• Trapped in discourse? Obstacles to meaningful social work education, research and practice within the neoliberal university

      Carey, Malcolm; University of Chester
      This article appraises the role of the neoliberal university in regulating social work education, research and practice. The dominance of governments and employers in determining social work education is highlighted, alongside the ascendancy of skills-based and vocational training. Moreover, it is proposed that research, associated learning, and practice are now more often moulded around essentialist science-based, behavioural or functionalist paradigms, which fit conveniently with free market, politically conservative and authoritarian agendas. The neoliberal university is increasingly able to rationally prepare social workers to fulfil narrow ideological objectives, which includes priority given to attempts to empower, pathologise, and scientifically manage structurally disadvantaged populations from minority groups. Reductive paradigms, nevertheless, can struggle to cope with social fragmentation and diversity, with social work students often ill prepared for many of the complex challenges which they later face as qualified practitioners. Analysis for the article draws from critical theory, and it is concluded that market-based discourses and related professional paradigms - and the symbolically constituted and hyperreal fantasies which they help to maintain - can prove difficult to escape. Social work continues to face a precarious future within university settings in which free market narratives, associated norms, targets, and labour insecurity prevail.
    • The trident: A three-pronged method for evaluating clinical, social and educational innovations

      Ellis, Roger; Hogard, Elaine; University of Chester (SAGE, 2006-07-01)
      This article describes a distinctive approach to programme evalution used in over forty funded evaluations in the Social and Health Evaluation Unit at the University of Chester. It categories the questions asked by evaluators into three main groups: those concerned with outcomes and impact; those concerned with process; and those representing the views of the stakeholders involved in the programme.
    • The trident: a three-pronged method for evaluating programmes and initiatives

      Ellis, Roger; Hogard, Elaine; University of Chester (Chester Academic Press, 2008)
      This book chapter discusses an approach to the evaluation of community safety initiatives.
    • Type 1 diabetes in young people: the impact of social environments on self-management issues from young people’s and parents’ perspectives.

      Spencer, Joy; Cooper, Helen; Milton, Beth; University of Chester; Liverpool University (SB Communications Group, 2014-02-08)
      In the UK, young people with type 1 diabetes generally have poor glycaemic control. Managing type 1 diabetes in young people is complex, and is underpinned by relationships with significant others in the social environments they inhabit. This qualitative study explores the social environments of young people with type 1 diabetes and their potential influence on glycaemic control. Twenty young people with type 1 diabetes and their parents (n=27) were interviewed about their experiences in the environments of the home, with friends (social), at school and in the diabetes clinic. It was found that the diabetes clinic was vital to the medical management of type 1 diabetes, and the family provided stable support for most young people with type 1 diabetes. However, there were barriers to self-management in school and social environments. It was concluded that each family had a unique story about the social factors in the environments they encountered that affected self-management of type 1 diabetes.
    • Type 1 diabetes mellitus in children and young people

      Cooper, Helen; University of Chester (2016-12-09)
      This article covers the following points: • Given the increasing prevalence, an up to date register, in line with the quality and outcomes framework, of those diagnosed with the condition in your area of practice should be maintained • Know the signs and symptoms to ensure rapid referral for diagnosis, treatment and effective long term management • Understand long term management as stipulated in NICE guidelines so you can engage with the patient and their family to reinforce the work undertaken in secondary care
    • The tyranny of ethics? Political challenges and tensions when applying ethical governance to qualitative social work research

      Carey, Malcolm; University of Chester (Taylor & Francis, 2018-11-29)
      This paper examines problems which current ethical governance processes generate for qualitative researchers within social work. It draws upon case studies and critical theory to detail the unpredictable and diverse nature of much social work qualitative research. It argues that too often this research is pitted against a narrow institutional focus placed on positivist-orientated empirical research and income generation. Overtly instrumental interpretations of ethics - often determined by realist and bioethical paradigms - can quickly inhibit the methodological dynamism required to meaningfully capture the complex and non-binary issues which social workers accommodate in their work and subsequent research. Arguments that policy-led, institutional and professional cultures have generated a conservative culture of risk-aversion within the neo-liberal university are also considered.
    • Underlying thinking pattern profiles predict parent-reported distress responses in autism spectrum disorder

