• The report of the Committee of Visitors, Superindendent and Chaplain and the Cheshire Lunatic Asylum together with the annual statement of accounts ...

      Committee of Visitors, Superindendent and Chaplain and the Cheshire Lunatic Asylum (Cheshire Lunatic Asylum, 1868-04-06)
    • A Research Portfolio: Transformational change by nursing, midwifery and care staff across health and care.

      Finnegan, Alan; Aitkenhead, Susan; NHS England & NHS Improvement
      It is widely accepted that nursing research is paramount to help address the challenges facing the international nursing workforce in caring for a growing and ageing population. Nursing, midwifery and care staff make up the largest proportion of the workforce across the NHS. In the UK, there are over 693,000 registered nurses and midwives (Nursing and Midwifery Council, 2018), all striving to prevent and tackle health inequalities and improve the care experience for patients, individuals and populations. The role that nursing, midwifery and care staff play should not be underestimated and specifically in this editorial, we describe a new research portfolio which signposts to examples of nursing, midwifery and care staff led research to demonstrate the significant academic contribution of these professions to transformational change across the health and care system. The Research Portfolio (NHS England, 2019a) showcases examples of research studies that demonstrate leadership in research and practice, all aligned to the key priorities outlined in the NHS Long Term Plan (LTP) (NHS England, 2019b). Evidence underpins so much of what we do and there is a huge opportunity to quantifiably demonstrate the contribution staff bring to the LTP, harnessing intelligence in closing gaps and addressing unwarranted variation in health and care.
    • Resilience and mindfulness in nurse training on an undergraduate curriculum

      Mitchell, Andrew E P; University of Chester
      Purpose. The aim is to investigate what relationships exist between resilience and mindfulness in undergraduate nurse training and how these might contribute to well-being. Design and Methods. One hundred and six students participated in this cross-sectional study. Multivariate and bivariate procedures were utilized to assess the differences between students' demographics, academic resilience and mindfulness. Findings. The findings suggested that acceptance and attention within mindfulness were important for resilience. Students who had higher levels of academic resilience also had higher indexes of mindfulness. Practice Implications. A key implication is that learning and practice areas should ensure that well-being, mindfulness and resilience literacy are key issues for students in training. This is at a time when mental health support and staff retention are foremost in policymakers’ minds.
    • Resources and information: Looking for answers

      Woodhouse, Jan; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses the need for information for patients and carers and how their information needs change over time.
    • Respect

      Baldwin, Moyra A.; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses respect as an ethic of healthcare.
    • Respiratory health in mental health practice

      Collins, Eve; University of Chester (SAGE, 2013-01-15)
      This book chapter aims to outline the structures of the respiratory system and their functions; identify the causes of respiratory disease among individuals with mental health problems; discuss the altered physiology of common respiratory cinditions; discuss ways to assess respiratory health; demonstrate an understanding of the effects of smoking on the respiratory system; and discuss the ways in which the respiratory function of indivuals with mental health problems can be enhanced.
    • Responding to Adverse Childhood Experiences: An evidence review of interventions to prevent and address adversity across the life course.

      Ford, Kat; Di Lemma, Lisa; Gray, Benjamin; Hughes, Karen; University of Chester; Public Health Collaborating Unit Bangor University; Public Health Wales.
      Adverse childhood experiences (ACEs) are stressful events during childhood that can have a profound impact on an individual’s present and future health (Section 1.3). Growing up in the face of such adversities is recognised as an important public health concern in Wales and internationally (Welsh Government, 2017a; World Health Organization [WHO], 2014). Actions to prevent and mitigate ACEs and their associated harms are essential to improve population health for present and future generations (Bethell et al., 2017; Pachter et al., 2017). In Wales, many sectors are working to identify and respond to adversity in order to improve outcomes for those who have experienced ACEs. Whilst a number of evidence-based interventions target specific types of adversity (e.g. domestic violence), we know that ACEs are strongly correlated (e.g. individuals exposed to adversity are often exposed to more than one type; Hughes et al., 2017). Thus, complex adversity requires a response which extends across sectors including health, social care, policing, education, community and others, and across the life course from early childhood through to adulthood. To support innovation in addressing ACEs we have undertaken a review of evidence on common approaches to prevent ACEs and/or mitigate their negative impacts. Over 100 interventions were identified and collated across four common approaches: supporting parenting; building relationships and resilience; early identification of adversity; and, responding to trauma and specific ACEs (Chapter 3). Whilst the interventions vary in type, the review identified cross-cutting themes, which could be used to inform a whole system approach (spanning individual, family and community levels) to tackle ACEs across the life course, supporting the development of an ACE-informed approach (Chapter 4). The report concludes by highlighting current gaps in the evidence and suggests key areas for further work to tackle ACEs for our future generations (Chapter 5). The report is not an exhaustive systematic evidence review of the interventions for specific ACE types, nor does it advocate any specific intervention, rather it seeks to present a summary of the research evidence and information on common approaches across the prevention of ACEs and mitigation of their impact. We hope the report will be a useful resource for service planners, practitioners and commissioners to support innovation and development towards an ACE-free future.
    • Responding to nerve agent poisoning: A guide for emergency nurses. Part 2

      Mcgee, Stephen; Clochesy, John; Finnegan, Alan P.; McGhee, Stephen; University of Miami
      The release of chemical agents can cause loss of life and result in major incidents. Chemical agent-related major incidents require a modified response by emergency services due to the chemicals’ transmissibility, lethality, latency and persistence. In general, modifications to casualty flow, triage and treatment are made to reduce transmissibility, and lethality of chemical hazards. This article, the second of a two-part series on nerve agents, describes the adapted response and explains how emergency nurses must be familiar with principles of care including incident and casualty management.
    • The responsiveness of negative cognitive content to an induced negative mood state in those with and without a previous history of depression in a student sample

