• The tattooed client – a phenomenological exploration of symbolic representations in Self-concept

      Parnell, Tony; Hughes, Leana (University of Chester, 2013-10)
      This study’s primary research questions sought to explore Tattoo Narratives as an alternative approach to understanding a client’s phenomenological sense of Self. The author was also interested in understanding why some clients choose to immortalise significant life events with tattoos and the personal meaning they attach to it. The intension of this study was to examine whether any knowledge produced is of benefit to a counsellor, working with a tattooed client. Interpretative Phenomenological Analysis was employed in an in-depth study of a small sample of tattooed counsellors. Three master themes emerged, detailed by eight interlinking super-ordinate themes. Master themes were Self, Tattoo Narratives and Meaning Making of the Tattoo Narrative.
    • Tears, blushes and beating hearts: Masculinity, emotions and feelings in Elizabeth Gaskell's North and South, Thomas Hardy's Far from the Madding Crowd and Sara Jeannette Duncan's The Imperialist.

      Abletshauser, Alexandra C. (University of Chester, 2017-11)
      This dissertation explores the relationship between masculinity, emotions and feelings in Elizabeth Gaskell’s North and South (1855), Thomas Hardy’s Far from the Madding Crowd (1874) and Sara Jeannette Duncan’s The Imperialist (1904). The Introduction gives an overview of gender theory and the ideology of masculinity in general, explains the terms ‘emotion’ and ‘feeling’ and discusses the relationship between the ideology of masculinity, emotions and feelings in the nineteenth century. Chapter One examines the relationship between masculinity, emotions and feelings in the industrial setting of North and South and studies the tension or discrepancy between them. In addition, it demonstrates the different functions of the display of emotions and feelings. Furthermore, it challenges the assumption that the expression of male emotions and feelings automatically emasculates a man. Chapter Two looks at the depiction of masculinity and emotions in relation to nature descriptions, such as landscape, weather and animals, in the rural setting of Far from the Madding Crowd. It further shows how the display of emotions changes in the second half of the nineteenth century to an indirect expression through nature descriptions. At the same time, this chapter indicates that emotions and feelings are natural for men and that their suppression can have destructive consequences. The final chapter investigates masculine identities in the imperial setting of The Imperialist. It shows how at the-turn-of-the 20th century the expression of male emotions and feelings is replaced by an increasing self-control. The Conclusion indicates the realignment of gender identities that are defined through the inclusion of feminine and masculine characteristics and demonstrate their application in further nineteenth-century texts.
    • Technology used as a tool to manage people

      Webb, Paul; Barros, Gisele A. C. do R. (University of Chester, 2011)
      This dissertation shows that nowadays it is impossible to manage people without manging use of technologies, therefore the title "technology used a tool to manage people", is perfectly suited to what will be presented in this project, which is a connection between what is already known about contemporary theories of human resource management (HRM) and what is being developed in terms of the e-HR platform to manage people. In addition, a new theory of HRM is outlined which is based on the E-HR technology and suggests the alignment between the human resource sector and the business strategy of the organisation. Firstly, the research statrts with the presentation of the evolution of HR, which was initially called 'industrial welfare', and then follows on with main activities and goals of HR today. Secondly, the disseration gives a different perspective of HR and its future challenges in regards to the relationship between technology and traditional HR, resulting in an e-HRM platform. It gives a new approach for the alignment of human resources with technology to show that HR is now part of the business and organisational strategy. HR cannot be restricted to administrative tasks any longer. Finally, it will apply management theories to the real world or, in other words, it will show that it is unavoidable to manage people and HR without making use of IT.
    • Telomere length analysis: A new tool for molecular photofitting

