Matching Items (8)
Description
Each family approaches a cancer diagnosis differently. While some families pursue traditional treatments to the fullest extent, others attempt to refuse chemotherapy, often in favor of alternative medicines. When the patient is a minor, his or her parents have the authority to make medical decisions on their behalf, and this authority is constitutionally protected and socially upheld. However, when the decision to forgo chemotherapy does not comply with minimum standard of care and puts the minor's life in danger, legal action can and has been taken to force the minor to undergo chemotherapy. Legal precedent and biomedical ethics principles guide the decision-making process of the physicians and judges involved, although there is no official framework by which to prioritize these principles. Neglect and abuse procedures, as well as capacity determinations, mature minor doctrines, and religious convictions, add complexity to each forced chemotherapy case. These complexities were explored through the context of four case studies: Cassandra Callendar, who was not granted mature minor status and was forced into treatment by the Connecticut Supreme court; Starchild Abraham Cherrix, who was allowed to pursue the alternative Hoxsey therapy with the consent of his parents and the local court; Dennis Lindberg, a 14-year-old Jehovah's Witness who was permitted to refuse blood transfusions under the Mature Minor Doctrine; and Daniel Hauser, a developmentally delayed teen who was forced to undergo therapy against his parents' religious convictions. In the analysis and comprehensive comparison of these cases, it was concluded that an attempt to establish a protocol by which to determine the ethics of forcing chemotherapy, while well-intended, would ultimately be ineffective and extremely complex. Thus, each forced chemotherapy case must be evaluated on an individual basis.
ContributorsNelson, Sarah Gabrielle (Author) / Hendrickson, Kirstin (Thesis director) / Lynch, John (Committee member) / Jaramillo, Andres (Committee member) / School of Molecular Sciences (Contributor) / Sanford School of Social and Family Dynamics (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Chemotherapy refers to the use of chemical agents to inhibit or stop the growth of rapidly dividing cancer cells. There are many side effects of systemic chemotherapy, which are caused because the drug not only kills cancer cells but healthy cells as well (American Cancer Society, 2017). Common side effects include fatigue, hair loss, bruising/ bleeding, infection, anemia, nausea and vomiting, appetite changes, constipation, diarrhea, oral sores, nerve and muscle pain, dry skin and color change, kidney dysfunction, weight loss, cognitive difficulties, mood changes, sexual dysfunction, and fertility problems (American Cancer Society, 2017). Research shows that complementary and alternative medicine (CAM) may help relieve some of the side effects of chemotherapy. Examples of CAM include herbal medicine, dietary supplements, acupuncture, yoga, Tai Chi, massage, electromagnetic therapy, meditation, biofeedback, music, dance, and guided imagery (Johns Hopkins Medicine, 2017). The aim of this creative project was to design a third-party website to provide information to patients undergoing chemotherapy and their family members regarding the use of CAM for the treatment of chemotherapy-induced side effects. Rationale for this project stemmed from a preliminary research step. We analyzed and coded for presence or absence of CAM-specific information on the websites of 20 National Cancer Institute-designated comprehensive cancer centers across the United States. Fifty percent of websites were double-coded. Inter-rater reliabilities (kappa values) for coding of the presence or absence of specific CAM therapies ranged from 0.38 for acupuncture to 1.00 for exercise and yoga, expressive arts, and herbs (mean kappa = 0.75). Fourteen of the 20 websites mentioned meditation or mindfulness; 13 mentioned nutrition; 12 mentioned acupuncture; 11 mentioned exercise or yoga; 11 mentioned massage; 8 mentioned expressive arts; and 3 mentioned herbs. Frequencies for presence of either a description of the specific CAM therapy or an explanation of how the therapy works were lower. We then conducted a literature review using PUBMED to find peer-reviewed research on the efficacy of the previously described seven CAM therapies. The literature search focused on systematic reviews and meta-analyses published within the past 10 years. Based on the literature obtained, we created summaries of the scientific evidence for each CAM therapy. This information is now provided on our third-party website in tabular form with summative statements. The website describes in lay language: chemotherapy, chemotherapy side effects, CAM, seven specific CAM therapies, and evidence for the efficacy or lack thereof of each. Per the American Nurses Association (2015), it is our responsibility to advocate for our patients through education and holistic treatment. The role of the nurse is to educate the patient about treatment options; however, it is not within the nurse's scope of practice to prescribe a treatment. As such, this website should not be viewed as a prescription for CAM therapies, but instead as a user-friendly and easily accessible resource for informed decision-making regarding the adjunctive use of CAM therapies.
