center. The aim of this study was to motivate veterans to notify primary healthcare staff of their armed forces status or register with a general practitioner, and to improve primary healthcare staff's understanding of veterans' health and social care issues. Materials and Methods: Data were provided by four primary healthcare centers' containing 40,470 patients in Lancashire, England during 2017. Pre- and post-patient medical record Read Code searches were conducted either side of a 6-wk intervention period centered on an advertising campaign. The data identified those veterans with the military specific Read code attached to their medical record and their age, gender, marital status and mental health disorders. Further information was gathered from interviews with eight members of staff, some of whom had completed an e-learning veteran healthcare academic module. The study was approved by the University of Chester's Research Ethics Committee. Results: The pre-intervention search indicated that 8.7% (N = 180) of veterans were registered and had the correct military specific code applied to their medical record. Post-intervention, this figure increased by nearly 200% to N = 537. Mental health disorders were present in 28% (N = 152) of cases, including 15% (N = 78) with depression. Interviews revealed the primary healthcare staff's interpretation of the factors that motivated patients to declare their ex-Forces status and the key areas for development. Conclusion: The primary healthcare staff took ownership and responsibility for this initiative. They were creative in introducing new ways of engaging with the local armed forces community. Many veterans' and staff were unaware of veterans' entitlement to priority medical services, or the wider provisions available to them. It is probable that veterans declaring their military status within primary healthcare, or registering with a general practitioner for the first time is likely to increase. Another review will be undertaken after 12 mo, which will provide a better indication of success. There remains however an ongoing need to reach out to those veterans who never access a primary healthcare practice. This paper adds to the limited international empirical evidence undertaken to explore help-seeking behavior in an armed forces community. The positive outcomes of increased awareness and staff commitment provide a template for improvement across the UK, and will potentially stimulate similar initiatives with international colleagues.
    • First Pass Metabolism

      Robertson, Deborah A. F.; University of Chester (Mark Allen Healthcare Ltd, 2017-06-08)
      In this article in the series of ‘bite sized’ pharmacology, we will look at the concept of first pass metabolism. All drugs given by the oral route undergo a degree of first pass metabolism either in the gut or the liver, with some drugs being destroyed before they reach the systemic circulation. This pharmacokinetic process affects the bioavailability of drugs administered by this route and is an important consideration for the prescriber. Knowledge of first pass metabolism can assist the prescriber when deciding on doses and dose schedules to ensure that patients receive their medications at the correct dosing, by the correct route for optimum therapeutic effect. It also helps the prescriber understand why dose adjustments are made for some drugs when switching the route of administration from oral and why some drugs cannot be given by the oral route.
    • Food supplementation among HIV-infected adults in Sub-Saharan Africa: Impact on treatment adherence and weight gain

      Audain, Keiron A.; Zotor, Francis B.; Amuna, Paul; Ellahi, Basma; University of KwaZulu Natal ; University of Health and Allied Sciences, Ghana ; University of Greenwich ; University of Chester (The Nutrition Society, 2015-03-12)
      Sub-Saharan Africa has the highest proportion of undernourished people in the world, along with the highest number of people living with HIV and AIDS. Thus, as a result of high levels of food insecurity many HIV patients are also undernourished. The synergism between HIV and undernutrition leads to poor treatment adherence and high mortality rates. Undernutrition has a debilitating effect on the immune system due to key nutrient deficiencies and the overproduction of reactive species (oxidative stress), which causes rapid HIV progression and the onset of AIDS. Therapeutic food supplementation used in the treatment of severe acute malnutrition is being applied to HIV palliative care; however, little biochemical data exist to highlight its impact on oxidative stress and immune recovery.
    • Forensic nurses' perceptions of labels of mental illness and personality disorder: Clinical versus management issues

      Mason, Tom; Hall, Rebecca; Caulfield, Mike; Melling, Katherine; University of Chester (Blackwell, 2010-02-09)
      Anecdotally, forensic psychiatric nurses generally have a more negative perception of people diagnosed with a personality disorder and this negativity is focused more towards managing the behaviours rather than on treatment efficacy and clincal outcomes. this study reports on research carried out across the High, Medium and Low secure psychiatric services in the UK. One thousand two hundred questionnaires were distributed with a response rate of 34.6%. The results indicated a statistically significant differences across High (z=9.69; P< 0.01), Medium (z=11.06; P< 0.01) and Low (z= 9.57; P=0.01) security with a focus on the management of people with a personality disorder using the Wilcoxon paired samples test. There was also a statistically significant difference in relation to a more clinical/treatment focus for those with a diagnosis of mental illness in Medium (z= 9.69; P=0.01) and Low (z= 9.57; P<0.01) security but not in the High security services. Finally, the results showed significant differences between High, Medium and Low security on each of the four scales of Personality Disorder Clinical - Personality Disorder Management and Mental Illness Clinical - Mental Illness Management. This raises issues of stigma, prejudice and discrimination and suggests a refocus on skills development, acquisition and application for those with a label of personality disorder.
    • Forensic psychiatric nursing: Skills and competencies: I role dimensions

