University of Chester Digital Repository: Recent submissions
Now showing items 1-20 of 5959
-
The Comparative Effects of Mesenchymal Stem Cell Transplantation Therapy for Spinal Cord Injury in Humans and Animal Models: A Systematic Review and Meta-Analysis.Animal models have been used in preclinical research to examine potential new treatments for spinal cord injury (SCI), including mesenchymal stem cell (MSC) transplantation. MSC transplants have been studied in early human trials. Whether the animal models represent the human studies is unclear. This systematic review and meta-analysis has examined the effects of MSC transplants in human and animal studies. Following searches of PubMed, Clinical Trials and the Cochrane Library, published papers were screened, and data were extracted and analysed. MSC transplantation was associated with significantly improved motor and sensory function in humans, and significantly increased locomotor function in animals. However, there are discrepancies between the studies of human participants and animal models, including timing of MSC transplant post-injury and source of MSCs. Additionally, difficulty in the comparison of functional outcome measures across species limits the predictive nature of the animal research. These findings have been summarised, and recommendations for further research are discussed to better enable the translation of animal models to MSC-based human clinical therapy.
-
Tears evoke the intention to offer social support: A systematic investigation of the interpersonal effects of emotional crying across 41 countriesTearful crying is a ubiquitous and likely uniquely human phenomenon. Scholars have argued that emotional tears serve an attachment function: Tears are thought to act as a social glue by evoking social support intentions. Initial experimental studies supported this proposition across several methodologies, but these were conducted almost exclusively on participants from North America and Europe, resulting in limited generalizability. This project examined the tears-social support intentions effect and possible mediating and moderating variables in a fully pre-registered study across 7007 participants (24,886 ratings) and 41 countries spanning all populated continents. Participants were presented with four pictures out of 100 possible targets with or without digitally-added tears. We confirmed the main prediction that seeing a tearful individual elicits the intention to support, d = 0.49 [0.43, 0.55]. Our data suggest that this effect could be mediated by perceiving the crying target as warmer and more helpless, feeling more connected, as well as feeling more empathic concern for the crier, but not by an increase in personal distress of the observer. The effect was moderated by the situational valence, identifying the target as part of one's group, and trait empathic concern. A neutral situation, high trait empathic concern, and low identification increased the effect. We observed high heterogeneity across countries that was, via split-half validation, best explained by country-level GDP per capita and subjective well-being with stronger effects for higher-scoring countries. These findings suggest that tears can function as social glue, providing one possible explanation why emotional crying persists into adulthood.
-
The impact of factor infusion frequency on health-related quality of life in people with haemophiliaAbstract Background Some studies suggest that people with haemophilia (PwH) who use prophylaxis value low frequency of clotting factor administration more than a lower risk of bleeding. However, more frequent infusions offer the potential of reducing joint disease and pain, which in turn may improve functioning and quality of life. Aims To explore the impact on health-related quality of life (HRQoL) aspects of haemophilia associated with adherence and annual infusion rate in the context of factors influencing treatment that are important to patients, including prophylaxis, chronic pain, concomitant conditions and hospital admission. Materials and methods HRQoL was assessed in participants with severe haemophilia in the ‘Cost of Haemophilia in Europe: a Socioeconomic Survey’ (CHESS) study who were using prophylaxis. Patients using on-demand treatment were excluded. This multivariate analysis examined the interaction between factors potentially influencing treatment and HRQoL, and minor and major bleeds. Results From the total CHESS population (n=1,285), 338 (26%) participants provided responses for major and minor bleeds and target joints, and 145 (11%) provided EQ-5D-3L responses. Major and minor bleeds were associated with pain. Patients with severe chronic pain reported a substantial negative impact on HRQoL; but this was significantly improved by increases in the annual infusion rate. This was not apparent in participants with mild or moderate pain. Conclusion Increasing the frequency of prophylaxis infusions is associated with improved quality of life in PwH who have severe chronic pain. However, increasing the number of infusions per week in those with mild or moderate chronic pain with the intention of improving prophylactic effect may not have the same effect.
-
Critical analysis of the Armed Forces Covenant Fund Trust Aged Veterans Fund.Relatively little research is available regarding the specific needs of older military veterans and the services introduced to support them. In 2016, the Armed Forces Covenant Fund Trust launched the Aged Veterans Fund (AVF), to understand the impact that military service may have on ageing, and to support initiatives targeting their health and well-being. This fund was financed for 5 years and included 19 UK portfolio projects. The paper presents a retrospective evaluation on the processes and impact of the AVF, with the intent of informing policy, educational services, service providers and stakeholders of the lessons learnt. The inclusion criteria was veterans and their families aged 65 years of age or over. In 2019, data were drawn from documentary evidence related to the programmes. Qualitative analysis were performed on 78 eligible sources and 10 themes were identified. Programmes were rolled out via collaborative partnerships referrals, focusing on person-centred or skill-exchange approaches. Challenges were encountered, such as capacity and timelines issues. A limited amount of associated cost-savings was observed, even if examples of sustainability and high satisfaction were reported. Evidence was found of programmes boosting health and well-being outcomes, in raising awareness, and in positively impacting on clinical practice, such as re-admission rates. The AVF programmes were successful in their intent to provide support to older veterans and their families. The findings provide indicators of the next steps required for the support of ageing veterans. Further investigation of the cost-effectiveness of age-friendly veterans' services is needed. [Abstract copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.]