ContributorsNichols, Abrianna (Co-author) / Varosky, Maxwell (Co-author) / Langer, Shelby (Thesis director) / Morris, Brenda (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Sanford School of Social and Family Dynamics (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
Description
As advanced as current cancer therapeutics are, there are still challenges that need to be addressed. One of them is the non-specific killing of normal cells in addition to cancerous cells. Ideal cancer therapeutics should be targeted specifically toward tumor cells. Due to the robust self-assembly and versatile addressability of DNA-nanostructures, a DNA tetrahedron nanostructure was explored as a drug carrier. The nanostructure can be decorated with various molecules to either increase immunogenicity, toxicity, or affinity to a specific cell type. The efficiency of the specific binding and internalization of the chosen molecules was measured via flow cytometry. Using a murine B cell lymphoma as the model system, several targeting molecules have been evaluated for their specific binding and induced internalization of DNA nanostructures, including an anti-Igκ antibody, an idiotype-binding peptide, and a g-quadruplex nucleolin specific aptamer. It was found that adding the anti-Igκ antibody appeared to provide increased binding and facilitated cellular internalization. Also, it was found that the presence of CpG appeared to aid in the binding of nanostructures decorated with other molecules, as compared to nanostructures without CpG. The g-quadruplex aptamer thought to specifically bind cancer cells that overexpress nucleolin was tested and found to have better binding to cells when linked to the nanostructure than when alone. The drug doxorubicin was used to load the DNA-nanostructure and attempt to inhibit cancer cell growth. The DNA-nanostructure has the benefit of being self-assembled and customizable, and it has been shown to bind to and internalize into a cancer cell line. The next steps are to test the toxicity of the nanostructure as well as its specificity for cancerous cells compared to noncancerous cells. Furthermore, once those tests are completed the structure’s drug delivery capacity will be tested in tumor bearing mice. The DNA-nanostructure exhibits potential as a cancer specific therapeutic.
ContributorsGomez, Amber Marie (Author) / Chang, Yung (Thesis director) / Anderson, Karen (Committee member) / Liu, Xiaowei (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / School of Molecular Sciences (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
This research addresses the importance of factors such as gestational weight gain (GWG) and postpartum weight of mothers, as well as obesity rates in infants born to these mothers who are included in the population of low-income Mexican-American mothers and infants enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Evaluating these factors will contribute to finding recommendations to help solve the obesity epidemic in this specific population. Breastfeeding duration, mother BMI, infant birth weight, and infant weight z-scores were statistically analyzed from a WIC population in Houston. The study participants are involved in a five year intervention study where the home environment and education on feeding practices, breastfeeding duration and obesity are evaluated. The results found that: (1) breastfeeding initially indicates a further continuation of breastfeeding; (2) mothers who breastfed for six months were likely to have a lower BMI at twelve to eighteen months than those who did not; (3) the birth weight of the infant is associated with the weight pattern of the child later; (4) the weight/height percentiles of a newborn are somewhat likely to stay the same until age three; (5) the prenatal weight of the mother impacts the weight of the newborn infant; and (6) the mother's postpartum BMI at one week is associated with a similar BMI at 12 months postpartum. In conclusion, women in this population tend to not breastfeed for 6 months and are not losing gestational weight postpartum, leading to increased wright retention after pregnancy, as well as heavier babies that will maintain this weight in early childhood. Further breastfeeding, nutrition, exercise, obesity, and proper infant feeding education are needed to reduce the rate of obesity in low-income Mexican-American WIC populations.
ContributorsSchmid, Emily Grace (Author) / Reifsnider, Elizabeth (Thesis director) / Danielson, Kim (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
Due to the Covid-19 pandemic, healthcare professionals including occupational therapy practitioners (OTPs) were required to transition to working utilizing an online-service delivery model called telehealth. The use of telehealth for occupational therapy (OT) sessions was limited prior to the pandemic, and this shift required OTPs to provide services in ways many had never experienced. The purpose of this study was to identify how the transition to telehealth impacted OTPs and their ability to provide proper care to the pediatric population via telehealth. The final analytic sample included 32 female OTPs who worked with the pediatric population. Results from qualitative and quantitative analyses showed that OTPs had positive feelings toward using telehealth and that the telehealth modality had a moderate impact on their job performance. The areas that pediatric OTPs want to be addressed included technology and internet issues, lack of parent involvement, decreased quality of care, inaccessibility of materials, decreased attention span and increased distractions, and lack of general knowledge about telehealth among clients, parents, and professionals. Despite these drawbacks, a positive theme emerged that the telehealth model is good for current circumstances. The results show telehealth is a positive experience for OTPs and allows OT to be more accessible to their clients. Implications for increasing education for healthcare professionals, clients, and parents/guardians to make telehealth accessible to clients on a large scale are discussed.
