/library/oar/handle/123456789/49204 Sun, 28 Dec 2025 01:15:15 GMT 2025-12-28T01:15:15Z /library/oar/handle/123456789/122431 Title: The cancer patient’s lived experience of the health system in Malta Abstract: This qualitative study explores the experiences of cancer patients and their support networks during their treatment. Within the context of public health services in Malta, it investigated the research question: How do cancer patients, their families and significant others live their experience as health service users during the illness? The Donabedian approach to service evaluation, encompassing structure, process and outcome, served as a guiding theoretical framework. Six patients and their significant others accepted an invitation by their medical consultant to be interviewed in-depth. Their detailed narratives were analysed using Interpretative Phenomenological Analysis (IPA). Five superordinate themes emerged: positive treatment experience; overcoming identified service limitations; humanity of care; centrality of support, and burden of treatment. IPA’s thorough idiographic approach captured the unique understanding through which each participant interpreted the cancer treatment reality. Participants expressed a generally positive experience of the health services, albeit identifying limitations needing ongoing improvement efforts that respond to their needs. Humane care was deemed indispensable, particularly at communication of diagnosis. Support, both familial and work related, were considered central to the management of their treatment. The burden of treatment experienced accentuates the criticality of cancer treatment structures and processes that respond to each patient’s unique experience to render the burden more manageable. A major weakness elicited from this study is the absence of structures and processes, including palliative care protocols, that respond to the particular needs of these patients upon admission to the acute care hospital. Notwithstanding the limitations around the small size of this study, the IPA design provided a means for integrating user input into health policy and services design and evaluation. It highlighted the importance of recognising the individuality of cancer treatment experiences, and the necessity that such experiences inform treatment policies and protocols to better serve the distinctiveness of each cancer treatment journey. Description: M.SC.HEALTH SERVICES MANGT. Tue, 01 Jan 2019 00:00:00 GMT /library/oar/handle/123456789/122431 2019-01-01T00:00:00Z /library/oar/handle/123456789/121349 Title: Real-time PCR assay for the quantification of RNA transcripts involved in the control of globin gene switching Abstract: In this project, the globin gene switch was studied using an innovative combination of small molecule screening and a transcriptomic approach using real time qPCR. This allowed the exciting possibility of directly correlate and assessing the role of small molecules in HbF induction. An in vitro cell culture model system was developed using K562 cell lines and a real time qPCR method optimized on globin transcripts. Induction of γ-globin reduces symptoms in β-thalassaemia and sickle cell disease patients but there is a clear need for drugs with a better efficacy, tolerability and patient response. At present, treatment involves lifelong monthly blood transfusions and iron chelation therapy, both of which impinge significantly on the quality of life and may lead to death prematurely. To the K562 cell line, three novel compounds provided by the European Molecular Biology Laboratory, Heidelberg were added. The correct cell number and drug concentrations were calculated after conducting cell viability assays, and subsequently ribonucleic acid was extracted from this cell line for quantification by real-time PCR to see whether these drugs have an effect on both proliferating and haemin-induced differentiating K562 cells. It was concluded that the drugs do have an effect on the K562 cells in vitro. This study can be beneficial for the therapeutic targeting in the treatment of haemoglobinopathies. Uncovering the molecular basis of γ-globin gene control might serve as a model for other clinically significant gene switch mechanisms. Description: B.SC.(HONS)APPLIED BIOMED.SCI. Tue, 01 Jan 2019 00:00:00 GMT /library/oar/handle/123456789/121349 2019-01-01T00:00:00Z /library/oar/handle/123456789/121002 Title: Protein based approach to identify key players in the control of globin gene switching Abstract: Elevated foetal haemoglobin (HbF) levels are known to lessen the severity of symptoms associated with disorders of β-globin which consequently improves the quality of life of patients affected with such disorders. To date the only treatment for β-thalassaemia remains the life-long blood transfusions which may bring about other complications due to subsequent iron accumulation in the body. In order to develop pharmacological and molecular therapies aimed at increasing HbF levels, an understanding of the mechanisms responsible for the regulation of the switch from foetal to adult haemoglobin during development is required. KLF1, which is a key regulator in the switching of γ to β-globin, directly drives expression of other transcription molecules which are necessary in the switching process, namely BCL11A and ZBTB7A. These are key repressors of foetal γ-globin gene expression and hence, providing a mechanism by which these key molecules can be silenced, can prove to be a fruitful approach in the development of new strategies targeted to increase HbF levels in patients. Other approaches towards increasing the HbF level in patients suffering from haemoglobinopathies, is by the pharmacological induction of the γ-globin gene. However, the detrimental health side-effects associated with these pharmacological inducing agents leaves their role questionable. Throughout this study, the effects of 3 novel compounds and their ability to alleviate HbF levels were investigated. Quantification of the different haemoglobin levels present in K562 cell lysates after exposure to these compounds was then performed using Western blotting. It was identified that in fact, these compounds exerted an effect on the γ-globin gene and hence, this data strongly suggested that these novel compounds under study, could play a role in increasing HbF levels in adults with β-haemoglobinopathies, with the possibility of being associated with less toxic side-effects. Description: B.SC.(HONS)APPLIED BIOMED.SCI. Tue, 01 Jan 2019 00:00:00 GMT /library/oar/handle/123456789/121002 2019-01-01T00:00:00Z /library/oar/handle/123456789/53274 Title: Our worst nightmare : the couples’ lived experiences of miscarriage Abstract: Background: Miscarriage is recognised as one of the most common complications of pregnancy and is associated with stigma, isolation, loss of dreams, hopes and identity of parenthood, for the couple. However, there is a dearth of literature, both local and international, on the lived experiences of the couple who have undergone a miscarriage. Objectives: The aim of this study was to explore the primigravida couples’ lived experiences of early miscarriage. The objectives of this study were to gain insight on the impact of miscarriage on the couples; to identify their support systems, needs and concerns; and to explore the coping strategies adopted. Design: A qualitative phenomenological study using the principles of Interpretative Phenomenological Analysis. Setting: The study took place in the local general state hospital. Participants: Five primagravida heterosexual adult couples who had experienced a first and early stage miscarriage. The females were at an advanced maternal age. Methods: Purposive sampling was used to recruit participants for this study using semistructured interviews which were audio recorded. The data was transcribed verbatim and analysed using Interpretative Phenomenological Analysis. Results: Three super-ordinate themes emerged that highlight the couples’ lived experiences of miscarriage. These were: A Worst Nightmare; The Aftermath of the Storm; Striving to Ride the Waves. Conclusion: The lived experience of miscarriage had a profound physical and emotional impact on the couples describing it as their ‘worst nightmare’ while also commenting on struggling with an identity as parents, which has now been lost. Couples also commented on how the miscarriage setting, hospital environment and the management of care provided by healthcare professionals shaped their experience when dealing with loss. They also expressed the support or lack thereof that they received after their loss from significant others, family, friends, colleagues, health care professionals, online support groups and society. Couples further recalled utilising different coping strategies in an effort to acknowledge their loss and initiate the healing process. Furthermore, they felt insecure about the possibility of future pregnancies and the difficulties that they might encounter to achieve a successful pregnancy. All participants, especially females, highlighted that their desire of parenthood was a race against time due to their advancing maternal age and the implications on their biological clock. Description: M.SC.MENTAL HEALTH NURSING Tue, 01 Jan 2019 00:00:00 GMT /library/oar/handle/123456789/53274 2019-01-01T00:00:00Z