-
Evaluation of a 'drop box' doorstep assessment service to aid remote assessments for COVID-19 in general practice.The COVID-19 is an established threat whose clinical features and epidemiology continues to evolve. In an effort to contain the disease, the National Health Service has adopted a digital first approach in UK general practice resulting in a significant shift away from face-to-face consultations. Consequently, more consultations are being completed without obtaining objective recording of vital signs and face-to-face examination. Some regions have formed hot hubs to facilitate the review of suspected COVID-19 cases and keep their practice site 'clean' including the use of doorstep observations in avoiding the risk of face-to-face examination. To support the safe, effective and efficient remote assessment of suspected and confirmed patients with COVID-19, we established a doorstep assessment service to compliment telephone and video consultations. This allows physiological parameters such as temperature, pulse, blood pressure and oxygen saturation to be obtained to guide further triage. Quality improvement methods were used to integrate and optimise the doorstep assessment and measure the improvements made. The introduction of a doorstep assessment service increased the proportion of assessments for patients with suspected COVID-19 in routine care over weeks. At the same time we were able to dramatically reduce face-to-face assessment over a 6-week period by optimising through a range of measures including the introduction of a digital stethoscope. The majority of patients were managed by their own general practitioner following assessment supporting continuity of care. There were no adverse events during the period of observation; no staff absences related to COVID-19. Quality improvement methods have facilitated the successful integration of doorstep assessments into clinical care. [Abstract copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.]
-
An Exploration into the Impact of Social Networking Site (SNS) Use on Body Image and Eating Behavior of Physically Active MenThe rapid proliferation of social networking sites (SNSs) has transformed the way people now socialize and communicate. SNSs have been recognized to contribute to body image (BI) dissatisfaction and disordered eating behavior (EB). Few qualitative studies have explored this issue in men. The aim of the current study was to investigate male SNS use and possible impacts on BI and EB. One-to-one semi-structured interviews were conducted with eight men in the United Kingdom. Interviews aimed to examine men’s views on the potential impact of SNSs on BI and EB. Data were thematically analyzed. Findings suggested that SNSs may be a useful nutrition idea tool and motivational platform for men to improve their diet and exercise uptake. However, results also indicated that SNS use may contribute to BI dissatisfaction and increased risk of disorder. Future research may identify risk factors of SNS use, male BI concerns, and eating pathology across the lifespan.
-
Differences in the vertical and horizontal force-velocity profile between academy and senior professional rugby league players, and the implications for strength and speed training.This study compared the vertical and horizontal force-velocity (FV) profile of academy and senior rugby league players. Nineteen senior and twenty academy players from one professional club participated in this study. The vertical FV profile was determined using a series of loaded squat jumps (0.4 to 80 kg) with jump height recorded. The horizontal FV profile involved a 30-m over-ground sprint with split times recorded at 5, 10, 15, 20 and 30 m. Theoretical maximal force (F0), velocity (V0) and power (Pmax), optimal F0 and V0, and activity specific variables (e.g. vertical FV imbalance) were determined. Absolute F0 and Pmax from the vertical and horizontal profile were moderately different between groups (standardised mean difference (SMD) = 0.64-1.20, P <0.001-0.026), whilst for V0, differences were small (SMD = 0.33-0.41, P = 0.149-0.283). Differences in relative F0, Pmax and optimal F0 during both assessments were trivial to moderate (SMD = 0.03-0.82, P = 0.021-0.907). These results highlight senior and academy players present with different FV profiles and highlight some potential developmental opportunities for senior and academy rugby league players that sport scientists, strength and conditioning and rugby coaches can implement when designing programmes and considering long-term athlete development.