      Tollerfield, Isobel; Chapman, Hazel M.; Lovell, Andrew; Cheshire and Wirral Partnership NHS Foundation Trust; University of Chester (Springer, 29-05-2021)
      Appreciating autistic neurodiversity is important when supporting autistic people who experience distress. Specifically, use of a profiling model can reveal less visible autistic differences, including strengths and abilities. Binary logistic regressions showed that the likelihood of extreme distress responses could be interpreted based on parent-reported autistic thinking pattern profiles for 140 young people. Perspective-taking (specifically empathy), extreme demand avoidance, and over-sensory sensitivity each contributed to the combined regression models. From the clinical perspective of autism as a multi-dimensional and inter-connected construct, there may be implications for planning support and building positive self-understanding. Individually tailored adjustments and support strategies may be identified more easily after delineating variables found across four core aspects: sensory coherence, flexible thinking, perspective-taking, and regulation. Keywords: Autism; Distress; Profile; Strengths; Thinking patterns.
    • Understanding and working with challenging behaviour

      Ingram, Charles; Lovell, Andy; University of Chester (RCN Publishers, 2011-03)
      This article examines the theoretical approaches to understanding and managing individuals with a learning disability who display behaviours that challenge. The authors explain how drawing on these approaches can help professionals from different disciplines to provide effective, patient-centred care.
    • Understanding and working with people with learning disabilities who self-injure

      Heslop, Pauline; Lovell, Andy; University of Bristol ; University of Chester (Jessica Kingsley, 2012-11-15)
      Adopting a predominantly psychological approach, this book provides carers with up-to-date information and resources to provide appropriately individualised care to people with learning disabilities who self-injure. Understanding and Working with People with Learning Disabilities who Self-Injure synthesises traditional (behavioural) and newer (psychological) approaches to understanding self-injury, drawing on psychoanalytic and social theory to provide practical guidelines for more sustained and effective support. It suggests that motivations for self-injury may be similar for people with and without learning disabilities, and draws on case work examples to suggest person-centred techniques that encourage communication particularly important with people who do not use verbal communication - and recovery. The book covers a range of specific needs, including people with autism who self-injure, and emphasises the views of people with learning disabilities themselves and their families about what has worked best, and why. At the end of each chapter, a variety of practical implications for the provision of support are given. This book is for those supporting people with learning disabilities who self-injure and will be a useful resource for social workers, psychologists, counsellors, learning support workers, nurses and social and health care students.
    • Understanding Blogging Motivations in Palliative Care Using Maslow’s Hierarchy of Needs.

      Ngwenya, Nothando; Kingston, Paul; Mills, Stella; Africa Health Research Institute, KwaZulu Natal, South Africa; University of Chester; Staffordshire University (Inderscience, 2018-09-24)
      The pervasive use and potential of weblogs has increased the field of social health informatics and is becoming increasingly difficult to ignore. The prevalence of these technologies for narrative use brings about the fusion of diverse schools of thought on motivation. One proven model is that of Maslow, whose theory of needs has an intuitive appeal in understanding bloggers’ needs and motivations. This paper considers theoretical and practical blogging experiences for palliative care users through the embracement of Maslow’s hierarchy of needs. Palliative care patients, carers and clinicians were interviewed about their weblogs and data qualitatively analysed. The results indicate that the experience of maintaining a weblog is therapeutic for individuals and fulfils needs hierarchically from the lowest to the highest as outlined in Maslow’s theory.
    • Understanding depression

      Khan, Nahim; University of Chester (Chemist and Druggist, 2016-07-11)
      Quiz on use of the NICE guidelines on depression
    • Understanding minimum and ideal factor levels for participation in physical activities by people with haemophilia: An expert elicitation exercise.

