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Thesis (Ph.D.)--Tufts University, 2002. / Advisers: Joseph Litvak; Modhumita Roy. Submitted to the Dept. of English. Includes bibliographical references (leaves 244-258). Access restricted to members of the Tufts University community. Also available via the World Wide Web;

Prevalence of overweight and obesity has increased in adult and child populations during the last two to three decades in both developed and developing countries. Childhood obesity is common in the United Kingdom and has become a major public health issue. There is a growing body of evidence to suggest that the development of overweight and obesity in children has its roots in early life, with evidence of increasing weight over time in pre-school children. The study explored the early development of overweight in infants in Halton, an area of Northwest England. It was a mixed methods study comprising a quantitative analysis of routinely collected infant weight data and a longitudinal qualitative study of the process of weaning. Phase one - patterns of weight in Halton infants: The retrospective quantitative study utilised birthweight, and weight and length/height at eight weeks, eight months and 40 months of age from Halton infants born between 1994 and 2006 (16,328 singleton births). Analysis of these data provided further evidence of the early development of overweight, and highlighted patterns of infant overweight at eight months of age not previously reported. Phase two - longitudinal qualitative study of the process of weaning: Given the findings of phase one, factors that may influence early weight gain were considered. Therefore, the second phase focussed upon weaning, which has been little researched in terms of the way in which mothers manage the process. The aim was to explore weaning as a social process, focussing on the experience, knowledge, perceptions and actions of mothers as they weaned, in order to consider whether this could shed light on infant growth and development in general and the early development of overweight in particular. A grounded theory approach was utilised. Twenty one women were recruited and interviewed antenatally and then up to three times after their babies were born. A total of 67 interviews took place. A grounded theory, or ‘plausible account’, of the weaning process was developed. The centrality of the baby, and the way in which mothers talk about following the lead of the baby as they wean was highlighted, along with the ways in which this focus may falter or shift because of the complexity of influences on mothers’ lives. The primacy of embodied knowledge, that is the knowledge that mothers built up through the experience of feeding and weaning their infant, and the significance of being a mother in terms of being an ‘authority’ on feeding and weaning, were evident. In addition, the limitations of providing information, such as the feeding and weaning guidelines, without taking account of the individual mother, infant and their context was indicated. This is how some mistrust of the advice of health professionals, and possibly other ‘health messages’ emerged, as mothers did not see the advice as appropriate to them, their infant, or circumstances. Mothers did recognise babies as ‘bigger’ or ‘smaller’, but through valuing weight and weight gain were particularly aware of having small babies, which may have limited their capacity for recognising the significance of early signs of overweight in their infants. Final conclusions: Using mixed methods in this study allowed a broad picture of patterns of weight and overweight in Halton infants, and what some of the contributory factors to those patterns might be, to emerge, than if a single research method had been used. A number of implications for policy and practice: at an individual level in terms of the way in which women are supported to feed and wean their babies; and at a population level in terms of the monitoring of weight, were identified.

