131 Works

The importance of inhaler adherence in severe asthma and its relationship to clinical outcomes

Patients with asthma who remain troubled with symptoms and asthma attacks despite the use of long acting beta-agonist and inhaled corticosteroid therapy are classed as having severe asthma. Some of these patients have “‘difficult to control’” asthma because of poor adherence or inhaler technique, while others have asthma that is ‘refractory’ to treatment. Identifying and addressing poor adherence to ICS/LABA therapy is essential in management of patients with severe asthma. In clinical trials, adherence assessment...

The importance of inhaler adherence in severe asthma and its relationship to clinical outcomes

Patients with asthma who remain troubled with symptoms and asthma attacks despite the use of long acting beta-agonist and inhaled corticosteroid therapy are classed as having severe asthma. Some of these patients have “‘difficult to control’” asthma because of poor adherence or inhaler technique, while others have asthma that is ‘refractory’ to treatment. Identifying and addressing poor adherence to ICS/LABA therapy is essential in management of patients with severe asthma. In clinical trials, adherence assessment...

Exploring New and Emerging Mechanisms to Target Difficult to Treat Cancers

Catherine Richards
Gastro-oesophageal cancers are associated with poor survival in patients, due to their aggressive nature, late-stage diagnosis, and a lack of specific targeted therapies. The development of new therapeutics will prove crucial to improve mortality rates. This thesis discusses two novel potential approaches which merit further investigation towards this goal.
Firstly, natural compounds have previously found several uses as chemotherapeutic agents. We found a diterpenoid compound in the same class as Taxol, Crassin, to have significant...

Recommendation for Future Development of Colorectal Cancer Surgery in Ireland and Guidelines for the Management of Rectal Cancer in Ireland

Deborah McNamara
Recommendation for Future Development of Colorectal Cancer Surgery in Ireland and Guidelines for the Management of Rectal Cancer in Ireland issued by the Irish Association of Coloproctology on 5th September 2010.

Identifying New Drug Targets to Treat Breast Cancer Brain Metastasis

Siobhan Purcell
Breast cancer brain metastasis (BrM) is indicative of poor prognosis, with a short median survival time and limited disease management strategies. Current treatment options are restricted to surgical resection, radiation therapy and limited targeted therapies. Therefore, there is an urgent need to uncover alterations responsible for BrM and to define novel effective therapeutic targets. RNA-sequencing (RNA-Seq) was performed to analyse gene expression differences between patient-matched breast tumours and their associated resected BrM. Importantly, common transcriptional...

The Optimisation and Derivative Design of Lead Compounds to Inhibit Staphylococcus aureus Surface Proteins Using Computational Tools

Atopic dermatitis (AD), also known as eczema, is a genetically transmitted chronic skin disorder that is associated with other conditions such as asthma and allergic rhinitis. It affects people at all stages of life and can seriously impair quality of life due to repeated itching and scratching resulting in crusted lesions and sleep loss. Staphylococcus aureus colonisation on the skin of patients with AD exacerbates the symptoms. Current treatments for S. aureus colonised AD skin...

The Impact of Technology on Medication Safety in Paediatric Critical care

Introduction:Evidence for the benefits of health information technology (HIT) in the paediatricsetting is currently limited. In 2012, electronic-prescribing, standardisedconcentration infusions (SCIs) and smart-pump technology were implemented intothe paediatric critical care unit (PCCU) in Our Lady’s Children’s Hospital, Crumlin.Aim:To assess the impact of this new HIT on PCCU medication errors.Methodology:A Delphi consensus process developed a list of novel or previously unaddressedmedication errors. The results, combined with published medication errorsdefinitions, were applied to three further studies: a...

Sleep Disturbance in Patients with Advanced Chronic Kidney Disease or End-Stage Renal Disease

Claire Kennedy
Patients with advanced chronic kidney disease (CKD) or end-stage renaldisease (ESRD) have a large burden of symptoms, with sleepdisturbance, restless legs syndrome and fatigue among the mostprevalent (1). These sleep-related symptoms are considered an absolutepriority for both treatment and research by patients and their caregivers(2). Despite this, clinicians consistently underestimate and overlook thesesymptoms in clinical encounters (3). The impact of RRT modality choiceon such symptoms is not well defined and is poorly communicated topatients choosing...

An analysis of cellular bioenergetics in K-ras and p53 mutant colon cancer cells using single cell imaging

James Kealey
A reprogrammed energy metabolism is an abundant feature in cancer. Thismechanism provides cells with the ability to evade cell death and increases theability to proliferate even under adverse conditions. K-ras and p53 are two of themost commonly mutated genes in colon cancer and many studies have shownthat mutations in these genes affect several cellular metabolic processes includingglycolysis and mitochondrial respiration.In this project, we employed a single-cell time-lapse imaging approach to analysehow colon cancer cell lines,...