      Martin, Antony P; orcid: 0000-0003-4383-6038; Burke, Tom; Asghar, Sohaib; Noone, Declan; Pedra, Gabriel; orcid: 0000-0002-2023-5224; O'Hara, Jamie (2020-04-08)
      The benefits of physical activity (PA) for people with haemophilia (PWH) may include improvements in joint, bone and muscle health. However, the factor VIII activity level required to avoid a bleeding episode associated with PA is unknown. To elicit the opinion of clinical experts on the minimum level and ideal factor VIII activity ('level') required to avoid a bleeding episode during participation in different types of PA for PWH. Based on the 2017 National Hemophilia Foundation PA descriptions, clinical experts estimated a minimally acceptable and an ideal factor level at which a bleed could be avoided. The uncertainty around estimates was quantified using an approach to construct a probability distribution to represent expert opinion. Minimum and ideal factor level increased with higher risk PA, whether or not joint morbidity was present, as did the experts' uncertainty in their estimates (ie the range between lowest and highest estimates for minimum and ideal levels). Mean minimum levels ranged from 4% to 48% for low to high risk for people without joint morbidity, and from 7% to 47% for those with joint morbidity. For ideal factor levels, corresponding figures were 9%-52% and 12%-64%, respectively. To support a patient-centric outcome, expert opinion indicates that the clinical norm of 0.01 IU/mL (1%) trough level is insufficient. It is anticipated that introducing a more targeted approach to meet the needs of patients who are increasingly physically active will benefit patients further in addition to recent treatment advances. [Abstract copyright: © 2020 John Wiley & Sons Ltd.]
    • Understanding of the Care Act 2014 among carers of adults with learning disabilities

      Gant, Valerie; University of Chester (RCN Publishing, 2017-05-26)
      The Care Act (2014) gave new rights to carers for assessment and aimed to provide a structure for a more personalised approach to care and support (DoH, 2014). The UK population is an aging one and research indicates that people with learning disabilities are part of this longevity (Emerson and Hatton, 2008; Foster and Boxall, 2015; Walker and Ward, 2013) with the majority of people with learning disabilities remaining in family care for many years (Cairns, et al. 2013; Gant, 2010). Thus carers are frequently providers of care for their relative with a learning disability and take on many levels of responsibility, often lasting for decades. This paper describes a research study involving 9 carers of adults with learning disabilities to establish their views on this piece of legislation, its likely significance to them and their relatives, and provides a forum for discussion and debate in terms of possible implications for practice.
    • Understanding perineal pain: Women's descriptions

      Steen, Mary; Royal College of Midwives/University of Central Lancashire (Mark Allen Publishing, 2008-06-01)
      Women perceive, describe and react to pain differently; it cannot be easily quantified. Pain is a private and personal experience to the individual. It is, therefore, impossible for another person to know exactly what someone else’s pain feels like. When measuring pain there is a need to assess both the intensity and the quality of the pain to gain an insight into a person’s experience of pain. Therefore during a PhD Study which involved the investigation of the effectiveness of localised cooling treatments to alleviate perineal pain, women were asked to describe the pain as well as the intensity (Steen & Marchant, 2007). The quality of pain was measured by asking the woman to describe the pain in her own words. These words were analysed as pain descriptors under the themes of sensory, affective, evaluative and miscellaneous as described by the McGill Pain Scale. In addition, intensity, discomfort, physical symptoms, metaphors used and links to the expectations of the woman were considered. (Melzack & Wall, 1996). This article will give an overview of the pain syndrome, discuss measurement of pain methods and the use of word descriptors to assess the quality of pain. The assessment of perineal pain and women’s descriptions will be further explored. This insight will give an understanding of the pain experience of women who have perineal trauma following childbirth and this may lead to further research and the development of a specific evaluating tool.
    • Understanding the association between teenage pregnancy and inter-generational factors: A comparative and analytical study

      Whitehead, Elizabeth; University of Chester (Elsevier, 2007-06-27)
      This article aims to identify the number of teenage pregnant women who also have mothers who became pregnant when they were in their teenage years and to explore the importance of this intergenerational experience on the teenagers themselves, their significant family, friends and society as a whole.
    • Understanding the Determinants of homelessness through examining the life stories of homeless people and those who work with them: a qualitative research protocol

