The observations that form the basis of this thesis were made mainly between 1969 and 1971, following a study of urine acidifying mechanisms in a group of patients, most of whom had renal stones. The patients generally had a substantial reduction in glomerular filtration rate, a…
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FRIENDS For Life' (Barrett, 2004) is a ten-week programme for children aged 7 - 11 years, based on cognitive behavioural principles, designed to teach coping skills and techniques to manage anxiety and depression. This study describes an evaluation of a universal programme, deli…
Introduction and Aims: The progressive nature of heart failure (HF) is reflected by its complex pathophysiology, featured by imbalance of damaging and reparative factors. The overall aim was to assess the implication of endothelial (dys)function, monocyte subsets, different type…
IL-21 is crucial for anti-viral defense, the germinal center reaction and anti-tumour immunity. Conversely, it has been implicated in various autoimmune conditions, including type-1 diabetes. This study set out to explore how IL-21 influences CD4 T cell immune responses, with pa…
In rheumatoid arthritis (RA), chronic inflammation and destruction of the joint is driven by local production of cytokines. My aims were to characterise cytokine mRNA expression in multiple synovial fluid cell populations in early and established RA and to study these, in additi…
The discourses of medicinal cannabis users are the topic of this thesis, examined by way of qualitative in-depth interviews with thirty-two medicinal cannabis users. The thesis focuses on four main aims: how medicinal users talk about their use of cannabis (including looking at …
The process through which new blood vessels are formed within the body is known as angiogenesis. An essential part of our survival, it has also been implicated more recently in many diseases both in terms of induced growth, and abnormal vascular structure. Angiogenesis is charac…
This thesis examines the use and implications of using coercive measures within a high security hospital. High security hospitals are unique environments where challenges are often faced in balancing care with safety and security. The use of coercive measures, namely, restraint,…
Multiple sclerosis (MS) is a chronic inflammatory and degenerative condition of the Central Nervous System. Focal demyelinating lesions are its neuropathological hallmark, but widespread abnormalities found in otherwise “normal-appearing” tissue are better associated with disabi…
Optical tomography is considered to be a non-invasive and non-ionising technique that can create a digital volumetric model of an object by reconstructing 3D images made from light transmitted and scattered through the object. It is becoming of increasing importance in the area …
Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disease involving both innate and adaptive immune responses. Abnormal numbers of inflammatory cells have been examined in COPD subjects, as well as the effects of cigarette smoking on immune cells and molecul…
Chronic kidney disease (CKD) is highly prevalent and recognised as a global public health problem. It has been consistently associated with hypertension and cardiovascular disease; many more patients with a glomerular filtration rate (GFR) below 60 ml/min/1.73m2 die from cardiov…
Feedback node genes (FNGs) are essential for negative feedback control of inflammatory responses. By definition, their expression is controlled by both pro- and anti-inflammatory stimuli, often in a cooperative manner. This thesis investigates three FNGs, namely Dual specificity…
Magnetic Resonance Spectroscopic Imaging (MRSI) is a functional MRI technique allowing non-invasive biochemical mapping of the brain. MRSI is advantageous for characterising many neurological conditions; however, its clinical application is limited by lengthy scan time and low s…
Background: Osteoarthritis (OA) is a highly prevalent joint degenerative disorder among the older population. The main symptoms of OA are chronic pain, swelling and stiffness of joint. OA histopathology is characterized by cartilage damage, synovial inflammation and remodelling …
Drug-induced liver injury (DILI) remains a prominent cause of patient morbidity and mortality, partly due to the lack of relevant in vitro hepatic models for accurate screening for drug-induced hepatotoxicity at the early stages of drug development, and also the lack of sophisti…
Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality but widely underdiagnosed. This thesis explores methods to improve case finding for COPD in primary care. It includes two systematic reviews - the first evaluated the diagnostic accurac…
Hepatitis C virus (HCV) is a major cause of global morbidity, causing long-term pathologies, including cirrhosis and hepatocellular carcinoma. While hepatocytes are the major site of viral replication, the liver contains multiple non-parenchymal cells that regulate the hepatic m…
This thesis describes the development and evaluation of a self-monitoring and patient-initiated follow-up service for people with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) on methotrexate. Using a mixed methods approach including a randomised controlled trial (RCT) …