This thesis describes an in-depth study of limestone pavements across North West England and North Wales. The aim was to combine elements of geodiversity and biodiversity in order to create a holistic limestone pavement classification to inform future management. A field-based research protocol was used to assess a stratified random sample (46 pavements), accounting for approximately 10% of the limestone pavements in the geographical area. Detailed analyses of key elements are presented, along with important issues that continue to pose threats to this Annex One Priority Habitat. This research resulted in a comprehensive classification, using TWINSPAN analysis and Nonmetric Multidimensional Scaling, identifying six distinct holistic functional groups. The prime factors driving limestone pavement morphology, and hence the classification, were established to be lithology, proximity to structural fault, altitude and human intervention, particularly in terms of grazing intensity. Three upland, open limestone pavement classes were formed. Of these, the richest in terms of geodiversity and biodiversity was the group with the thickest bedding planes and hence the deepest grikes, typically greater than 1m. The class that was most species-poor was "at the highest altitude (above 450m), formed on the thin limestones of the Yoredales. These were characterised by shallow, wide grikes. The third upland limestone pavement group had mid-range grikes, generally 0.5-1m in depth, and small clints. Two wooded classes were identified. One was a lowland 'classic' wooded limestone pavement group with deep, narrow grikes and shallow soils. Indicator species included Juniperus communis and Taxus baccata. The second wooded group was situated proximal to a major structural fault. In this group the pavement dip ranged between 10°-40° with well-runnelled clints that were heavily moss-covered. The sixth group was low altitude, proximal to the coast, characterised by low moss growth, un-vegetated clints and the presence of Ulex europaeus. Conservation management was identified as key to the quality of the limestone pavement habitat and this thesis identifies best management practises and links these to the holistic limestone pavement classification. Finally, as a sample case study, this thesis presents mollusc species and diversity from eleven of the Yorkshire limestone pavements. Analysis establishes significant links between geodiversity and mollusc populations, with key drivers for mollusc communities echoing those of plant species on limestone pavement.

The thesis is comprised of four parts. The first, consisting of two chapters, challenges some generally accepted views about the 1930's as a whole and emphasises the change in political consciousness that occurred in the minds of ordinary people. The ideology of the B. U. F. is analysed in the context of the decade. The second part, consisting of five chapters, provides a detailed history of the B. U. F. in the North of England from the days of its precursor, the New Party, to the detention of the leading B. U. F. members in 1940- Much of the history of the movement is concerned with Manchester though attention is also paid to other areas in the North of England. The 1938 Manchester municipal elections also receive attention, because of the campaigns waged by the B. U. F. candidates. This is the first major regional study of the B. U. F. The third part deals with the ordinary membership of the B. U. F. in the North of England. The two chapters in this section assess previous judgements regarding B. U. P. membership and make use of interviews and unpublished manuscripts to provide the most detailed analysis of the membership of a British Pascist party. The final part of the thesis consistsq firstlyq of a detailed account of the reaction of the Jewish community, both nationally and in-thrighesterg to the anti-Semitism of the B. U. P., and, secondly, the attitude of the police, judiciary, local authorities and the government to the rise of the British Union of Fascists.

The thesis is comprised of four parts. The first, consisting of two chapters, challenges some generally accepted views about the 1930's as a whole and emphasises the change in political consciousness that occurred in the minds of ordinary people. The ideology of the B. U. F. is analysed in the context of the decade. The second part, consisting of five chapters, provides a detailed history of the B. U. F. in the North of England from the days of its precursor, the New Party, to the detention of the leading B. U. F. members in 1940- Much of the history of the movement is concerned with Manchester though attention is also paid to other areas in the North of England. The 1938 Manchester municipal elections also receive attention, because of the campaigns waged by the B. U. F. candidates. This is the first major regional study of the B. U. F. The third part deals with the ordinary membership of the B. U. F. in the North of England. The two chapters in this section assess previous judgements regarding B. U. P. membership and make use of interviews and unpublished manuscripts to provide the most detailed analysis of the membership of a British Pascist party. The final part of the thesis consistsq firstlyq of a detailed account of the reaction of the Jewish community, both nationally and in-thrighesterg to the anti-Semitism of the B. U. P., and, secondly, the attitude of the police, judiciary, local authorities and the government to the rise of the British Union of Fascists.

