http://theses.ncl.ac.uk/jspui/handle/10443/5259 2026-02-12T16:49:51Z 2026-02-12T16:49:51Z Asiri, Rayah http://theses.ncl.ac.uk/jspui/handle/10443/6676 2026-02-12T11:28:43Z 2025-01-01T00:00:00Z

Title: Understanding the influence of ethnicity on medicines adherence Authors: Asiri, Rayah Abstract: Diabetes is a significant global public health issue, resulting in serious and costly complications and reduced life expectancy. Adherence to prescribed medication is an essential component of diabetes management to obtain optimal outcomes. Understanding the factors influencing adherence is key to optimising adherence to antidiabetic medication. One factor that has yet to be studied in this context is ethnicity and given the increased incidence of diabetes in certain ethnic groups, it is important to establish if or how adherence to diabetes medication varies by ethnic group (Chapter 1). A systematic review of the existing quantitative literature was conducted to explore whether medication adherence to antidiabetic medications in people with diabetes varied by ethnicity (Chapter 2). Most of the included studies showed statistically significant disparities in adherence among different ethnic groups, with minority ethnic groups in high-income countries often reporting the lowest rates. A second systematic review (meta- ethnography) was undertaken to synthesise the existing qualitative data to explore the barriers to and facilitators of adherence to antidiabetic medications experienced by people from minority ethnic communities in high-income countries (Chapter 3), revealing a gap in the literature concerning ethnicity-related factors from the perspectives of both minority ethnic communities and the majority within the context of socioeconomic deprivation. Chapters 4 and 5 detail two qualitative studies conducted in socioeconomically deprived settings in the United Kingdom and Saudi Arabia. The UK study (Chapter 4) explored the perspectives of people from South Asian and White British ethnic backgrounds in the North East of England. The results identified a range of barriers and facilitators, with some shared by both groups and others unique to the South Asian participants, including a preference for alternative medicine, certain religious-related beliefs and practices, social stigma associated with the condition, and unawareness of free prescription availability. The Saudi Arabian study (Chapter 5) involved participants from South Asian and Saudi Arabian backgrounds, highlighting a range of barriers and facilitators—some shared across both groups and others unique to each ethnic community. This research identified several factors influencing adherence, including ethnicity- related and socioeconomic influences, as well as personal and healthcare system-related factors; these findings should inform the development of tailored interventions (Chapter 6). Description: Ph. D. Thesis.

2025-01-01T00:00:00Z Boon Seen, Shuwirda http://theses.ncl.ac.uk/jspui/handle/10443/6179 2024-06-05T11:00:12Z 2023-01-01T00:00:00Z

Title: Development of HIV-1 Allosteric Reverse Transcriptase (RT) Inhibitors Authors: Boon Seen, Shuwirda Abstract: Forty years after the initial outbreak, HIV/AIDS remains one of the major global public health issues. The development of the Highly Active Antiretroviral Therapy (HAART) has made it possible to delay the progress of the disease hence prolonging survival, however, as the virus continues to evolve rapidly, issues are rising surrounding the resistance to the available drugs as well as associated toxicities. Therefore, the search for new drugs is an ongoing process. A key viral enzyme in HIV is Reverse Transcriptase (RT), which interacts with various viral proteins and cellular factors at different stages in reverse transcription. Previous studies have reported a protein-protein interaction (PPI) involving RT and the cellular eukaryotic translation elongation factor 1A (eEF1A), which could serve as potential new target for drug discovery. The eEF1A protein is a dominant cellular factor that plays a pivotal role in protein synthesis to ensure successful replication of a number of RNA viruses. In HIV, eEF1A is required in the late stages of reverse transcription and impairing binding of RT to eEF1A results in significant reduction in reverse transcription efficiency, ultimately leading to defective viral replication. The region of the RT that is required for interaction with eEF1A has recently been identified which presents as a valuable target for novel drug design. The development of drugs targeting this PPI in HIV could be the new treatment paradigm as there is potential of both an effective prophylactic agent and maintenance treatment. This work is based on targeting the RT-eEF1A interaction by identifying new small molecule leads through an in-silico screening programme, followed by the synthesis and testing of those leads. Several leads and associated analogues have been shown to inhibit the interaction between RT and eEF1A however, future work must be undertaken to quantify the level of inhibition. Description: Ph. D. Thesis.

2023-01-01T00:00:00Z