Now showing items 21-40 of 10006

    • A scoping review: Strategic workforce planning in health and social care

      Prowse, Julie M.; Sutton, Claire; Eyers, Emma; Montague, Jane; Faisal, Muhammad; Neagu, Daniel; Elshehaly, Mai; Randell, Rebecca (2022-04)
      Aim This aim of this scoping review was to undertake a detailed review of the pertinent literature examining strategic workforce planning in the health and social care sectors. The scoping review was tasked to address the following three questions: 1. How is strategic health and social care workforce planning currently undertaken? 2. What models, methods, and tools are available for supporting strategic health and social care workforce planning? 3. What are the most effective methods for strategic health and social care workforce planning? Methods The scoping review utilised the five-stage scoping review framework proposed by Arksey and O’Malley (2005). This includes identifying the research question; identifying relevant studies; study selection; charting the data and collating, summarizing, and reporting the results. The search included a range of databases and key search terms included “workforce” OR “human resource*” OR “personnel” OR “staff*”. Relevant documents were selected through initially screening titles and abstracts, followed by full text screening of potentially relevant documents. Results The search returned 6105 unique references. Based on title and abstract screening, 654 were identified as potentially relevant. Screening of full texts resulted in 115 items of literature being included in the synthesis. Both national and international literature covers strategic workforce planning, with all continents represented, but with a preponderance from high income nations. The emphasis in the literature is mainly on the healthcare workforce, with few items on social care. Medical and dental workforces are the predominate groups covered in the literature, although nursing and midwifery are also discussed. Other health and social care workers are less represented. A variety of categories of workforce planning methods are noted in the literature that range from determining the workforce using supply and demand, practitioner to population ratios, needs based approach, the utilisation of methods such as horizon scanning, modelling, and scenario planning, together with mathematical and statistical modelling. Several of the articles and websites include specific workforce planning models that are nationally and internationally recognised, e.g., the workload indicators of staffing needs (WISN), Star model and the Six Step Methodology. These models provide a series of steps to help with workforce planning and tend to take a more strategic view of the process. Some of the literature considers patient safety and quality in relation to safe staffing numbers and patient acuity. The health and social care policies reviewed include broad actions to address workforce planning, staff shortages or future service developments and advocate a mixture of developing new roles, different ways of working, flexibility, greater integrated working and enhanced used of digital technology. However, the policies generally do not include workforce models or guidance about how to achieve these measures. Overall, there is an absence in the literature of studies that evaluate what are the most effective methods for strategic health and social care planning. Recommendations The literature suggests the need for the implementation of a strategic approach to workforce planning, utilising a needs-based approach, including horizon scanning and scenarios. This could involve adoption of a recognised workforce planning model that incorporates the strategic elements required for workforce planning and a ‘one workforce’ approach across health and social care.
    • User engagement on global social networks: Examining the roles of perceived brand globalness, identification and global identity

      Akram, M.S.; Malhotra, N.; Goraya, M.A.S.; Shareef, M.A.; Malik, A.; Lal, Banita (2022-08)
      Building on the global branding literature, brand relationship theory and social identity theory, this study investigates the relationship between perceived brand globalness (PBG) and user engagement (active/passive) on global social networks (GSN). Additionally, the study investigates the mediating effects of two distinct forms of user identification (i.e., user identification with the GSN brand and user identification with the GSN community) as well as the moderating effects of user global identity on the relationship between PBG and user engagement with such brands. Covariance-based structural equation modeling was used to analyse data collected from users of a GSN (i.e., Facebook) in the United Kingdom (UK) and India. The results indicate that PBG significantly influences both active and passive user engagement. This relationship is mediated by users' identification with a GSN brand and community. Additionally, the findings indicate that the associations between PBG and user engagement (active/passive) on GSN vary as a function of users' global identity. The results also demonstrate some country-specific variations in key relationships. Finally, the study offers useful recommendations for social media managers to rethink and redesign their user engagement strategies, keeping in mind global cultural diversity.
    • Language Management: From Bricolage to Strategy in British Companies

