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Title: Airway clearance in cystic fibrosis
Author: McIlwaine, Patricia Margaret
ISNI:       0000 0004 5361 7733
Awarding Body: University of Ulster
Current Institution: Ulster University
Date of Award: 2014
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This thesis overviews and highlights a body of work performed at the BC Children's Hospital, Vancouver, Canada between 1986 and 2013, and involving travel to Belgium, Denmark and the United Kingdom. It is based on five articles published by McIlwaine on research and development in the use of various airway clearance techniques for the treatment of cystic fibrosis, namely: Autogenic Drainage; Positive Expiratory Pressure; Oscillating Positive Expiratory Pressure; and High Frequency Chest Wall Oscillation. The thesis comprises of seven chapters, including the introduction. Chapter 2 presents the physiological evidence and theories to support each technique. Chapter 3 describes various types of airway clearance studies based on the published studies submitted by McIlwaine and discusses barriers and challenges related to each study design. A clinical research pathway for future airway clearance studies is proposed. Chapter 4 examines the use of outcome measures for each stage of the pathway. Chapter 5 is based on the most recent published paper by McIlwaine, and offers an overview on how to optimise designing a multi-centre clinical airway clearance study, identifying challenges and barriers to performing such a study. The work presented in this thesis has contributed to research by furthering an understanding of the physiology upon which various airway clearance techniques are based, as well as providing guidance on the use of appropriate outcome measures. The published papers underlying the thesis have validated the airway clearance techniques of Autogenic Drainage and positive Expiratory Pressure and have in-validated the use of Oscillating PEP using Flutter and High Frequency Chest Wall Oscillation, in the treatment of cystic fibrosis. Outcomes of this work have lead to a change in clinical practice, in Europe and N. America, and have had a direct and positive effect in decreasing the burden of care in people living with cystic fibrosis.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available