      McDowall, Ian; Commane, Daniel; Cargill, Stephen R. (University of Chester, 2011-01)
      This thesis describes a new assay and analytical protocol to determine the telomere length of an individual, and its potential application in criminal investigations. The most commonly used existing assay is based on real-time qPCR. The Telomeric Multiplication Factor (TMF) assay described here instead uses end-point PCR and densitometry. Because most existing forensic DNA techniques already use end-point PCR, the TMF assay can be more easily integrated into the suite of tests available. Along with the TMF assay, a new procedure to use telomere length to determine age is presented. Previous attempts to do this rely on the calculation of a linear regression, and the interpolation of an age based on telomere length, which is not accurate enough for use in criminal investigations (with a covariance between known and predicted age of 0.2848, P=0.010564). Telomere Length Analysis (TLA) uses a database of known individuals. An unknown individual’s telomere length is compared to all telomere lengths on the database, and used to calculate the unknown individual’s age as a multiple of each age on the database. This increases exponentially the number of comparisons that can be made, and improves the accuracy of age predictions (with a covariance between known and predicted age of 0.4561, P=0.000021). The accuracy increases as the size of the database increases. TLA was developed using buccal epithelial cell samples. However, this thesis demonstrates that TLA also works on hair and blood samples, although to a lesser degree of accuracy. This makes TLA applicable in more forensic scenarios. TLA is intended to operate alongside the recent developments in molecular photofitting, to provide phenotypic and biographical information about an unknown offender to hasten his arrest and conviction, in the event that no matching DNA profile is recorded on investigating authorities’ databases. The new TMF assay and TLA analytical profile are more accurate and more applicable to a forensic scenario than other, previous, attempts to use telomere length to determine age.
    • Tensor decomposition and its applications

      Roberts, Jason A; Tock, Daniel (University of Chester, 2010-09)
      This dissertation reviews classical vector - tensor analysis, building up to the necessary techniques required to decompose a tensor into a tensor train and to reconstruct it back into the original tensor with minimal error. The tensor train decomposition decomposes a tensor of dimensionality d into a train of d third order tensors, whose sizes are dependent upon the rank and chosen error bound. I will be reviewing the required operations of matricization, tensor - matrix, vector and tensor multiplication to be able to compute this decomposition. I then move onto analysing the tensor train decomposition by ap-plying it to different types of tensor, of differing dimensionality with a variety of accuracy bounds to investigate their influence on the time taken to complete the decomposition and the final absolute error. Finally I explore a method to compute a d-dimensional integration from the tensor train, which will allow larger tensors to be integrated with the memory required dramatically reduced after the tensor is decomposed. I will be applying this technique to two tensors with different ranks and compare the efficiency and accuracy of integrating directly from the tensor to that of the tensor train decomposition.
    • A text message based weight management intervention

      Fallows, Stephen; Donaldson, Eleanor L. (University of ChesterLeicestershire Nutrition & Dietetic Service, 2010-10-21)
      Purpose: This study aimed to determine whether a text message based intervention helped participants maintain or lose weight following completion of a weight loss programme. Low fat diet, regular exercise, breakfast consumption, goal setting and self monitoring are behaviours of weight losers and maintainers (Wing & Hill, 2001). Weight management interventions can be enhanced using mobile telephone technology to deliver support in real time, real world settings (Heron & Smyth, 2010) Methods: In this controlled study, overweight adults completing a weight management programme participated in an additional 12-week text message based intervention (‘LEAP Beep’). Participants (n=17, 7 males; 10 females; mean age 58.3 ± 12.1 years) were allocated daily targets for steps, fruit, vegetable and breakfast consumption. Twice weekly, participants ‘texted’ with progress and received practitioner feedback. Pre and post intervention body mass, waist circumference, Body Mass Index (BMI), quality of life (QOL), anxiety and depression measurements were collected and compared retrospectively to a control group (n=17; 4 males, 13 females; mean age 59.1 ± 9.5 years) receiving optional weight checks only (standard care). Paired t tests and Wilcoxon signed ranks tests evaluated differences between pre and post intervention variables. Results: Compared to the control, intervention group body mass, waist circumference and BMI reduced significantly (p=0.006; p=0.0005; p=0.03). QOL and depression scores improved, but not significantly (p=0.134; p=0.228). No difference was found between group anxiety scores (table 1.) Satisfaction surveys showed 100% (n=14) of participants strongly agreed they were satisfied with the overall programme. Conclusions: ‘LEAP Beep’ resulted in weight and waist circumference losses, improved quality of life parameters and was highly acceptable to participants. Text messaging is a cheap, portable, convenient and innovative contact medium that promotes goal setting, self monitoring and facilitates information exchange with patients. Text messaging inclusive of practitioner feedback opens up increasing possibilities for practitioner to patient support and helps maintain a positive weight outcome following initial weight loss. Further improvements to automation whilst maintaining individual support are necessary to ease practitioner burden.
    • ‘There is a great deal to the build and wearing of hats, a great deal more than at first meets the eye’: The significance of headwear in the novels of Charlotte Brontë and Elizabeth Gaskell