      Wilmot, Natalie (Multilingual Matters, 2022-08)
      This book draws on case studies of language management within British organisations to examine the decisions they make about language diversity in their professional communications in order to be successful in a multilingual world. It explores the practices that the organisations use to manage language diversity in interorganisational relationships, and why certain practices occur in some situations and not others. The book highlights how organisations rely on individual employees to perform a variety of language tasks and the implications of this; the effect of English as a global lingua franca; and the translation challenges which organisations face. The book demonstrates that practices to manage language diversity are often a result of the resources organisations have at given moments in time, rather than being part of a deliberate language management strategy.
    • The Use of Function Modelling Methods in Industry: Insights from a Large Scale Study with an Automotive OEM

      Yildirim, Unal; Campean, I. Felician; Uddin, Amad (Cambridge University Press, 2022-05)
      This paper presents an evaluation study for the System State Flow Diagram function modeling framework based on a large-scale study with an automotive OEM. Technical reports are used to evaluate the usage of the framework within the organization. The paper also introduces a list of the type of problems that engineers are interested in in practical function modelling. The findings suggest that there is a widespread uptake of the framework across the organization and it supports the usage of relevant key engineering tools within the context of a broader model-based Failure Mode Analysis methodology.
    • Towards a Model-Based Systems Engineering Approach for Robotic Manufacturing Process Modelling with Automatic FMEA Generation

      Korsunovs, Aleksandrs; Doikin, Aleksandr; Campean, I. Felician; Kabir, Sohag; Hernandez, E.M.; Taggart, D.; Parker, S.; Mills, G. (Cambridge University Press, 2022-05)
      The process of generating FMEA following document-centric approach is tedious and susceptible to human error. This paper presents preliminary methodology for robotic manufacturing process modelling in MBSE environment with a scope of automating multiple steps of the modelling process using ontology. This is followed by the reasoning towards automatic generation of process FMEA from the MBSE model. The proposed methodology allows to establish robust and self-synchronising links between process-relevant information, reduce the likelihood of human error, and scale down time expenses.
    • Evaluation of the Impact of Collaborative Research on Robust Design Methodologies: A Large Scale Empirical Case Study with an Automotive OEM

      Campean, I. Felician; Uddin, Amad; Bridges, J.; Fannon, S.R.; Yildirim, Unal (Cambridge University Press, 2022-05)
      The evaluation of impact of collaborative research on robust design methodologies and methods is important to both academic and industry stakeholders. This paper introduces a framework for impact evaluation which combines the broader framework adopted for the academic research impact assessment with the organisation viewpoint centred on business results, process improvement and product development teams capability improvement. A large scale empirical study conducted with evidence from technical reports on workplace projects from an automotive OEM proved the validity of the proposed framework.
    • A New Beamforming Approach Using 60 GHz Antenna Arrays for Multi–Beams 5G Applications

      Al-Sadoon, M.A.G.; Patwary, M.N.; Zahedi, Y.; Parchin, N.O.; Aldelemy, Ahmad; Abd-Alhameed, Raed A. (MDPI, 2022-05-30)
      Recent studies and research have centred on new solutions in different elements and stages to the increasing energy and data rate demands for the fifth generation and beyond (B5G). Based on a new-efficient digital beamforming approach for 5G wireless communication networks, this work offers a compact-size circular patch antenna operating at 60 GHz and covering a 4 GHz spectrum bandwidth. Massive Multiple Input Multiple Output (M–MIMO) and beamforming technology build and simulate an active multiple beams antenna system. Thirty-two linear and sixty-four planar antenna array configurations are modelled and constructed to work as base stations for 5G mobile communication networks. Furthermore, a new beamforming approach called Projection Noise Correlation Matrix (PNCM) is presented to compute and optimise the fed weights of the array elements. The key idea of the PNCM method is to sample a portion of the measured noise correlation matrix uniformly in order to provide the best representation of the entire measured matrix. The sampled data will then be utilised to build a projected matrix using the pseudoinverse approach in order to determine the best fit solution for a system and prevent any potential singularities caused by the matrix inversion process. The PNCM is a low-complexity method since it avoids eigenvalue decomposition and computing the entire matrix inversion procedure and does not require including signal and interference correlation matrices in the weight optimisation process. The suggested approach is compared to three standard beamforming methods based on an intensive Monte Carlo simulation to demonstrate its advantage. The experiment results reveal that the proposed method delivers the best Signal to Interference Ratio (SIR) augmentation among the compared beamformers
    • Exploring the obesity concerns of British Pakistani women living in deprived inner-city areas: A qualitative study