      Mitchell, Andrew E. P.; University of Chester (Nova Science Publishers, 2015-03-31)
      This study investigates the responsiveness of cognitions to an induced negative mood state in those with and without a previous history of depression in a non-clinical student sample (n = 101). The Automatic Thought Questionnaire (ATQ-30) was used to observe the negative cognitive content. The negative mood state was induced in small groups utilising the Velten Negative Mood Induction Procedure (VNMIP). Self-reported mood was measured using the University of Wales Institute of Science and Technology (UWIST) Mood Adjective Checklist (UMACL) before and after VNMIP. 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 cognitive content was shown in a 2 x 2 ANOVA with time (pre-test vs. post-test) as a within subjects factor and history of depression (with a history of depression vs. without a history of depression) as a between subjects factor. The results indicate no significant interaction between time and group in their effects on negative cognitive content. Also, there was no significant main effect for time on negative cognitive content. However, there was a significant main effect for previous history of depression on negative cognitive content. Findings are discussed on the basis of the literature and possible applications for practice.
    • Retention and sustained viral suppression in HIV patients transferred to community refill centres in Kinshasa, DRC

      Moudachirou, Ramsia; Van Cutsem, G; Chuy, R; Tweya, H; Senkoro, Mbazi; Mabhala, Mzwandile; Zolfo, Maria; University of Chester
      Background The adoption of the UNAIDS 90-90-90 targets acceleration plan and the implementation of ‘test and treat’ strategy has resulted in a significant increase in the number of people living with HIV/AIDS (PLWHA) receiving lifelong antiretroviral therapy (ART). To improve and sustain ART retention in care and virologic suppression, innovative service delivery models are needed. In 2010, Médecins Sans Frontières (MSF) set-up decentralized community ART refill centres (“poste de distribution communautaire”, PODI) for follow-up of stable ART patients from Kabinda Hospital (CHK), in Kinshasa, Democratic Republic of Congo. Objective To assess retention in care and virologic suppression on ART after transfer to the three main PODIs in Kinshasa. Methods A retrospective cohort study was conducted using routine program data for PLWH aged >15 years and stable on ART transferred from CHK to a PODI between January 2015 and June 2017. Kaplan-Meier analysis was used to estimate retention in care. Viral load (VL) suppression was defined as a VL ≤ 1000 copies/ml. Results A total of 337 patients were transferred to a PODI. Of these, 306 (91%) patients were on ART 12 months after transfer to PODI and were eligible for the 12-month routine VL testing. A total of 118 (39%) had VL done at 12 months; VL suppression was 93% (n=110). Median time from enrolment into PODI to 12-month routine VL was 14.6 months [IQR: 12.2-20.8]. Overall, 189 (62%) patients had at least one VL load test done during follow-up. Retention in PODI at 6, 12 and 18 months was 96%, 92% and 88% respectively. Retention at 18 months was statistically different between PODIs; 91%, 88% and 78% in PODI East, PODI West and PODI Central respectively, (p=0.0349). Conclusion Retention and VL suppression in community-based ART refill centers were high, although VL coverage was low. HIV programs need to scale–up VL testing services PLWHA receiving ART in PODIs.
    • Retrospect and Prospect: What are the future possibilities in the Care Act (2014) for older parent-carers of adults with learning disabilities? A discussion Paper.

      Gant, Valerie; Bates, Claire; University of Chester; Edge Hill University (Journal of Health and Social Care Improvement, 2017-01)
      Building on this previous research and the practice background of both authors, this paper aims to identify and then explore potential new opportunities and possible challenges brought about by the introduction of the Care Act 2014 for older parent-carers of adults with learning disabilities. By considering some of the themes that had emerged in this earlier research, set within the then current legislative and political landscape (2006), this paper aims to provide a retrospective and prospective analysis of the legal and policy context within which service delivery to this group takes place, such as to orient thinking regarding the role and function of law and policy in relation to the delivery of services to this and, potentially, other carer-groupings. Plans for future research to develop further these areas will also be discussed.
    • A review of baby skin care

      Steen, Mary; Macdonald, Susan; UCLan/Royal College of Midwives ; Royal College of Midwives (Royal College of Midwives, 2008-08)
      This article describes and discusses the findings from a structured review of baby skin care and guidelines based on the best available evidence which was undertaken on behalf of the Royal College of Midwives. Health professionals and parents can download the full article from the RCM URL:
    • Risk, recognition and repair of perineal trauma

      Steen, Mary; University of Chester (Mark Allen Publishing, 2012-11-01)
      The risk of perineal injury during childbirth continues to affect the majority of women. Morbidity associated with perineal injury and repair is a major health problem for women. Therefore, it is vitally important that midwives are educated and trained to recognise risk factors and the extent of perineal injury. Education and training has been shown to assist midwives to gain confidence and clinical skills to suture competently and keep themselves up-to-date with the best available evidence on which to base their care. This article provides an overview of the literature relating to risk, recognition and repair of the perineum during the childbirth continuum.
    • Riverside NHS Museum - list of archive collections

      Riverside NHS Museum; University of Chester (2014-04)
      List of archives up to April 2014.
    • Riverside NHS Museum archives list

      University of Chester (2015)
      A list of the archival collection held by the Riverside NHS Museum at the University of Chester.
    • Role model

      Phipps, Dianne; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses being a role model as a nurse.
    • The role of the midwife: Time for a review

      Walsh, Denis; Steen, Mary; University of Central Lancashire (2008-06-04)
      This article examines the current situation of impersonalised midwifery and the ideal of combining holistic care with evidence-based practice.
    • Safeguarding and qualitative research

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

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

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