• Identifying patterns in signs and symptoms preceding the clinical diagnosis of Alzheimer’s disease

      Bature, Fidelia (University of BedfordshireUniversity of Bedfordshire, 2018-08)
      Previous research indicates that there is a major challenge caused by the late diagnosis of Alzheimer’s disease (AD), with no suitable diagnostic tool available for use in primary care. Aim: This research is aimed at identifying patterns in the early signs and symptoms of AD to suggest the development of a predictive model for the early detection of AD. Objectives: To; a) map, synthesise and appraise the quality of existing literature on the signs and symptoms preceding the diagnosis of AD via the systematic scoping review of the literature; b) identify patterns in signs and symptoms preceding the clinical diagnosis of AD in general practices via a retrospective medical record review study (RMRRS); c) explore the clinicians perspectives regarding the early signs and symptoms, issues surrounding the late diagnosis and collect recommendations for overcoming barriers to timely detection of AD via a semi-structured interview. Methods: This was a mixed method research comprising a systematic scoping review of literature from 1937-2016, undertaken using the descriptive analysis on the sequence and the timing of signs and symptoms preceding the diagnosis of AD. Methodological quality of studies was assessed with the QUADAS-2 tool as well as PRISMA guidelines and descriptive analysis followed. A RMRRS followed using the logistic regression analysis and a semi-structured interview of general practitioners (GPs) in Milton Keynes (MK) and Luton, using the framework analysis. Results: The findings from the review suggest that neurological and depressive behaviours are an early occurrence in early-onset AD with depressive and cognitive symptoms in the measure of semantic memory and conceptual formation in late-onset AD. It appears that there is a big variation in the patterns of signs and symptoms with cases of misdiagnosis. However, there was limited evidence due to the limited number of studies of this kind. The nested case control design of 109 samples indicates that auditory disturbances could have diagnostic value, with a range of signs and symptoms that appears at different time. While the interviews highlight and confirm areas for consideration in the primary care and NHS. Additionally, the study reports practices in relation to the early diagnosis of AD. However, the result is not an overall representation of the views of GPs. Conclusion: Findings suggest that individuals with auditory disturbances have increased odds of AD. This was more striking in the white female population, with borderline significance due to limited data that is too small to detect such an uncommon symptom(s).
    • Infectious diseases management framework for Saudi Arabia (SAIF)

      Alanezi, Fahad (University of BedfordshireUniversity of Bedfordshire, 2017-02)
      Infectious disease management system area is considered as an emerging field of modern healthcare in the Gulf region. Significant technical and clinical progress and advanced technologies can be utilized to enhance the performance and ubiquity of such systems. Effective infectious disease management (IDM) can be achieved by analysing the disease management issues from the perspectives of healthcare personnel and patients. Hence, it is necessary to identify the needs and requirements of both healthcare personnel and patients for managing the infectious disease. The basic idea behind the proposed mobile IDM system in this thesis is to improve the healthcare processes in managing infectious diseases more effectively. For this purpose, internet and mobile technologies are integrated with social networking, mapping and IDM applications to improve the processes efficiency. Hence, the patients submit their health related data through their devices remotely using our application to our system database (so-called SAIF). The main objective of this PhD project was the design and development of a novel web based architecture of next-generation infectious disease management system embedding the concept of social networking tailored for Saudi patients. Following a detailed literature review which identifies the current status and potential impact of using infectious diseases management system in KSA, this thesis conducts a feasibility user perspective study for identifying the needs and the requirements of healthcare personnel and the patients for managing infectious diseases. Moreover, this thesis proposes a design and development of a novel architecture of next-generation web based infectious disease management system tailored for Saudi patients (i.e., called SAIF – infectious diseases management framework for Saudi Arabia). Further, this thesis introduces a usability study for the SAIF system to validate the acceptability of using mobile technologies amongst infected patient in KSA and Gulf region. The preliminary results of the study indicated general acceptance of the patients in using the system with higher usability rating in high affected patients. In general, the study concluded that the concept of SAIF system is considered acceptable tool in particularly with infected patients.