      Iqbal, Halima; West, Jane; McEachan, Rosemary; Haith-Cooper, Melanie (2022)
      British South Asians have a higher prevalence of overweight and obesity than the wider population. Bradford (UK), with its high Pakistani presence and levels of economic deprivation, has exceptionally high instances, especially in deprived areas where many Pakistanis reside. British Pakistani women in Bradford are more likely to be overweight and obese. There is uncertainty on how these women can be aided to manage their weight. Therefore, the objective of this study was to explore the obesity concerns of Pakistani women living in deprived inner-city areas of Bradford. Three focus groups interviews were carried out with 23 Pakistani women living in deprived areas of Bradford. Data were analysed thematically. This exploratory study identified a wide range of concerns that women had around managing their weight. Participants disclosed distrust in information given around medication, conflicting dietary information and reported low levels of trust in women-only organized physical activities. Cultural barriers were identified, which included the gender role of the woman, the lack of culturally appropriate dietary advice, cultural misunderstandings of what constitutes a healthy diet and healthy weight, the lack of culturally suitable exercise facilities and conforming to family and community expectations. Other concerns were language barriers around a lack of understanding, the inability to read Urdu and reliance on others to translate information. These findings have implications for researchers, local authorities, policy makers and others with an interest in reducing the rates of obesity in this population. Recommendations include training health practitioners to be culturally aware of the diet and eating practices of this community, exploring different ways to support socially isolated women to be more physically active at home, addressing physical activity and diet misconceptions and designing obesity management information materials appropriate for a range of literacy levels. Public contributors were involved in the development of the interview guide and design of the research. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Interview transcripts were member checked by participants, and participants assisted with data analysis.
    • A Security-enabled Safety Assurance Framework for IoT-based Smart Homes

      Kabir, Sohag; Gope, P.; Mohanty, S.P. (2022)
      The exponential growth of the Internet of Things (IoT) has paved the way for safety-critical cyber-physical systems to enter our everyday activities. While such systems have changed the way of our life, they brought new challenges that can adversely affect our life and the environment. Safety and security are two such challenges that can hamper the widespread adoption of new IoT applications. Due to a large number of connected devices and their ability to control critical physical assets, intended attacks on them and/or unintended failure events such as mechanical failure of devices, communication failure and unforeseen bad interactions between connected devices may cause an IoT-based system to enter into unsafe and dangerous physical states. By considering the importance of safety and security of IoT systems, in this article, we present a security-enabled safety monitoring framework for IoT-based systems. In the proposed framework, we utilise design-time system analysis to create an executable monitoring model that enables run-time safety assurance provision for a system via collecting and analysing operational data and evidence to determine the safety status of the system and then taking appropriate actions and securely communicating the safety status and recommended actions to the system users to minimise the risk of the system entering into an unsafe state.
    • Organizational non-compliance with principles-based governance provisions and corporate risk-taking

      Ahmad, S.; Akbar, Saeed; Halari, A.; Shah, S.Z. (Elsevier, 2021-09-04)
      This paper examines how risk-taking is affected by non-compliance with a ‘comply or explain’ based system of corporate governance. Using System Generalized Methods of Moments (GMM) estimates to control for various types of endogeneity, the results of this study show that non-compliance with the UK Corporate Governance Code is positively associated with total, systematic, and idiosyncratic risk. However, profitability moderates the impact of non-compliance on firms' risk-taking. The findings of this study further reveal that the impact of non-compliance with various provisions of the UK Corporate Governance Code is not uniform. That is, non-compliance with board independence provisions is associated with higher risk-taking. However, non-compliance with committees' chair independence is associated with lower risk-taking. These findings have implications for investors, policy makers, and corporations regarding the usefulness of compliance with a prescribed code of corporate governance.
    • Transparency, authenticity and purchase intentions: Chinese independent restaurants