No / To examine the beliefs and experiences of South Asians with epilepsy and the extent of provision of appropriate information and accessible services for them by health professionals. Methods: Qualitative interviews with 30 South Asians with epilepsy, 16 carers and 10 health professionals. In addition, two focus groups were held with 16 South Asians without epilepsy recruited from community centers. The interview sample was divided by religious groupings (Hindus, Sikhs and Muslims). Fieldwork was conducted in Bradford and Leeds (England Results: Beliefs that epilepsy is caused by spirit possession (Muslims) or attributable to sins committed in a past life (Sikhs and Hindus) were reported as being widely held among South Asians living both in the UK and the Indian subcontinent, although few informants themselves subscribed to such views. Compliance with conventional medication was high; however, those who experienced seizures most often were most likely to turn to traditional South Asian therapies. Most informants used both treatments simultaneously. The main issues regarding the provision of services were: lack of appropriate information and advice; language and communication barriers; problems in interaction with health professionals. Also discussed were the potential merits of attending support groups. Greatest dissatisfaction was expressed in relation to primary care, whereas the highest praise was reserved for specialist epilepsy nurses. Conclusions: Our findings show both similarities and differences between participants¿ experiences, where gender, age or other aspects of personal biography can be as important as religion, culture or country of origin. Furthermore, the impact of being diagnosed with epilepsy can be exacerbated by structural impediments to accessing information and appropriate services.

No / This paper examines the incidence of innovation and the configuration of innovation systems in rural areas, which are viewed as possessing weak knowledge-generating subsystems. Drawing on the results of a microlevel study in rural Cumbria, North West England, the paper shows that entrepreneurs were able to access nonlocal knowledge infrastructure. Thus, the emergent actor-constructed regional innovation system stretched well beyond the confines of Cumbria. This configuration can be explained, in large part, by considering entrepreneurial origin. New arrivals (especially immigrants) demonstrated the greatest propensity to innovate, using innovation systems which cut across the regional and national boundaries. Locally born and returnee entrepreneurs demonstrated a low incidence of innovation. The paper concludes that a distinction between regional innovation systems (as macrolevel analytical units with a normative dimension) and actor-constructed regional innovation systems (as microlevel descriptive units) offers scope for the advancement of research in this field of study.

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This research study explored the meaning of 'Being' (i.e. Heidegger's four philosophical concepts of Being-in the-world, fore-structures, time and space) as a nurse involved in the work of death investigation in the USA. The objectives were to: reveal the hidden meaning of Being; transfer the findings into an English context by examining what nurses could offer beyond their current role boundaries in an area not currently practised to the extent that nurses make to other medical specialities; and finally put forward developments that would need to take place to ensure such proposals were successful in making an effective difference to health care. In the USA there are two systems of death investigation, the Coronial and Medical Examiner system. The Coroner is an elected county or state position with varied educational and professional requirements. Some Coroner positions have been filled by registered nurses as they have put themselves forward successfully for election. In contrast, the Medical Examiner is an appointed county or state position who must be a licensed physician and a qualified pathologist or forensic pathologist in most cases. Within the Medical Examiner systems death investigators may also be appointed of which some have been filled by registered nurses. It was under the interpretive paradigm that a Heideggerian hermeneutic study was undertaken. Snowball sampling was instigated to reach a hidden population and collect qualitative data by means of unstructured interviews, non-participant observations, interrogation of historical records and the keeping of a personal reflective diary. The seven phase analysis process underpinned by the hermeneutic circle was developed to enable a synopsis of the shared meaning of Being to be revealed through the presentation of paradigm cases that encompass stories and themes. Of the 22 nurses found to be working as either death investigators or Coroners in the USA who fulfilled the inclusion criteria, 17 nurses from 11 States in the USA consented to take part. Fore-structures concerning age (average 37), gender (82% were women) and professional experience (majority came from an adult nursing background with emergency department or critical care experience) are discussed. Overall participants were interviewed for a total of 78 hours in 11 States, five of which were also observed in practice for a total of 142 hours in 3 States, giving a total of 220 hours of interview and observational data. The interpretive analysis revealed the three major paradigms of: the authentic and inauthentic reality of Being (the death investigator nurse in action); the everydayness and averageness of Being (community outreach) and the publicness of Being (mass fatality care). This study reveals knowledge concerning the meaning of Being as a nurse involved in the work of death investigation in the USA. Aspects of this illuminated landscape have propositioned for the advancement of nursing clinical practice to replace and further develop the current coroner's officer and soon to be implemented medical examiner officer role in England and Wales. Hence recommendations are made for practice development and further research in England.