• 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.
    • Gaining employment: The experience of students at a further education college for individuals with learning disabilities

      Skellern, Joanne; Astbury, Geoff; University of Chester (Wiley, 2012-01-02)
      Employment is widely acknowledged as a key factor to social inclusion, but it is estimated that <7% of people with learning disabilities are in paid employment. It was the aim of the research study to critically examine the experience of gaining employment from the perspectives of students with learning disabilities, parents, education staff and employers. All participants were recruited from one collaborating UK organisation, a college offering further education for young people with learning disabilities. Twenty-three interviews were conducted. Analysis of the data identified three themes surrounding the perceived roles of: Protector, Rescuer and Worker. Recommendations are discussed to improve collaborative working between student, parent, education staff and employer to overcome some of the difficulties influencing employment rates and contribute to the empowerment and inclusion of people with learning disabilities in society.
    • A genetic approach to examine the relationship between vitamin B12 status and metabolic traits in a South Asian population

      Surendran, S; Alsulami, S; Lankeshwara, R; Jayawardena, R; Wetthasinghe, K; Sarkar, S; Ellahi, B; Lovegrove, JA; Anthony, D; Vimaleswaran, KS; et al.
      Background: Observational studies in South Asian populations have suggested an association between vitamin B12 status and metabolic traits; however, the findings have been inconclusive. Hence, the aim of the present study was to use a genetic approach to explore the relationship between metabolic traits and vitamin B12 status in a Sri Lankan population and to investigate whether these relationships were modified by dietary intake. Methods: A total of 109 Sinhalese adults (61 men and 48 women aged 25-50 years), from Colombo city underwent anthropometric, biochemical, dietary intake analysis and genetic tests. Genetic risk scores (GRS) based on 10 metabolic single nucleotide polymorphisms (SNPs) (metabolic-GRS) and 10 vitamin B12 SNPs (B12-GRS) were constructed. Results: The B12-GRS was significantly associated with serum vitamin B12 (P=0.008), but not with metabolic traits (P>0.05); whereas, the metabolic-GRS had no effect on metabolic traits (P>0.05) and vitamin B12 concentrations (P>0.05). An interaction was observed between B12-GRS and protein energy intake (%) on waist circumference (P=0.002). Interactions were also seen between the metabolic-GRS and carbohydrate energy intake (%) on waist to hip ratio (P=0.015). Conclusion: Our findings suggest that a genetically lowered vitamin B12 concentration may have an impact on central obesity in the presence of a dietary influence; however, our study failed to provide evidence for an impact of metabolic-GRS on lowering B12 concentrations. Given that our study has a small sample size, further large studies are required to confirm our findings.
    • The Global Mental Health Assessment Tool Primary Care and General Health Setting Version (GMHAT/PC) – Spanish version: A validity and feasibility study

      Tejada, Paola A.; Jaramillo, Luís Eduardo; Marulanda, Jefferson; Sharma, Vimal; University of Chester; National University of Colombia; Cheshire and Wirral NHS Foundation Trust (University of Zaragoza, 2016-08-31)
      The study aims to assess the feasibility of using a computer assisted diagnostic interview by GPs and to examine the level of agreement between the Spanish version GMHAT/PC diagnosis and psychiatrists' ICD-10 based clinical diagnosis. Participants in the study ranged from those who were in remission to others who had different mental illnesses. They were recruited from inpatient and outpatient mental health settings. All consecutive patients were interviewed using Spanish version of GMHAT/PC and they were assessed independently by psychiatrists to in order to get their ICD-10 based diagnosis. Two hundred ninety-nine patients participated in the study. The mean duration of interview was 12.5 minutes. There is an acceptable to good level of agreement between the GP’s (GMHAT/PC) diagnoses and the psychiatrists’ (clinical) diagnoses of any mental illness, Kappa 0.58 95% C.I (0.46, 0.72). There is good level of sensitivity (81%) and specificity (92%), with GPs correctly identifying 242 out of the 250 participants diagnosed with mental illness and 27 out of 35 of those without. The finding of the study suggest that GMHAT/PC Spanish version used by GPs detected mental disorders accurately and it was feasible to use GMHAT/PC (Spanish version) in Latin America settings.
    • Good death

      Baldwin, Moyra A.; Woodhouse, Jan; University of Chester (2010-10-15)
      This book chapter discusses the concept of a good death.
    • GP practice pharmacist collaboration

      Khan, Nahim; University of Chester (Chemist and Druggist, 2016-06-11)
      This is a short case study how community pharmacy and pharmacists part of the NHS England GP Practice Pharmacy Pilot can work together to each others' benefit.
    • Guest editorial

      Skellern, Joanne; University of Chester (Emerald, 2016-06-13)
      This is the editorial for a special edition entitled 'Intellectual Disabilities: Nursing' of the Journal of Intellectual Disabilities and Offending Behaviour.