      Yang, H.; Song, Hanqun; Ding, Q.S.; Wang, H. (Emerald Publishing, 2022)
      Purpose – Drawing on signalling theory and focusing on independent restaurants, this research investigates how business signals (transparency information and exposure) affect business transparency, food authenticity, and ultimately purchase intentions. Design/methodology/approach – Using a 2x2 between-subject experimental design, Study 1 examines the recipe and an internet-famous restaurant, and Study 2 assesses the food supply chain and a celebrity-owned restaurant. Analysis of covariance and PROCESS is used to analyse the data. Findings – The results suggest that while revealing information on recipes and food supply chains positively affects business transparency, exposure has no significant impact. Additionally, secret recipes and revealed food supply chains contribute to higher food authenticity whilst being a celebrity owner or internet-famous restaurant negatively affects food authenticity. Research implications – Restaurant managers must be strategic and selective about the kinds of business signals they wish to reveal to customers. Secret recipes lead to higher food authenticity; whereas the revealed recipes and revealed food supply chains elicit higher business transparency. Independent restaurants should not rely on celebrity owners or seek internet fame, as neither type of exposure contributes to transparency or authenticity. Originality – This study advances the theoretical understanding of signalling theory relating to the determinants of transparency and food authenticity in a hospitality context. Contrary to previous studies, it reveals that exposure, as a transparency signal, has no impact on either business transparency or food authenticity. It extends knowledge and understanding of different types of independent restaurants, especially internet-famous restaurants.
    • Single-Element and MIMO Circularly Polarized Microstrip Antennas with Negligible Back Radiation for 5G Mid-Band Handsets

      Alnahwi, F.M.; Al-Yasir, Yasir I.A.; See, C.H.; Abd-Alhameed, Raed A. (2022-04)
      In this paper, single-element and MIMO microstrip antenna with two pairs of unequal slits is proposed as a circularly polarized antenna with negligible back radiation for 5G mid-band handsets. The unequal pairs of slits are engraved on the antenna patch to guarantee the presence of the circular polarization (CP). The proximity-coupled feeding technique is used to excite the proposed microstrip antenna in order to provide larger antenna -10 dB bandwidth which approaches 10.8% (3.48-3.87 GHz). A novel analysis technique is proposed in this paper that demonstrates the 3D axial ratio pattern in order to generate CP in the broadside direction without affecting the structure of the ground plane which ensures weak back radiation. The 3 dB axial ratio bandwidth (ARBW) is found to be equal to 4.1% extended along the range (3.58-3.73 GHz). To make the design more compatible with the 5G mid-band handsets, the 2 × 2 MIMO structure of the proposed antenna with reduced mutual coupling (less than -20 dB) is also presented in this work. The simulation and measured results are in good agreement, and both verify the CP characteristics and the weak back radiation of the proposed antenna.
    • Analysis of Gyrobianisotropic Media Effect on the Input Impedance, Field Distribution and Mutual Coupling of a Printed Dipole Antenna

      Lamine Bouknia, M.; Zebiri, C.; Sayad, D.; Elfergani, Issa; Matin, M.; Alibakhshikenari, M.; Alharbi, A.G.; Hu, Yim Fun; Abd-Alhameed, Raed A.; Rodriguez, J.; et al. (Springer, 2022-06-20)
      n this paper, we present an analytical study for the investigation of the effects of the magnetoelectric elements of a reciprocal and nonreciprocal bianisotropic grounded substrate on the input impedance, resonant length of a dipole antenna as well as on the mutual coupling between two element printed dipole array in three configuration geometries: broadside, collinear and echelon printed on the same material. This study examines also the effect of the considered bianisotropic medium on the electric and magnetic field distributions that has been less addressed in the literature for antenna structures. Computations are based on the numerical resolution, using the spectral method of moments, of the integral equation developed through the mathematical derivation of the appropriate spectral Green’s functions of the studied dipole configuration. Original results, for chiral, achiral, Tellegen and general bi-anisotropic media, are obtained and discussed with the electric and magnetic field distributions for a better understanding and interpretation. These interesting results can serve as a stepping stone for further works to attract more attention to the reciprocal and non-reciprocal Tellgen media in-depth studies.
    • A New mm-Wave Antenna Array with Wideband Characteristics for Next Generation Communication Systems

      Munir, M.E.; Al Harbi, A.G.; Kiani, S.H.; Marey, M.; Parchin, N.O.; Khan, J.; Mostafa, H.; Iqbal, J.; Khan, M.A.; See, C.H.; et al. (MDPI, 2022-05-13)
      This paper presents a planar multi-circular loop antenna with a wide impedance bandwidth for next generation mm-wave systems. The proposed antenna comprises three circular rings with a partial ground plane with a square slot. The resonating structure is designed on a 0.254 mm thin RO5880 substrate with a relative permittivity of 2.3. The single element of the proposed design showed a resonance response from 26.5 to 41 GHz, with a peak gain of 4 dBi and radiation efficiency of 96%. The proposed multicircular ring antenna element is transformed into a four-element array system. The array size is kept at 18.25 × 12.5 × 0.254 mm3 with a peak gain of 11 dBi. The antenna array is fabricated and measured using the in-house facility. The simulated and measured results are well agreed upon and are found to be suitable for mm-wave communication systems.
    • Reproductive life histories: can incremental dentine isotope analysis identify pubertal growth, pregnancy and lactation?

