• Relationship based practice past and present and its knowledge foundations in the contemporary curriculum

      Harlow, Elizabeth; University of Chester (2012-07-02)
      Published in 1957, Biestek’s text The Casework Relationship might be described as a social work classic. According to Biesteck, social science formed the foundations for practice. Whilst sociology was valued, it was psychoanalytic and humanist psychology that appeared to be of greatest significance. Biestek drew on psychological knowledge as a means of understanding others, but personal reflection was also considered to be crucial: put another way, in order to understand others, a practitioner had to understand him or herself. It was scientific knowledge, as well as a deep understanding of the self, that enabled practitioners to build purposeful relationships with clients or service users. Biestek emphasised relationship as essential to humanity: relationships were seen as the most crucial component of our existence and the main source of our happiness. In terms of social work, it was by means of the practitioner – client relationship that problems were resolved. With the cultural change of the 1960s, Biestek’s work became an edifice of another era. Whilst Howe (2008) suggests that enclaves of relationship based casework have continued over the years, of late there has been a more evident promotion of this approach (see Hennessey 2011; Munro 2011 and Ruch et al. 2010). Concerned as this conference is with the question of whether developments in social work are evolving or revolving, this theory based paper draws on evidence from the literature, and compares relationship based practice of the past with relationship based practice of the present. In acknowledging the particular contribution of psychology to this approach, the paper will include a brief reflection on the place of this discipline in the newly emerging curriculum.
    • The relationship between target joints and direct resource use in severe haemophilia

      O’Hara, Jamie; Walsh, Shaun; Camp, Charlotte; Mazza, Giuseppe; Carroll, Liz; Hoxer, Christina; Wilkinson, Lars; University of Chester; HCD Economics, The Innovation Centre, Daresbury; University College London; The Haemophilia Society; Novo Nordisk A/S (SpringerOpen, 2018-01-16)
      Objectives Target joints are a common complication of severe haemophilia. While factor replacement therapy constitutes the majority of costs in haemophilia, the relationship between target joints and non drug-related direct costs (NDDCs) has not been studied. Methods Data on haemophilia patients without inhibitors was drawn from the ‘Cost of Haemophilia across Europe – a Socioeconomic Survey’ (CHESS) study, a cost assessment in severe haemophilia A and B across five European countries (France, Germany, Italy, Spain, and the United Kingdom) in which 139 haemophilia specialists provided demographic and clinical information for 1285 adult patients. NDDCs were calculated using publicly available cost data, including 12-month ambulatory and secondary care activity: haematologist and other specialist consultant consultations, medical tests and examinations, bleed-related hospital admissions, and payments to professional care providers. A generalized linear model was developed to investigate the relationship between NDDCs and target joints (areas of chronic synovitis), adjusted for patient covariates. Results Five hundred and thirteen patients (42% of the sample) had no diagnosed target joints; a total of 1376 target joints (range 1–10) were recorded in the remaining 714 patients. Mean adjusted NDDCs for persons with no target joints were EUR 3134 (standard error (SE) EUR 158); for persons with one or more target joints, mean adjusted NDDCs were EUR 3913 (SE EUR 157; average mean effect EUR 779; p < 0.001). Conclusions Our analysis suggests that the presence of one or more target joints has a significant impact on NDDCs for patients with severe haemophilia, ceteris paribus. Prevention and management of target joints should be an important consideration of managing haemophilia patients.
    • Relationship between the individual and society

      Lovell, Andy; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses social order, social change, and socialisation.
    • Relationship to practice

      Watkins, Caroline; Carlisle, Caroline; Whitehead, Elizabeth; Mason, Tom; Manchester University ; University of Liverpool ; Chester College of Higher Education ; Clinic/University of Glamorgan (Routledge, 2001-07-12)
      This book chapter discusses the macro and micro levels of practical impact that theories relating to stigma can have on individuals and groups.
    • 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 factors for intimate partner homicide in England and Wales

      Chopra, Jennifer; Sambrook, Laura; McLoughlin, Shane; Randles, Rebecca; Palace, Marek; Blinkhorn, Victoria; Liverpool John Moores University; University of Birmingham; University of Chester (Wiley, 2022-02-17)
      Intimate partner homicides are often situated within the context of domestic abuse, and although less prevalent than domestic abuse, there have been several multi-agency approaches to understanding the risk for these fatal crimes. Domestic Homicide Reviews (DHRs) were introduced in 2011 to provide information to help with assessing such risk. This paper aims to analyse DHRs in England and Wales to investigate/determine risk factors for domestic homicide following intimate partner abuse. All publicly available DHRs published between July 2011 and November 2020 where the victim and perpetrator were or had been intimate partners (N = 263) were retrieved from Community Safety Partnership websites in England and Wales. A quantitative design was used to extract data from DHRs, and descriptive and inferential statistics were generated by SPSS 26. Findings identified risk factors relating to domestic abuse, including stalking, separation, and the victim being in a new relationship. Sociodemographic risk factors included higher levels of deprivation, lower income and higher barriers to housing and services. This highlights the role of both individual and sociodemographic factors in domestic homicides, and particularly the need for greater socioeconomic security for victims of domestic abuse. In conclusion, though much of the data is in line with previous research, our analysis highlights the pivotal role of regional poverty, with comfortable socioeconomic conditions offering protection against intimate partner homicides. This research suggests important directions for future research and makes a valuable contribution to a more in-depth understanding of the relationship between domestic abuse and intimate partner homicide.
    • 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.