      Lyon, Olivia (University of Chester, 2013)
      The aim of this dissertation is to investigate the significance of headwear to Victorian culture and society, primarily through an analysis of the ways in which headwear is presented in selected works by Charlotte Brontë and Elizabeth Gaskell. The dissertation will also examine articles, illustrations and periodicals from the time in order to gain an insight into the way headwear was viewed in the nineteenth century, in conjunction with information gathered from Brontë and Gaskell’s works. Further research into the subject area has suggested that this is an area of research which has been unusually overlooked, as there are many works which discuss the importance of nineteenth century clothing, but very few with any in-depth analysis of the importance of headwear. The investigation is split into two chapters. The first chapter analyses headwear and its significance to the representation of the individual, as well as the way in which the adornments and trimmings associated with headwear can reveal aspects of a character’s personality. There is also an analysis of the significance of headwear and its relation to the representation of masculinity and femininity, with reference to cross-dressing and Judith Butler’s ideas of gender construction. The second chapter examines headwear as a class signifier, primarily focusing on the headwear of the middle and working classes, including maids and servants. The socially ambiguous nature of the governess’s position is investigated, as well as highlighting the usage of headwear as a means of advancing one’s social class.
    • To determine what are the critical success factors in Liverpool City Council ensuring the placement stability of its Looked After Children

      Cureton, Peter J.; Jones, Peter (University of Chester, 2009-06)
      Liverpool City Council (LCC) is the corporate parent for 853 (as at January 2009) Looked After Children (LAC). It is the council’s responsibility therefore to ensure that these children have the same opportunities and quality of life that all other children enjoy. One of the crucial factors is that that they should have a stable and happy home life. The stability of placement of LAC is one of the most important performance indicators monitored by central government. The stability of placement is judged by how many placements a LAC child has in a given year. If the number of placements, in the given year, is above three then this is considered poor performance. The best performing local authorities are achieving a percentage of below 10% of LAC with three or more placements. Liverpool’s published figure for this performance indicator in 2007/08 was 13.3%. It is important therefore that this performance is improved. This dissertation examines the positive outcomes of placement stability and the negative outcomes of placement instability. It investigates how the problem of placement instability can be resolved in both Liverpool and in the other five greater Merseyside local authorities. The final chapter offers recommendations on possible measures to improve placement stability for Liverpool’s LAC.
    • To establish the views of residential care workers and what they perceive to be the key factors that hold back some of the young people in their care in the achievement of their educational goals? A qualitative study

      Harlow, Elizabeth; Burdett, Lyndsey A. (University of Chester, 2012-10-15)
      The aims of this dissertation was to investigate the views and experiences of residential care workers and establish what factors they believe help and hinder educational achievement of young people in their care. National and local policy on children in care is based mainly on children in care quantitative research. It is important that qualitative research is undertaken on the subject and the views of residential care workers are sought so that people who support young people with their education can be educated about what helps and hinders educational achievement of young people in care. The disparity between the achievements of looked after children and their peers remains unacceptably wide. There is evidence in some children’s homes that insufficient priority is given to education, for example some young people are not attending school regularly. (Ofsted 2008-2009) For these reasons and more it is significant that more focus should be on those who provide the day to day care for looked after children, this is why it is vital to gain an insight into the perspectives of residential care workers to establish what factors influence the educational outcomes of children in care. Six residential care workers were interviewed using semi structured interviews. Participants were asked for their views on what hinders and helps educational achievement and what they believe can support children in residential care. These data were transcribed and subjected to thematic analysis. Participants shared their experiences and identified areas where young people struggle the most, also reflecting on the positive aspects in terms of support. There was a mixture of experiences and both positive and negative attitudes. The study demonstrates that some children in residential care do not always achieve their educational goals. This is because of a number of factors that impact on their lives; these include early childhood loss or trauma. However in ascertaining the views of the care workers this has offered an insight into how young people can be supported so they are enabled to reach their full potential. The study also contributes to the knowledge of what works well in helping young people in care to reach their educational goals. It is an ongoing process of engaging the young people with positive activities and to promote educational learning. It appears that the care staff interviewed was able to reflect on their experiences and on this process. Hopefully the findings can contribute to research already undertaken on this subject and help inform other professionals on how they can contribute to supporting young people in care in their educational journey and good practice for this group.
    • To what extent and how did the instability of Henry VI’s kingship, culminating in civil war, affect the Paston and Stonor families between 1422-1483?