-
Acceptance and commitment therapy (ACT)-enhanced communication skills: development and evaluation of a novel training programme.Psychological suffering is ubiquitous with cancer and frequently presents as an unmet supportive care need. In clinical practice, distress-related needs are often addressed by nurses and non-psychologist allied healthcare professionals who may have limited training in psychological therapeutic frameworks, particularly more recently developed interventions such as Acceptance and Commitment Therapy (ACT). We developed a single-day training programme for professionals working in supportive and palliative cancer care settings to change the nature of clinical communication about psychological distress and suffering towards an ACT-consistent approach. We report on experiences of training delivery, and evaluation data about training satisfaction and intention to apply the training to clinical practice, from three training iterations in British and Australian, government-funded and charitable sectors. One hundred and sixteen cancer care professionals participated in the training. Evaluation data were collected from 53 participants (at either 2-week or 3-month follow-ups, or both) using self-report survey, including both quantitative and free-text questions. At 2 week follow-up, 73% of trainees rating our course as having relevance to their work, and at 3 month follow-up, 46% agreed that they were better placed to provide improved clinical services. Qualitative feedback supported the inclusion of experiential learning and theoretical explanations underpinning ACT techniques. Undertaking this training did not significantly increase trainees' stress levels, nor did implementation of this new way of working negatively affect staff well-being. Positive, ACT-consistent, changes in communication behaviours and attitudes were reported, however there was a lack of significant change in psychological flexibility. Acceptability and applicability of this training to supportive and palliative healthcare is positive. The lack of change in psychological flexibility suggests a potential need for more experiential content in the training programme. Logistical challenges in one training group suggests the need for more robust train-the-trainer models moving forward. [Abstract copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.]
-
Evaluating the impact of COVID-19 on supportive care needs, psychological distress and quality of life in UK cancer survivors and their support network.The COVID-19 pandemic is having considerable impact on cancer care, including restricted access to hospital-based care, treatment and psychosocial support. We investigated the impact on unmet needs and psychosocial well-being. One hundred and forty four participants (77% female), including people with cancer and their support networks, were recruited. The most prevalent diagnosis was breast cancer. Forty-one participants recruited pre-pandemic were compared with 103 participants recruited during the COVID-19 pandemic. We measured participants' unmet supportive care needs, psychological distress and quality of life. Half of our patient respondents reported unexpected changes to treatment following pandemic onset, with widespread confusion about their longer-term consequences. Although overall need levels have not increased, specific needs have changed in prominence. People with cancer reported significantly reduced anxiety (p = 0.049) and improved quality of life (p = 0.032) following pandemic onset, but support network participants reported reduced quality of life (p = 0.009), and non-significantly elevated anxiety, stress and depression. Psychological well-being of people with cancer has not been detrimentally affected by pandemic onset. Reliance on home-based support to compensate for the lost availability of structured healthcare pathways may, however, explain significant and detrimental effects on the well-being and quality of life of people in their support and informal care networks. [Abstract copyright: © 2021 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.]
-
Current strength, temperature, and bodyscape modulate cleaning services for giant manta raysAbstract: The cleaner–client system among reef teleosts has received considerable attention in both wild and captive environments, but the spatially and taxonomically diverse associations between cleaner fish and elasmobranchs are less understood. Using remote video, we investigated interactions between giant manta rays (Mobula birostris) and cleaner wrasse at a seamount in the Philippines. Cleaning events occurred between 11:00 and 16:00 h on a seasonal basis and were constrained by current strengths and ambient water temperatures. The frequency with which giant manta rays interacted with cleaner fish varied on an individual basis. Blue streaked cleaner wrasse (Labroides dimidiatus) and moon wrasse (Thalassoma lunare) selectively foraged on manta rays’ gills and pelvis, with L. dimidiatus also demonstrating slight preferences for the pectoral fins. Cleaners’ foraging preferences may indicate ectoparasitic infections in specific areas of a manta ray’s body. The exclusivity with which giant manta rays visited a particular cleaning station on the seamount may be a response to the quality of services that cleaners provide there. Giant mantas’ fidelity to this site may also be attributed to localised concentrations of food that are available nearby. The seamount provides habitat that appears to be important to the life history strategies of the region’s giant manta rays.
-
The Fall of the House of Wynnstay: The 1885 Election in East DenbighshireThis article discusses the 1885 election in East Denbighshire when the Williams-Wynn family of Wynnstay lost the parliamentary seat that the family had represented for over 170 years. The election took place amidst the backdrop of legislative changes to corrupt practices, the electorate, and changing constituency boundaries. Conservative and Liberal party organisation in East Denbighshire is discussed.
-
Planting critical ideas: Artists reconfiguring the environmental crisisThis article looks at possible artistic responses to the environmental crisis, using the theory of anti-mimesis as a means to rethink and reconfigure the ways that the crisis is understood. Initially using the nineteenth-century idea of anti-mimesis, or life imitating art, where art brings nature into existence in people’s minds, the article looks at the work of contemporary artists and writers who are challenging existing assumptions about human interventions into the natural world and the ways in which thinking may be reconfigured by these responses. In particular the sluggish response of governments towards tree preservation and planting is used as an example of the potential for artist educators to revivify the thinking around this issue through their creative insights, hence the metaphor of planting critical ideas, with the aim of creating a momentum of consciousness about the preciousness and fragility of our natural environment.