      Feuillâtre, C.; Beaumont, Julia; Elamin, F. (Taylor and Francis, 2022)
      Background: There are few reliable osteological indicators to detect parity or infer puberty in skeletal remains. Nitrogen (δ15N) and stable carbon (δ13C) isotope ratios in human tissues can be affected by metabolically unbalanced states engendered by pregnancy or rapid growth, offering potential biomarkers. Aim: This pilot study explores the potential of incremental dentine-collagen isotope ratio analysis to identify puberty and gestation. Methodology: Incremental dentine δ15N and δ13C profiles were produced by analysing third molars extracted as part of dental treatment of 10 individuals living in Sudan. Demographic and anthropometric data at the time of tooth extraction was available. Medical histories were unknown. Results: Isotopic signatures potentially related to pubertal growth, with an average δ15N reduction of 0.78±0.29‰, are indicated. Six isotopic signals suggestive of pregnancy, with an average δ15N decrease of 0.48±0.22‰, are also observed. The timing, speed and amplitude of post-partum δ15N patterns seemingly infer infant feeding practices and maternal nutritional status. Conclusion: This pilot study highlights the potential of incremental dentine isotope analysis for the reconstruction of early reproductive histories in skeletal remains. However, controlled studies with larger human cohort are needed to validate these findings, establish isotopic signals linked to puberty and lactation, and improve chronology accuracy.
    • Predictors of awareness of functional ability in people with dementia: the contribution of personality, cognition, and neuropsychiatric symptoms. Findings from the IDEAL programme

      Martyr, A.; Gamble, L.D.; Nelis, S.M.; Collins, R.; Alexander, C.M.; Morris, R.G.; Quinn, Catherine; Pentecost, C.; Rusted, J.M.; Victor, C.; et al. (2022)
      Introduction: Discrepancy scores reflecting the difference between parallel ratings made by people living with dementia (PwD) in the mild-to-moderate stages and by their informants provide a way to investigate awareness of functional ability in relation to activities of daily living (ADL). Methods: Two measures of ADL (Functional Activities Questionnaire; Dependence Scale) were completed by 1,227 PwD and their informants in the IDEAL cohort study baseline assessment. Self-rated and informant-rated scores were used to calculate discrepancies, which were used as an indicator of awareness of functional ability. Smaller discrepancy scores were considered to reflect greater awareness on the part of PwD. PwD completed questionnaires on depression, personality, comorbidities, neuropsychiatric symptoms, and completed a measure of cognition. Informants provided ratings of stress. Univariable and multiple regressions were used to investigate factors related to ADL discrepancy. Results: A similar pattern of associations were found for both ADL discrepancy scores. Smaller discrepancy scores were associated with higher levels of depression, higher neuroticism, fewer neuropsychiatric symptoms, higher comorbidity, lower carer stress, and receipt of less than 1 hour of care per day from the informant. Discussion/Conclusion: There was a clear pattern of factors that were associated with greater awareness for both measures of functional ability. These factors associated with smaller discrepancy scores could be used to identify PwD who might benefit from targeted interventions to support their independence.
    • Demonstrating the Potential of Using Bio-Based Sustainable Polyester Blends for Bone Tissue Engineering Applications