      O'Driscoll, Lilly (University of Chester, 2014)
      This dissertation will explore how two gentry families in the fifteenth century were affected by the instability of Henry VI’s kingship, which culminated in war and political turmoil throughout the 1400’s. The Stonor and Paston letter collections will be examined to understand the social impacts war and political instability had on two different gentry families.
    • To what extent can 'the CSR framework' be adapted to meet the needs of BS 8900?: A qualitative study

      Whalley, Kelly (University of Chester, 2009-06)
      The growing global interest in corporate responsibility (CR) and the pressure felt by organisations in all sectors to demonstrate commitment and progress in CR has led to demands for guidelines and standards that can help companies shape their response to CR in a measurable and consistent way. In recent years a number of models and guidance documents have been produced; however companies are still struggling to understand how to approach CR and what mechanisms to use to integrate it into their organisation’s systems. The link between Quality Management Systems and CR has been noted by many authors and a respected model was developed by Castka et al (2004) which combined the systems used in the ISO 9001 accreditation with the requirements of a CR process. Their CSR Framework however does not link to any accredited standards and lacks practical steps for organisations to follow. This study takes the underlying basis of The CSR Framework and combines it with the guidance and structure found in the British Standard for Sustainability, the BS 8900, to create a model for CR integration. Through qualitative case study research of four organisations, the benefits and development areas of this model are discussed in relation to the CR needs of the organisations concerned and the practicalities of using a model to shape the integration of CR.
    • To what extent has the adoption of flexible mobile working transformed staff operations within Cheshire East Council ICT strategy?

      Evans, Sarah-Jayne (University of Chester, 2010-06)
      For many years Central Government has investigated ways in which to streamline Local Government Authorities (LGA), in order to provide better value services to its citizens. Following a Local Government Review (LGR) of two-tier councils, six district councils and one County Council were merged to form two unitary councils; namely Cheshire West and Chester Council and Cheshire East Council. This study investigates the extent of staff operation transformation following the adoption of flexible mobile working initiatives within the Cheshire East Council ICT Strategy. The adoption of such initiatives allows the organisation to tackle issues of accommodation, staff well-being and service delivery. To do this, the researcher uses a mixture of inductive and deductive approaches (supported by a contemporary literature review and a conceptual model), in order to investigate the research aim. Following a phenomenological philosophy, the researcher “seeks an understanding of human behaviour” (Hagyard & Keenan, 2006; Saunders et al, 2009, p. 116) to support the investigation into the extent of staff operation transformation. The data collection for this study is achieved through a research strategy of a survey approach, in which the researcher employs the use of two questionnaires distributed to two groups of respondents. Employing the methodological considerations from Chapter 3 leads the researcher to believe that the extent of staff operation transformation at this stage (year 1) is substantial. The researcher deduces this as the majority of employees adapt their work practices to suit working in a flexible, mobile manner. Staff efficiency is increased, their work-life balance is improved, and, they now have a choice of where they work from. In addition, the organisation benefits from tangible changes, such as reduced sickness absence, reduced overall travel costs, and improved use of existing office space. However, at the end of this report, in order to improve the benefits realised thus far, the researcher presents seven recommendations, to further promote the adoption of flexible mobile working within the organisation.
    • To what extent is marketing essential to the sustainability of maternity services within East Cheshire

      Lucas, Amanda (University of Chester, 2013-06)
      The aim(s) of the research are: • To understand contemporary literature on marketing within the National Health Service (NHS) • To critically analyse the concept of marketing maternity services • To investigate a strategic marketing pathway in relation to the sustainability of maternity services within East Cheshire • To draw conclusions and make recommendations for future marketing strategies to ensure the sustainability of maternity services within East Cheshire Marketing within the NHS and specifically maternity services is not common place in a traditional sense although perhaps the concepts and strategies outlined by academics such as Porter, Kottler and Ansoff can be transferred to this area with a beneficial effect. This piece of work is guided by the research aims and looks to seek out relevant information regarding the selling of products in the market place and attempts to analyse its effectiveness within the NHS and maternity. By the author’s involvement in the real time implementation of a private midwifery service within an existing maternity service, a combination of deductive and inductive techniques are used demonstrating a phenomenological approach to the research. Through personal interviews and completion of a questionnaire, the author gained insight into the current practice within the organisation’s geographical area, essential in the decision making process of where to begin the implementation of the new service. Following implementation of the private midwifery service, the author evaluates the process utilised during the change management, discussing lessons learned and providing recommendations transferrable for future projects. Key findings in the provision of care, however, provide minimal data after one month as the private midwifery service is yet to 4 become fully functional due to delays in its implementation. Uptake, however, is good and two women are enrolled in the service due to success in marketing the new service.
    • To what extent is social network ‘Facebook’ used as a communications tool to develop brands in Chester’s nightlife scene