      Mabhala, Mzwandile A.; Ellahi, Basma; Massey, Alan; Kingston, Paul; University of Chester (Insight Medical Publishing Group, 2016-07-04)
      There has been a sharp increase in homelessness following recent UK welfare and other social policy reforms; these reforms included public expenditure reductions, compounded by benefit cuts which lowered/capped housing benefits and weakened welfare protection and the housing safety net. The increase occurred despite efforts by the government and charitable organisations to mitigate it, which raises questions about their strategies’ effectiveness and about policymakers’ understanding of homelessness. This study aims to gain insight into the determinants of homelessness through examining the life stories of homeless people and those who work with them. Constructivist grounded theory (CGT) is used to develop a theoretical explanation of the determinants of homelessness. Qualitative in-depth semi-structured interviews are being conducted in several centres for homeless people in the north west of England, UK. Initial analysis of the stories of homeless people reveals four determinants of homelessness: home and childhood environments; experiences during school life; type of social lifestyle; and opportunities for access to social goods. Participants see their homelessness as a manifestation of fundamental determinants of social inequalities such as education; income inequality; unemployment and welfare; barriers to housing and other services; crime and living environment.
    • Understanding violence when the perpetrator has an intellectual disability: The perceptions of professionals

      Lovell, Andy; Skellern, Joanne; University of Chester (SAGE, 2017-12-18)
      Aim: The research sought to enhance professional understanding of the violence perpetrated by some people with an intellectual disability. Background: The violent behaviour exhibited by some people with intellectual disabilities remains poorly understood, particularly with regard to a clear and informative definition. Design: A qualitative study investigating the views and perceptions of professionals working directly with people with an intellectual disability in different settings. Methods: 22 semi-structured interviews were undertaken with professionals from a variety of backgrounds and four themes were generated through data analysis. Findings: Themes produced comprised the degree of intellectual disability, impulsivity, intentionality and unpredictability. Findings indicated tension between understanding violence as purposeful and explaining it in relation to the intellectual disability and/or additional conditions. Conclusion: Intellectual disability is central to understanding the impact of the other three themes, though there is a professional reluctance to use such knowledge as evidence to inform practice.
    • Universal credit, Lone mothers and poverty: Some context and challenges for social work with children and families

      Carey, Malcolm; University of Chester
      Universal Credit is a streamlined benefits delivery system initially introduced in the United Kingdom (UK) in 2008. Conditionality-based welfare policies are increasingly international in scale, and are now widely adopted by neoliberal governments on the basis that paid employment offers the most efficacious route out of poverty for citizen-subjects. Numerous studies suggest otherwise, and highlight their negative impact upon the social rights, lived experiences, and attempts to alleviate poverty for service users. This article analyses the reformed benefit system and wider workfare policies effect upon lone mothers, including as a consequence of engagement with an ever more stigmatizing benefit system, and associated risks posed by sanctions or precarious low-paid employment. It highlights some of the consequences for social work with children and families of Universal Credit: including ongoing tensions and challenges created for the profession by the punitive policies of the workfare-orientated centaur state.
    • University-Trust collaboration: A secure learning disability service in transition

      Lovell, Andy; University of Chester (RCN Publishers, 2011-06)
      This article describes how a research project, looking at the management of change within a learning disability service in transition from medium to low security, confirms the importance of staff involvement in the process.
    • The use of a mobile app in health visiting to support school readiness

      Lee, Fiona; Wright, Paula; University of Chester; Bridgewater Foundation Trust (Mark Allen Group, 2016-08-24)
      Starting school is a major milestone in family life, and there is increasing awareness that a child who is ‘ready for school’ when they begin full-time education is more likely to reach their full potential. This is not only in terms of academic achievement, but also social and behavioural skills, which have an impact later in adulthood (UNICEF, 2012). Health visitors’ responsibilities include supporting parents to maximise their child’s health and development from birth onwards—a complex and challenging remit for which they need to be continually developing engaging strategies and tools (Department of Health, 2009). This article reviews the collaborative development of a school readiness mobile app for Bridgewater Community Foundation NHS Trust. The project won the prestigious 2016 Journal of Health Visiting Award for School Readiness, and the University of Chester was recognised as a key collaborator in this innovative development. The article seeks to inspire health visiting colleagues to search for collaborative partners to address school readiness in an engaging way with parents.