http://bura.brunel.ac.uk/handle/2438/3672 2026-04-17T09:18:19Z http://bura.brunel.ac.uk/handle/2438/23505 Title: Understanding patient engagement: exploring factors around utilisation of screening and surveillance services in individuals with or at risk of rare endocrine syndromes Authors: Elyoussfi, Samia Abstract: Individuals with rare genetic endocrine syndromes, such as von-Hippel Lindau, Multiple Endocrine Neoplasia and mutations in the succinate dehydrogenase complex genes can develop diverse and unpredictable new tumour formations. Regular screening is recommended as best practice for early detection and management of tumours in those deemed at risk. However, little is known about screening attendance in gene carriers and the experiences of screening which may influence attendance. The aim of this thesis was to address this gap by gaining a deeper understanding of how individuals carrying genes for rare endocrine tumour syndromes comprehend and use health services generally and, in particular, the service provided by the Barts endocrine screening clinics. This was a multimethod three staged study in the context of a national specialist clinic. Study 1 was a retrospective cohort study to determine screening attendance rates over a three-year period and examine the relationship between patient demographic characteristics and attendance. Study 2 examined the experience of attending appointments through in-depth interviews with 12 participants. Study 3 was designed to enhance engagement with initial screening through the co-production of an information resource using focus groups. Integration of qualitative findings explored the relationship between the themes. Study 1 identified an 83.27% attendance rate. Attendance showed no significant association with patient demographic characteristics. Study 2 interviews illuminated how the complexities of living with an incurable diagnosis interacted with the anticipation and attendance at screening. Study 3 resulted in a simple leaflet with signposting, noting the importance of reassurance and availability of family clinics. Issues regarding data quality and recruitment were encountered. These studies contribute to understanding of and engagement with patients with rare syndromes and screening. Considerations of data collection, life-course, diagnosis familiarity, family dynamics, practical accessibility and navigating the system are specific and novel insights that should inform future service delivery. Description: This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University 2021-01-01T00:00:00Z http://bura.brunel.ac.uk/handle/2438/22716 Title: Organizational excellence based approach to manage the interactions between religion and organizations Authors: Alhabeeb, Abdussalam Abdullah Abstract: The increasing interest in the relationship between religion and organizations is attributed to the significance of religion to human life and to the vital role of organizations in modern societies as a structural social relationship of social actors. The influence of religion on organizations and management, with some exceptions, is insufficiently discussed by the researchers of organization and management theory (OMT). Scarce of studying the religion as a powerful contextual factor that influences organizations will be at organizations’ expense. The aim of this research is to fill the knowledge gap of holistic recognition and understanding of religion-organizations relationship aspects and how to effectively manage these aspects. This research proposes the organizational excellence model of the European Foundation for Quality Management (EFQM) as a means to conceptualize this phenomenon and help organizations in managing the religious interactions effectively. This research focuses on the context of Islam and large Saudi private organizations where the phenomenon of religious interactions with organizations is profound. This research takes pragmatism stance as a research paradigm to investigate the research problem. And employed a qualitative method to obtain an in-depth understanding of the phenomenon of religion-organizations relationship and to develop the religion interactions management framework. The empirical data was collected from 42 interviews, 29 documents analysis, and three Delphi rounds with a panel of 23 experts. As a pragmatist, the researcher assumes three epistemological roles during this research: firstly, act as developer of the research conceptual framework based on the identification of existing theoretical aspects of the religion-organizations relationship and the theoretical proposal of EFQM capability to facilitate the management of this relation. Secondly, the researcher acts as an explorer for the empirically emergent aspects of religion-organizations relationship within the research setting, and as an explorer for a systematic approach to managing this relationship. Thirdly, the researcher acts as a contributor to theory and practice through the expansion of existing theoretical work on religion-organizations relationship studies and the proposal of religion interactions’ management (RIM) model and assessment tool. The main findings of this research are that: first, the theoretically identified aspects of the religion-organizations relationship are empirically supported and