      Paul, Stuart; Cawley, Ryan (University of Chester, 2009-09)
      The purpose of this dissertation is to investigate the extent social networking has on branding within Chester’s night life clubs. The concept of using social network ‘Facebook’ to develop a brand is relatively modern; therefore there is little previously bounded literature within this area. Therefore the approach taken during this process will aim to build a theory that answers such questions. The literature that will be analyzed will be centered on generalized marketing terms around the areas of building a brand image, creating word of mouth and developing a brand community. Under the bracket of such headings, many differing academic theories and models can be considered. The research will evaluate and consider existing research concerning many differing aspects of branding. Such as creating brand awareness, re-forcing the brands image, creating brand associations, building brand perception, developing a corporate image, communication messages. The base knowledge gathered from such data will give the project a good base from which to move from. The information hear will then be used to develop relevant questions ready for the qualitative data to be gathered in the form of the interviews and the student-led focus group. This approach will although for the results to be compared and contrasted against and viable conclusions to be drawn.
    • Trace element status in critical illness polyneuropathy

      O'Reilly, James; Strang, Rachael (University of Chester, 2009-10)
      Critical illness polyneuropathy (CIP) is a term for neuromuscular weakness acquired by patients treated in a hospital intensive care unit (ICU). It is thought to affect almost half of all patients admitted and causes delayed weaning from mechanical ventilation, increased requirement for renal replacement therapy and increased length of stay in ICU. Although evidence is inconsistent, increased mortality has been shown in patients who experience CIP. The pathophysiology of CIP remains largely unexplained but it is known to be associated with sepsis and systemic inflammatory response syndrome (SIRS), which can lead to multi-organ failure. Recently the potential of antioxidants and minerals to modulate the immunological processes contributing to SIRS has been an area of increasing interest. Large scale trials are currently underway to establish if intravenous supplementation of selenium is of benefit in the ICU population. In certain clinical conditions it has been shown that enteral feeds enriched with specific trace elements, vitamins and lipids can improve outcomes for ICU patients. However, very little work has been done to specifically investigate any potential contribution of nutritional status to the development of CIP. The present study investigated if plasma levels of trace elements are different in CIP patients compared to matched controls. This retrospective case-control study investigated eighteen patients diagnosed with CIP at the Royal Liverpool University Hospital ICU over a thirteen-month period. Information collected included length of stay, mortality data, use of inotropic drugs and steroids, nutritional intake and biochemical markers including plasma levels of zinc, selenium and copper. Mean length of stay in ICU was more than doubled in CIP patients compared to controls (p=0.002). Patients with CIP were also less likely to survive their ICU admission compared with controls (p=0.034). No significant differences were found between any of the plasma trace element levels or biochemical markers apart from alkaline phosphatase levels, a marker of liver function. The retrospective nature of this study caused several limitations with the methodology, which made it difficult to draw firm conclusions from the results. Further research is required to investigate the role of trace elements and antioxidants in the pathophysiology and treatment of CIP.
    • Transforming adult social care: Personalisation and brokerage

      Page, Steve; Lavelle, Lynn (University of Chester, 2009-06)
      Social care in the UK is undergoing a massive transformation. Central government is demanding that care services are tailored to the individual, rather than forcing individuals to take up services which may not be appropriate to their needs. Timescales for this transformation are extremely tight, meaning large scale change in a short period of time. With a rapidly ageing population, the impact of giving citizens more choice and control over their own care will be considerable, meaning individuals will have to undergo substantial change in how their services are assessed, procured and delivered. The effect of these transformation efforts on the social care work force means significant changes to their ways of working and the culture of the organisations they work for. This study will assess the impact of the changes brought about by personalisation of care services, and critique how the changes are managed within a large organisation with strong cultural links and ideas. It will also consider whether introducing an intermediary service to streamline services is beneficial and appropriate. The study is based around Liverpool City Council, and 4 other local authorities across England and Wales.
    • Trends in Saturated Fat, Total Fat and Coronary Heart Disease in the United Kingdom 1950-2010: Does the evidence support current dietary guidelines