      Mason, Tom; Lovell, Andy; Coyle, David L.; University of Chester (Blackwell, 2008-01-18)
      This paper reports on an investigation into the skills and competencies of forensic psychiatric nurses from the perspective of three groups (a) forensic psychiatric nurses, (b) non-forensic psychiatric nurses and (c) other disciplines. A national survey of freonsc psychiatric services in the UK was conducted, and information gathered on the perceived skills and competencies in this growing field of psychiatric practice. From 3360 questionnaires, 1172 were returned making a response rate of 35%. The results indicate a small discrepancy between forensic nurses' and non-forensic nurses' perceptions of the role constructs of forensic practice. However, a larger difference was noted between nurses'perceptions and other disciplines' perceptions of the constituent parts to forensic psychiatric nursing. Nurses tend ed to focus on personal qualities both in relation to themselves and th epatients, while the other disciplines focused on organizational structures both in defining the role and in the resolution of perceived deficits. The findings have implications for multidisciplinary working, as well as policy formulation and curriculum development in terms of the skills and competencices of forensic nurse training.
    • Forensic psychiatric nursing: Skills and competencies: II Clinical Aspects

      Mason, Tom; Coyle, David L.; Lovell, Andy; University of Chester (Blackwell, 2008-01-18)
      This study reports on research undertaken to identify the skills and competencies of forensic psychiatric nurses working in secure psychiatric services in the UK. The rationale for this research is the lack of clarity in the role definition of nurses working in these environments and the specific content that may underscore the curriculum for training forensic nurses. Over 3300 questionnaires were distributed to forensic psychiatric nurses, non-forensic psychiatric nurses and other disciplines and information obtained on (1) the perceived clinical problems that give forensic nurses the most difficulty, (20 the skills best suited to overcome those problems and (3) the priority aspects of clinical nursing care that needs to be developed. A 35% response rate was obtained with 1019 forensic psychiatric nurses, 110 non-forensic psychiatric nurses and 43 other disciplines. The results highlighted a 'top-ten' list of main problems with possible solutions and main areas for development. the conclusions drawn include a focus on skills and competencies regarding the management of personality disorders and the management of violence and aggression.
    • Forensic psychiatry: Influences of evil

      Mason, Tom; University of Chester (Humana Press, 2005-12-15)
      Many conscientious mental health professionals caring for disturbed patients have either unscientifically formulated for themselves notions of 'evil' to explain the behavior of their patients, or have been given patients described by judges and the press as 'evil'. Although such notions may be deemed unscientific, beyond the purview of medicine, and better suited for discussion by theologians and moral philosophers, the fact remains that these notions of 'evil' have a definite impact on the practice of psychiatry, if not all medical fields.
    • Forensic services

      Lovell, Andy; University of Chester (SAGE, 2010-02-15)
      This book chapter offers an overview of the changing context of forensic learning disability services and a discussion of the relationship between learning disability and crime.
    • Foster care matters

      Harlow, Elizabeth; University of Chester (Whiting & Birch, 2011-08-05)
    • Fostering matters: A foster carer's perspective

      Harlow, Elizabeth; Blackburn, Foluke; University of Chester ; University of Salford (Whiting & Birch, 2011-08-05)
      This book chapter explores the symposium 'Fostering Matters' which took place at the University of Salford in March 2007 before then addressing training for foster care, assessing and supporting foster carers and final discussion and concluding statements on the matters.
    • The fragmentation of social work and social care: some ramifications and a critique

      Carey, Malcolm; University of Chester (Oxford University Press, 2015-09-29)
      This paper critically appraises the impact of the fragmentation of social care and social work. In particular it examines the impact of splintered services and roles upon employees, service users and carers. The article concentrates upon three inter-related areas as part of a more general critique: first, reliability of services; second, relations with stakeholders; and finally, the identity of employees. Despite differences across sectors and some largely collateral benefits it is proposed that fragmentation has promoted inconsistent and unreliable services, the development of superficial relations with users and carers and the loss of belonging and fractured identities of social care employees. Fragmentation regularly spoils professional identities and generates uncertainty amidst attempts to provide effective or reliable services. Indeed fragmented, disorganised or reductive provisions often generate new risks for the recipients of services.
    • Fruit and vegetables on prescription: A brief intervention in primary care