An analysis of cellular bioenergetics in K-ras and p53 mutant colon cancer cells using single cell imaging

James Kealey
A reprogrammed energy metabolism is an abundant feature in cancer. Thismechanism provides cells with the ability to evade cell death and increases theability to proliferate even under adverse conditions. K-ras and p53 are two of themost commonly mutated genes in colon cancer and many studies have shownthat mutations in these genes affect several cellular metabolic processes includingglycolysis and mitochondrial respiration.In this project, we employed a single-cell time-lapse imaging approach to analysehow colon cancer cell lines,...

Investigating the Patient Admission Pathway to Improve Theatre Start Time for a General Surgery Service

Aishling Brett
The operating theatre accounts for a large percentage of a hospital’s total expenses. Optimum efficiency and utilisation of theatre time are paramount. There are a number of contributing factors when discussing theatre time utilisation including starting theatre on time, reducing turnover time and minimising theatre overruns, all of which require the cooperation of surgical, anaesthetic and allied health professionals. Day of Surgery Admissions (DOSA) is a service that allows for the planned admission of patients...

Investigating the Patient Admission Pathway to Improve Theatre Start Time for a General Surgery Service

Aishling Brett
The operating theatre accounts for a large percentage of a hospital’s total expenses. Optimum efficiency and utilisation of theatre time are paramount. There are a number of contributing factors when discussing theatre time utilisation including starting theatre on time, reducing turnover time and minimising theatre overruns, all of which require the cooperation of surgical, anaesthetic and allied health professionals. Day of Surgery Admissions (DOSA) is a service that allows for the planned admission of patients...

Reducing variation in the Latent TB service by improving adherence with the national TB guideline

Joy Oguntuase
Latent TB screening and management in accordance with the Heath surveillance protection centre (HSPC) guidelines is imperative for patient safety and public health. A clinical audit was performed in the TB services of a large teaching hospital in Dublin. The audit measured wait times from referral to diagnosis and compliance with the components of the HSPC guidelines; The results revealed variance incompliance with the HSPC guideline for the screening process and the management process of...

Reducing variation in the Latent TB service by improving adherence with the national TB guideline

Joy Oguntuase
Latent TB screening and management in accordance with the Heath surveillance protection centre (HSPC) guidelines is imperative for patient safety and public health. A clinical audit was performed in the TB services of a large teaching hospital in Dublin. The audit measured wait times from referral to diagnosis and compliance with the components of the HSPC guidelines; The results revealed variance incompliance with the HSPC guideline for the screening process and the management process of...

Tailoring Activators for the Selective Reactions of Ethyl 2-(Trimethylsilyl)acetate Under Batch and Continuous Flow Conditions

Ian Fox
The use of silicon-based reagents in organic synthesis has received significant attention and has been an ever-growing area of focus in recent years. Since Hosami and Sakurai first described the fluoride-initiated reaction of allytrimethylsilane to aldehydes, there have been several advancements in the field. Alternative sources of silicon activation have been developed such as tBu-P4 and proazaphosphotrane bases as well as work completed by my research group into the tetrabutylammonium controlled addition to aldehydes under...

An Exploration of Carers of Stroke-Survivors in Ireland Experiences of the Discharge Planning Process and Transition of Care to the Home Setting

Shelagh O'Connor
IntroductionIn Ireland, it is estimated that 10,000 people have a stroke annually. A high numberof stroke-survivors with residual deficits requiring care are discharged to their own.Informal carers are often central in homecare provision. The discharge planningprocess (DPP) is the process used to establish the requirements necessary for apatient to transition from one level of care to another, and may involve carers.
Aims and ObjectivesThe aim of this study was to explore the experiences of carers of...

Novel Antibiotic-Free Scaffold for the Treatment of Infection and Regeneration of Bone

Emily J. Ryan
The bone infection osteomyelitis (typically caused by Staphylococcus aureus) usually requires a multistep procedure – long term administration of high-dose systemic antibiotics combined with surgical debridement and bone grafting. However, the disease remains notoriously difficult-to-treat due to the poor penetration of systemic antibiotics into the necrotic bone, antibiotic resistance, and the steep decline in antibiotic discovery. Therefore, osteomyelitis treatment has a dual challenge: ensuring an effective and non-toxic dose of antimicrobial, while ensuring bone regeneration...