      Carlsson, James (University of Chester, 2015-09)
      Background and aims The aim of this study was to evaluate the relationship between saturated fat, total fat and coronary heart disease (CHD) at United Kingdom (UK), national and regional level and to establish if available data supports current dietary guidelines for the reduction of total and saturated fat intake. Methods Data was sought pertaining to historical trends in dietary intake, CHD mortality and associated measures within the UK. Trends were then analysed to establish if a relationship, if any existed between measures. Results Results show that from a peak in 1978 male CHD mortality to 2010 fell by 79% in men and 83% in women. In the same period relative saturated fat intake fell by 4.6% and total fat by 3.4%. Analyses showed at the UK population level there was a consistent significant positive association between saturated fat intake and coronary heart disease mortality in men and women between 1972 to 2010 (P<0.01). The relationship between total fat intake and CHD was less consistent as were associations at national and regional level. There was no association between saturated fat intake, total fat intake and CHD prevalence. 56 Conclusion The results of this study support current population dietary guidelines however the disparity between the percentage change between saturated and total fat intake compared to the decline in CHD mortality over time questions the impact saturated fat has on CHD. It is clear further research is needed.
    • "Trust me… I’m a counsellor…”: A heuristic exploration of the therapist’s ability to trust themselves to work effectively and ethically as a person-centred counsellor, and not to fall in love with clients

      Mintz, Rita; Harrison, Mark T. (University of Chester, 2011-11)
      A person-centred counsellor’s use of self may be seen to include offering a non-possessive, and certainly non-sexual, love. For any practitioner, the question arises as to what underpins conformance to professional codes of ethics, both theoretically and personally. Generally, counselling approaches align with professional prohibitions against sexual activity through some combination of predefined techniques and explicit theoretical exclusion. The person-centred approach avoids the systematic use of techniques and the theory might be considered less explicit, and so maybe demands careful consideration. This research thus considers the underpinning which supports how a therapist can trust themselves not to fall in love with clients, and not to engage in any form of sexual exploitation. The research addresses self-trust through a highly reflexive, heuristic exploration of a therapist’s fundamental beliefs. These are discussed in relation to literature on ethics and to counselling theory. What emerges is a greater separation between falling in love and sexual exploitation, supporting a therapist’s ability not to engage in unethical activity with clients and opening the way to greater discussion of such concerns within the person-centred arena.
    • Two temples, one God: A consideration of Sikh-Christian inter-faith relations in a West Yorkshire urban parish

      Dixon, Stephen W. (University of Liverpool (Chester College of Higher Education), 1999-09)
      The project is based on the multi-cultural parish of St Thomas, Longroyd Bridge, Huddersfield; and specifically the faith communities at St Thomas's Church, and at the Shri Guru Nanak Gurdwara which is situated within the parish boundary. The aims and methodology of the project are: to produce a literature-based review of some current issues in inter-faith relations - from a general perspective, and then from specifically Christian and Sikh perspectives; to survey views on Sikh-Christian inter-faith relations within the two faith communities, based on 'official' views, interviews, and discussion groups; to reflect on the material produced in order to discern ways in which members of different religious traditions can work together in God's service, both in the particular setting of the project, and in the wider community of faith. The findings are that: whilst wishing to maintain their own integrity, both communities seek to view inter-faith relations positively and look for God's purpose therein; purposes which could be explored together, both locally and in a wider context, are the deepening of understanding in one's own faith through contact with another; and a shared social and spiritual mission to the wider society; the experience of working together as two distinct faiths suggests a new model of inter-faith relations - not the 'Copernican' model of Hick, in which each faith is a planet in a single solar system, but a 'Hubblite' model in which each faith is a solar system within a wider galaxy and universe.
    • Understanding attitudes of ethnic minorities towards uptake of cardiac rehabilitation services: A qualitative systematic review

      Kennedy, Lynne; Yung, Jenny (University of Chester, 2014-08)
      The prevalence of cardiovascular disease (CVD) and coronary heart disease (CHD) varies across different ethnicities. Epidemiological studies show that people from a South Asian background, including Indians, Bangladeshis and Pakistanis have a higher risk of CHD. It is important to understand the risk factors that explain this increased prevalence, both conventional and unconventional i.e. applicable to the general population and also specific to a certain ethnic group. Modifying these risk factors is a vital part of secondary prevention measures to reduce the possibility of developing further cardiac disease. Cardiac rehabilitation is the recommended programme for post-MI care and aims to influence positively the underlying causes of cardiovascular disease through exercise and education. It has been shown to improve both cardiac mortality and morbidity. Despite the clear benefits of this intervention, uptake to cardiac rehabilitation is particularly low in ethnic minority populations. If the reasons and influences behind this can be understood, then the way that rehabilitation services are delivered can be altered to provide culturally sensitive care and maximize uptake.