expanded. Second, identification of 23 emergent aspects and propositions for the religion-organizations relationship that did not get enough attention in literature or not reported to date. Third, confirmation of the significance of recognizing, understanding, and addressing religion as one of the critical contextual factors for any organization particularly in societies with Intense religiosity such as Saudi Arabia. Fourth, confirmation of the assumption of capability and appropriateness of EFQM as a basis to conceptualize the management of religious interactions. The main contribution of this research is the identification of an overarching scheme of the phenomenon of the relationship between religion and organizations and the proposal of a comprehensive conceptualization on how to manage this relationship as well as pave the path for further theoretical and empirical researches on the identified relationship’s aspects and the proposed management model. Description: This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London 2021-01-01T00:00:00Z http://bura.brunel.ac.uk/handle/2438/10544 Title: Integrated strategies for investigating endocrine mechanisms in Biomphalaria Glabrata as a test organism for androgenic chemical testing Authors: Kaur, Satwant Abstract: Endocrine and metabolic disease or dysfunctions are of growing concern in modern societies across the globe, underlining the need for continued focus on the development of pharmaceuticals. Subsequent scientific research has revealed a trend in the increase of such abnormalities and expansion of chemical industries, highlighting concerns that these disorders may, in part, be caused by exposure to environmental pollutants. This has led to changes in legislation concerning chemicals safety testing involving an increasing number of vertebrate animal tests as a part of environmental risk assessment process, at significant financial and ethical costs. A solution that is appropriate and aligned with the three R’s (reduction, refinement and replacement) in relation to animal research is to exploit the use of small invertebrate organisms as possible replacements for mammals. In line with the above approach/solution, this thesis is based on the null hypothesis that common genes, proteins and processes in gastropod molluscs and humans underlie the response of male reproductive organs to androgenic chemicals. Using a freshwater pulmonate snail, Biomphalaria glabrata, physiological effects of two steroid androgens on the development of mollusc secondary sexual organs were studied. Furthermore, an exhaustive investigation on the mollusc nuclear receptor repertoire and reproductive type neuropeptides was conducted. This also included the study of the evolutionary degree of conservation of these genes in non-model molluscs. The results obtained suggest that the snails did not respond to, and were not affected by exposure to the androgens. These results were supported by the absence of the members of subfamily 3C of nuclear receptors, which includes some of the “vertebrate” steroid hormone targets, suggesting that this mollusc may be an inappropriate model for steroid hormone mediated mammalian endocrine function. The nuclear receptor (NR) repertoire of B. glabrata comprised of 39 nuclear receptors representing all the known subfamilies of the NR superfamily. 21 reproductive type neuropeptide genes were identified encoding precursors that are predicted to release over 124 bioactive cleavage products. The consequence of these findings is significant in the context of the development of alternative model organisms for chemical testing as well as elucidating the taxonomic scope of nuclear receptor mediated endocrine disruption. Description: This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London. 2015-01-01T00:00:00Z http://bura.brunel.ac.uk/handle/2438/10450 Title: Long and short term effects of X-rays on charge coupled devices Authors: Tudge, Mark Vernon Abstract: EEV buried channel charge coupled devices (BC CDs) with technological variations have been studied with respect to their response to 70kVp X-rays. Process variations considered are the conventional BCCD, scintillator coated BCCDs ( (Gadox(Eu) and Csl(Tl)) and the inversion mode device. The work was made necessary by the use of these CCDs for dental X-ray imaging. Effects investigated include changes in device operating voltages and dark current. The dark current buildup has been characterised in terms of a prompt component seen immediately following irradiation, and a time dependent component which occurs gradually. A major part of this work was the determination of the location and concentration of the energy states responsible for this dark current buildup. Also a novel aspect of the work was the derivation of an expression describing the time dependent component as a function of time and temperature. Effects associated with the bias dependence of the BCCD have also been considered, with particular regard to the effect of a negative substrate bias, and the theoretical explanation has been developed. The findings of this work have demonstrated the suitability of these devices for the commercial application of imaging x-rays for dentistry. Description: This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London 1996-01-01T00:00:00Z