The role of sub-epidermal moisture measurement versus traditional risk assessment and visual skin assessment in the prediction of pressure ulcer risk among adults undergoing surgery.

Ana Lucia M. De Oliveira
Aim: To compare the predictive ability of sub-epidermal moisture measurement versus traditional risk assessment and visual skin assessment as a means of detecting early pressure ulcer damage development among adults undergoing surgery. Method: A non-experimental, comparative, prospective, descriptive design was used. Participants who gave their informed consent had their skin assessed over the areas that were weight bearing during surgery, using visual skin assessment and the sub-epidermal moisture measurement. Visual pressure ulcers were graded according...

Bone Health in Psychotic Disorders, and Risk Factors for Decreased Bone Health in Established and Early Psychosis

John Lally
Both schizophrenia and osteoporosis are prevalent and disabling disorders. Risk factors for osteoporosis are highly prevalent in people with psychotic disorders. It remains unclear to date as to what are the main drivers of reduced bone mineral density (BMD) in schizophrenia. In this PhD I reviewed risk factors associated with reduced bone mineral density and osteoporosis in schizophrenia. In cross sectional and longitudinal studies in first episode psychosis (FEP) and established psychosis cohorts, I investigated...

Material development and characterisation of a functionalised biomaterial to support pancreatic islet viability.

Liam McDonough
Diabetes mellitus is a chronic disease which affects over 425 million people worldwide (2017), a number which is expected to rise to 629 million people by 2045. Diabetes mellitus occurs when the pancreas does not produce enough insulin to meet the demands of the body, due to the malfunction or immune-mediated destruction of the insulin producing β-cells. The bio-artificial pancreas approach aims to return endogenous insulin production to the patient, by delivering donor pancreatic islets...

Identification of driver mutations and tumour evolution in HER2 positive breast cancer

Peter O'Donovan
This thesis describes the results of a variant calling project using data from the TCHL (Trastuzumab, Carboplatin, and Docetaxel, with Lapatinib) breast cancer whole exome sequencing project. Using a data processing pipeline based on the GATK (Genome Analysis Tool Kit) Best Practices Pipeline, variants were called on a total of 34 tumour samples from 25 patients. This included 20 patients where only a pre-treatment sample was taken from that patient, and 5 patients where samples...

Development of an ultrasound triggered, thermally responsive hydrogel as an on-demand delivery system for bone repair

Bones can physiologically regenerate themselves. In the case of non-unionfractures and certain pathological conditions, however, regeneration issuboptimal, too slow, or does not occur. The clinical ‘gold standard’,autografting, can result in numerous complications including infection, chronicpain and donor site morbidity. Current commercial bone graft substitutes haveshown limited success and an effective ‘off-the-shelf’ solution is required. Theobjective of this study was to develop an ultrasonic-thermally responsivehydrogel for bone regeneration and to investigate its potential for on-demanddelivery of...

Molecular mechanisms of biofluid microRNA transfer in human and experimental epilepsy

Elizabeth Brindley
Epilepsy is a common neurological disease characterised by recurring seizures. Diagnosing epilepsy is both difficult and expensive. A molecular biomarker to aid with diagnosis would be a major advance in the field. Plasma microRNAs (miRNAs) could provide a potential solution as a molecular biomarker. MiRNAs are small non-coding RNAs that regulate protein expression. MiRNAs are enriched in the brain and are also found in biofluids; typically bound to the Ago2 protein and encapsulated in exosomes....

Elucidating the Role of Complement Activation in the Pathogenesis of Alpha-1 Antitrypsin Deficiency

Laura Fee
Alpha-1 antitrypsin deficiency (AATD) is characterised by low circulating levels of alpha-1 antitrypsin (AAT) and is associated with neutrophil-driven chronic obstructive pulmonary disease (COPD), liver disease and other autoimmune comorbidities including vasculitis and panniculitis. Complement C3 has recently been identified as a binding partner of AAT. The aim of this study was to evaluate the significance of the lack of this binding event in AATD. A significant link between AATD manifestations and those which are...

Investigating the correlation between job satisfaction, autonomy, and self-efficiency among school nurses in Bahrain- a mixed methods study

Faten Hasani
To understand the relationship between job satisfaction, autonomy, and self-efficacy amongst school nurses in Bahrain a total of 142 school nurses in Bahrain were surveyed. Twenty-seven school nurses were also interviewed. Data were collected using structured psychometric tools and analyzed using Burnard’s (1991) framework. Conclusion drawn remarkably shows high level of job satisfaction among school nurses in Bahrain. Herzberg’s two-factor theory was used to determine the hygiene and motivation factors. The relationship between self-efficacy correlates...

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