Browsing by Author "White, Nicola"
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Item Open Access Development of a quantum dot-encoded microsphere suspension assay for the genotyping of single nucleotide polymorphisms(Cranfield University, 2009-03) Thiollet, Sarah; Morgan, Sarah; White, NicolaThis thesis describes the investigation of quantum dot-doped particle fluorescent technology commercially available for its application to analyte profiling in suspension. The first part of the thesis described the characterisation of the quantum dot-encoded microspheres, QDEMs, developed by Crystalplex (PA, USA). The multiple fluorescence signatures of QDEMs were analysed using microscopy and flow cytometry technology which provided high-content measurements with a single excitation sources and multiple emission wavelength detectors. The sensitivity and stability of the materials was evaluated under typical biomedical conditions encounter in multiple analyte suspension assays. Novel analytical parameters were defined to study QDEM stability and confocal microscopy detection system was used to provide structural and fluorescent imagines of the fluorescent microspheres under various conditions. Composition of the aqueous environment, temperature and physical forces applied to QDEM induced changes in their fluorescent codes and structural properties. Optimal conditions were then defined for the application of the material to biomedical assays. In a second stage, a conjugation method was developed to produce optimised QDEM bioconjugates for the detection of single strand DNA in suspension. The impact of the conjugation buffer, the concentration and the structure of oligonucleotides was evaluated to optimise QDEM bioconjugates. Then, a novel approach was investigated to optimise the hybridisation of ssDNA to QDEM bioconjugates. Experimental design with response surface methodology determined optimum conditions for the hybridisation of oligonucleotides to QDEM surface in suspension array. Finally, the specific hybridisation of ssDNA to QDEM bioconjugates in a small liquid format adapted to single nucleotide polymorphism detection was demonstrated. The work presented here shows the potential of QDEM bioconjugates for suspension array technology and DNA genotyping. Further, this report highlights the challenges that remain for QDEM fluorescent technology to be reliable for biomedical and suspension array applications.Item Open Access Evaluation of a novel approach to measuring well-being in the workplace(Cranfield University, 2010-10) Juniper, Bridget; White, NicolaThe well-being of employees is an important issue. Researchers, policy makers and organisations are directing more resource into this field as the link between the health of people and their performance in the workplace becomes increasingly understood. This research programme examines how employee well-being can be measured. Having the right tools to successfully appraise well-being at the outset is judged to be imperative where any research or organisational programme to bring about change is under consideration. A review of existing methods indicates that the current provision of scales to assess the well-being of workers is limited and the construction techniques used in their development may be improved upon. At the core of this study is the testing of a new measurement framework which seeks to address these deficiencies. This innovative approach is taken from one established practice used to assess the well-being of patients using health related quality of life instruments. Three organisations participated in the study; a call centre operation, a police force and a county-based library service. Using qualitative and quantitative methodologies, three pilot questionnaires were constructed using Impact Analysis; an established procedure deployed in health related quality of life settings. Basic findings from each case study were analysed against conventional construction methods and against existing employee well-being scales. Results were also examined in respect of how they compared with the wider literature on employee well-being. ii The Impact Analysis method was critically appraised. Although weaknesses in respect of some of the qualitative phases of analyes were noted, the overall notion of transferring the practice of Impact Analysis to an occupational setting was assessed as cautiously encouraging. While this scale construction method lacks the statistical elegance of factor analytical methods, provisional indications suggest potential benefits in content validity over extant occupational scales where the assessment of a study population’s own experiences are critical to any well-being evaluation strategy. Based on the findings, a new operational definition for employee well-being is posited. A new, working model is also proposed. This emphasises for the first time, the need for specificity when researchers and organisations are seeking to evaluate a multi-dimensional, subjective construct that is employee well-being. Limitations regarding the study are noted. This means that the findings should be treated as tentative rather than conclusive. Nevertheless, it is hoped that this study will inject new thinking on how employee well-being may be evaluated using an alternative approach. By doing so, it is ventured that research communities and employers alike may take up the methods described in this study to conduct assessment programmes that could benefit not just the study teams or the employers, but importantly, the workers themselves.Item Open Access Improving treatment outcomes through personalised medicine - assessment of disease activity in acromegaly.(2017) Gomez, Roy; White, NicolaPurpose Personalised Medicine (PM), also known as stratified medicine has been known to improve treatment outcomes in a wide variety of disease area settings. Individualising treatment based on patient needs may also offer cost benefits to healthcare spend. Despite availability of multimodal treatment options for acromegaly, achievement of long-term disease control is suboptimal in a significant number of patients. Furthermore, disease control as defined by biochemical normalization may not always show concordance with disease related symptoms or patient’s perceived quality of life. Methods An assessment to gauge the need to have an easy and helpful tool which may support acromegaly management was elucidated through a multinational qualitative survey. Subsequently, a validated a tool was developed to measure disease activity in acromegaly to support decision-making in clinical practice through a 2 step-approach. Firstly, an international expert panel (n = 10) convened to define the most critical indicators of disease activity. Patient scenarios were constructed based on these chosen parameters. Secondly, a panel of 21 renowned endocrinologists at pituitary centres (Europe and Canada) categorized each scenario as stable, mild, or significant disease activity in an online validation study. Results The international qualitative survey revealed that current treatment practice does have shortcomings in fully achieving disease control as well as identifying the need for a helpful solution to guide acromegaly care. As part of elucidating the most important disease activity indicators, from expert opinion, five parameters emerged as the best overall indicators to evaluate disease activity: insulin-like growth factor I (IGF-I) level, tumour status, presence of comorbidities (cardiovascular disease, diabetes, sleep apnea), symptoms, and health-related quality of life. In the validation study, IGF-I and tumour status became the predominant parameters selected for classification of patients with moderate or severe disease activity. If IGF-I level was ≤1.2x upper limit of normal and tumour size not significantly increased, the remaining three parameters contributed to the decision in a compensatory manner. Conclusion The validation study underlined the importance of IGF-I and tumour status for routine clinical decision-making, whereas patient-oriented outcome measures received less medical attention. A disease specific tool named Acromegaly Disease Activity Tool (ACRODAT) is in its final stages of development that will support clinicians in reviewing the disease activity in a holistic manner.Item Open Access Urogenital function in morbidly obese men following bariatric surgery(Cranfield University, 2016-01) Aleid, Maha Mustafa; White, Nicola; Cellek, Selim; Muneer, Asif; Ralph, David; Hashemi, MajidIntroduction: Obesity has been suggested to be one of the risk factors for erectile dysfunction (ED) and lower urinary tract symptoms (LUTS). Bariatric surgery has been used for the treatment of obesity and has been suggested to have a significant impact on obesity-related conditions such as diabetes mellitus, ED and LUTS. Previous studies have investigated the effect of bariatric surgery on erectile and urological function in obese men; however those studies used long-term time points post-operatively (more than 1 month). Since it is now known that bariatric surgery can potentially induce glycaemic improvement within one week independent of weight loss, this study aimed to investigate the short-term effect in order to test the hypothesis as to whether improvement in urogenital function after bariatric surgery is due to weight loss or whether it is due to glycaemic improvement. Aim: To evaluate the baseline characteristics of patients with erectile dysfunction and to determine the early effects of bariatric surgery on erectile and urological function in morbidly obese men ... [cont.].