      Ramos-Rodriguez, D.H.; Pashneh-Tala, S.; Bains, A.K.; Moorehead, R.D.; Kassos, Nikolaos; Kelly, Adrian L.; Paterson, T.E.; Orozco-Diaz, C.A.; Gill, A.A.; Ortega Asencio, I. (2022-04)
      Healthcare applications are known to have a considerable environmental impact and the use of bio-based polymers has emerged as a powerful approach to reduce the carbon footprint in the sector. This research aims to explore the suitability of using a new sustainable polyester blend (Floreon™) as a scaffold directed to aid in musculoskeletal applications. Musculoskeletal problems arise from a wide range of diseases and injuries related to bones and joints. Specifically, bone injuries may result from trauma, cancer, or long-term infections and they are currently considered a major global problem in both developed and developing countries. In this work we have manufactured a series of 3D-printed constructs from a novel biopolymer blend using fused deposition modelling (FDM), and we have modified these materials using a bioceramic (wollastonite, 15% w/w). We have evaluated their performance in vitro using human dermal fibroblasts and rat mesenchymal stromal cells. The new sustainable blend is biocompatible, showing no differences in cell metabolic activity when compared to PLA controls for periods 1-18 days. FloreonTM blend has proven to be a promising material to be used in bone tissue regeneration as it shows an impact strength in the same range of that shown by native bone (just under 10 kJ/m2) and supports an improvement in osteogenic activity when modified with wollastonite.
    • Reduction of scour around circular piers using collars

      Pandey, M.; Pu, Jaan H.; Pourshahbaz, H.; Khan, M.A. (2022-03)
      River dynamics and sediment transport play an important role in river bed morphology. Building a bridge pier along the river alters the cross-section of the river and causes the change in flow processes. These changes are mainly responsible for pier scour. In this paper, the usage of collars to reduce scour around circular piers has been investigated. The collars with different diameters and depth positions have been studied using previous data and additional data collected in the present study to assess their effectiveness in reducing scour. Using a wide range of measured data, an empirical equation to compute the maximum scour depth around the circular piers in the presence of collars has been proposed. The proposed equation has been validated and proven to be applicable to a wide range of pier layouts. It has been found that the maximum efficiency can be achieved by fixing the collar at bed level and adopting a collar diameter 1.5–2.5 times of pier diameter.
    • Improving bond of fiber-reinforced polymer bars with concrete through incorporating nanomaterials  

      Wang, X.; Ding, S.; Qiu, L.; Ashour, Ashraf A.; Wang, Y.; Han, B.; Ou, J. (Elsevier, 2022-06)
      The bond between FRP bars and concrete, the foremost performance for implementation of such reinforcements to corrosion-free concrete structures, is still unsatisfied due to the weak nature of duplex film in the interface. The existing approaches show low efficiency in improving the microstructures and bond between FRP bars and concrete. To address these issues, this paper provided a new approach for improving the bond between FRP bars and concrete by incorporating nanomaterials, as well as explored the modifying mechanisms and established the bond-slip models. For these purposes, the pull-out test, scanning electron microscope observation, as well as energy dispersive spectrometry analysis were performed. The experimental results demonstrated that the presence of nanomaterials increased the ultimate bond strengths between glass/carbon FRP bars and concrete by up to 16.2% and 37.8%, while the corresponding slips decreased by 28.7% and 35.4%, respectively. Such modification effects can be attributed to the optimized intrinsic composition and the reduced pore content of hydration products in the interface, especially in the duplex film, through the nanomaterial enrichment and nano-core effects. The bond-slip relationship between FRP bars and concrete with nanomaterials can be accurately predicted by the mBPE model.
    • Phenotypic differences between microvascular and macrovascular smooth muscle cells and their contribution to coronary microvascular dysfunction

      Riches-Suman, Kirsten (2021-06-11)
      Coronary microvascular dysfunction (CMD) is an under-diagnosed condition characterized by functional alteration of the small coronary arterioles and the cardiac capillary bed. The vessels do not dilate appropriately in response to changes in cardiac oxygen demand, leading to chest pain and symptoms of angina. These blood vessels contain two major cell types: the endothelial cells, which line the blood vessels and detect changes in oxygen demand, and smooth muscle cells (SMC) which respond to these changes by contracting or relaxing to provide an optimal blood supply to the cardiac tissue. Many CMD studies have focused on the endothelial cells as these cells secrete vasorelaxants and vasoconstrictors. However, comparably fewer studies have examined SMC despite their functional role in contracting and relaxing. A variety of health conditions and lifestyle choices, such as diabetes, hypertension and cigarette smoking, can promote the development of both CMD and macrovascular coronary artery disease; a condition where SMC have been studied extensively. This review article will consider the influence of CMD on SMC phenotype. It will discuss the structural, cellular and molecular changes in CMD, and will summarise how co-morbidities can have differing effects on micro- and macro-vascular SMC phenotype and function, which complicates the development of new therapeutic avenues for CMD.