      Buyuktuncer, Zehra; Kearney, Matt; Ryan, Christine L.; Thurston, Miranda; Ellahi, Basma; University of Chester/Haccettepe University, Turkey; Department of Health; University of Chester; University of Chester/Hedmark University College, Norway (Journal of Nutrition and Dietetics, 2014-05-07)
      Background Increasing fruit and vegetable consumption is a goal for the UK. Therefore, the effectiveness of a fruit and vegetable voucher scheme coupled with key ‘5-a-day’ consumption messages as a brief intervention in primary care consultations was assessed in this study. Methods 1188 vouchers as a prescription for fruits and vegetables were routinely distributed to patients attending a primary health care centre in a deprived area, and 124 volunteer patients routinely attending the centre were included. Telephone based questionnaires were used to examine changes in consumption in the short and medium term. Other key aspects assessed in the evaluation related to fruit and vegetable purchasing behaviour, knowledge relating to what constitutes a portion size, the relationship between food and health, and barriers to consumption. Results Although 76.2% of participants used the prescription vouchers when purchasing fruits and vegetables, a significant change in the consumption or purchasing behaviour was not observed (p0.05). Participants’ level of knowledge relating to number of portions recommended and the portion size of different fruits and vegetables showed moderate increase from baseline to short term and to medium term. The primary barriers to fruit and vegetable consumption were reported as ‘the quality of fresh fruits and vegetables’ and ‘the money available to spend on food’. Conclusion The use of “the fruit and vegetable on prescription” scheme was an effective method of engaging participants in improving awareness of key diet related health messages. However, further intervention is required to produce a significant impact on the actual behaviour change. Keywords fruit and vegetable prescription, mainstreaming prevention, health settings
    • FTO gene-lifestyle interactions on serum adiponectin concentrations and central obesity in a Turkish population

      Isgin-Atici, Kubra; Alsulami, Sooad; Turan-Demirci, Busra; Surendran, Shelini; Sendur, Suleyman Nahit; Lay5, Incilay; Karabulut, Erdem; Ellahi, Basma; Lovegrove, Julie; Alikasifoglu, Mehmet; et al. (Taylor & Francis, 2020-08-04)
      The aim of the study was to investigate whether lifestyle factors modify the association fat mass and obesity-associated (FTO) gene single nucleotide polymorphisms (SNPs) and obesity in a Turkish population. The study included 400 unrelated individuals, aged 24-50 years recruited in a hospital setting. Dietary intake and physical activity were assessed using 24-hour dietary recall and self-report questionnaire, respectively. A genetic risk score (GRS) was developed using FTO SNPs, rs9939609 and rs10163409. Body mass index and fat mass index were significantly associated with FTO SNP rs9939609 (P=0.001 and P=0.002, respectively) and GRS (P=0.002 and P=0.003, respectively). The interactions between SNP rs9939609 and physical activity on adiponectin concentrations, and SNP rs10163409 and dietary protein intake on increased waist circumference were statistically significant (Pinteraction=0.027 and Pinteraction=0.044, respectively). This study demonstrated that the association between FTO SNPs and central obesity might be modified by lifestyle factors in this Turkish population.
    • Funerals

      Woodhouse, Jan; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses the role of health care professionals in funeral arrangements.
    • Further essentials of pharmacology for nurses

      Barber, Paul; Parkes, Joy; Blundell, Diane; University of Chester (Open University Press, 2013-07-08)
      This book is aimed at pre-registration nursing students who want an accessible guide to drug groups that goes beyond the essentials. It covers cardiovascular drugs, gastrointestinal drugs, drugs used in cancer, drugs used in nausea and vomiting, anaesthesia, fluid, and topical medicines.
    • The future of nursing: Career choices in potential student nurses

      Whitehead, Elizabeth; Mason, Tom; Ellis, Jackie; University of Chester (Mark Allen, 2007-04-01)
      Young people leaving schools and sixth-form colleges have the opportunity to choose a career path from an increasing number of courses in colleges of further and higher education. Nursing studies are now competing with a range of health-related disciplines such as health studies, psychology and complementary therapy. Compared with nursing studies, many of these courses appear more exciting and appealing to studnets who are in the process of choosing a career or programme of study. while the increased choice is a positive move for students it may contribute to the shortage of students currently entering some areas of nursing. Indeed, some specialities in nursing, including mental health and learning disabilities, are so depleted in students that they are reaching a point of crisis. There is also concern that recruitment into nursing remains predominantly female and White British. Given the diversity of the UK population and the reliance on school leavers as a potential source of supply, it is important to understand why male students and those from multiracial and multicultural environments choose, or do not choose, nursing studies. This research study involved a sample of 106 16-year old students from three secondary schools in the North-West and South-East of England. The questionnaire results, collected in schools, revealed that students held tradtional views or knew very little about the nursing profession.