ContributorsMulvaney, Kaitlin Marie (Author) / Bryce, Crystal (Thesis director) / Seeley, Bridget (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / Department of Psychology (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
Preliminary studies indicate that the use of dietary menthol may prevent excessive weight gain through the activation of the transient receptor potential melastatin family member 8 (TRPM8) ion channel. It has also been expressed that elevation of the core temperature (Tc) inducing mild hyperthermia via an increase in ambient temperature aids in a marked reduction of the drive to eat and weight gain. While caloric restriction (CR) aims to treat obesity and secondary sicknesses, weight regain is a common result during long term weight maintenance. The goal of these studies was to evaluate and identify if the menthol and mild hyperthermia mechanisms could couple synergistically to reduce or abrogate weight gain. Ambient temperature (Ta) was increased incrementally to identify the threshold in which rodents display mild hyperthermia. Our initial attempts at hyperthermia induction failed because of limitations in the environmental chamber. These trials fail to note a threshold at which elevated Tc is sustained for any period of time. The data suggests an ambient temperature of 36-38 °C would be appropriate to induce a mild hyperthermia. A mild hyperthermia is described as the elevation of Tc 2-3 ° above the hypothalamic set point. To facilitate future hyperthermia studies, an environmental chamber was designed. A wine cooler was converted to withstand the desired temperatures, through the use of heat tape, a proportional controller, and a translucent Plexiglas custom fit door. Beyond leveraging temperature to regulate weight gain, dietary changes including a comparison between standard chow food, high fat diet, and menthol supplemented chow food treatment illustrate a strong likelihood of weight gain variability. In this pilot study, weight gain expression when given a diet supplemented with menthol (1%) showed no statistical significance relative to a high fat diet nor chow food, however, it revealed a trend of reduced weight gain. It is assumed the combination of supplemental menthol and mild hyperthermia induction will exacerbate their effects.
ContributorsJohnsson, Kailin Alexis (Author) / Van Horn, Wade (Thesis director) / Herman, Richard (Committee member) / Towe, Bruce (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / School of Life Sciences (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Diabesity is a global epidemic affecting millions worldwide. Diabesity is the term given to the link between obesity and Type II diabetes. It is estimated that ~90% of patients diagnosed with Type II diabetes are overweight or have struggled with excess body fat in the past. Type II diabetes is characterized by insulin resistance which is an impaired response of the body to insulin that leads to high blood glucose levels. Adipose tissue, previously thought of as an inert tissue, is now recognized as a major endocrine organ with an important role in the body's immune response and the development of chronic inflammation. It is speculated that adipose tissue inflammation is a major contributor to insulin resistance particular to Type II diabetes. This literature review explores the popular therapeutic targets and marketed drugs for the treatment of Type II diabetes and their role in decreasing adipose tissue inflammation. rAGE is currently in pre-clinical studies as a possible target to combat adipose tissue inflammation due to its relation to insulin resistance. Metformin and Pioglitazone are two drugs already being marketed that use unique chemical pathways to increase the production of insulin and/or decrease blood glucose levels. Sulfonylureas is one of the first FDA approved drugs used in the treatment of Type II diabetes, however, it has been discredited due to its life-threatening side effects. Bariatric surgery is a form of invasive surgery to rid the body of excess fat and has shown to normalize blood glucose levels. These treatments are all secondary to lifestyle changes, such as diet and exercise which can help halt the progression of Type II diabetes patients.
ContributorsRobles, Alondra Maria (Author) / Woodbury, Neal (Thesis director) / Redding, Kevin (Committee member) / Allen, James (Committee member) / Hendrickson, Kirstin (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / School of Molecular Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
Children with cancer can experience decreased emotional health along with deteriorating
physical health compared to children without cancer. Many studies have been done to examine the effects of emotional distress and mental health on the cancer patient, as well as the role of familial support. It was found that children with cancer may suffer from depression, anxiety, PTSD, and socio-emotional problems as a result of the trauma of being diagnosed and treated for a pervasive, life-threatening disease. Late effects may also worsen co-morbid mental health disorders. Childhood cancer patients who experience co-morbid mental health problems of depression and anxiety end up having a longer duration of recovery, as well as a worsened outcome than others with a single disorder (Massie, 2004). It was also shown that family members are affected emotionally and mentally from dealing with childhood cancer. Not only is the cancer patient at risk for PTSD during or after treatment, but also family members (National Cancer Institute, 2015). Siblings of the child with cancer may experience feelings of loneliness, fear, and anxiety, as the parent’s attention is focused on the child suffering with cancer. According to the National Cancer Institute (2015), familial problems can affect the child’s ability to adjust to the diagnosis and treatment in a positive way. However, children with strong familial and social support adjust easier to living with cancer. A common theme found in literature is that regular mental health checkups during and after cancer treatment is important for quality of life. Therefore, it is important for all childhood cancer patients and their families to receive information about mental health awareness, as well as therapeutic interventions that are developed for families caring for a child with cancer.
physical health compared to children without cancer. Many studies have been done to examine the effects of emotional distress and mental health on the cancer patient, as well as the role of familial support. It was found that children with cancer may suffer from depression, anxiety, PTSD, and socio-emotional problems as a result of the trauma of being diagnosed and treated for a pervasive, life-threatening disease. Late effects may also worsen co-morbid mental health disorders. Childhood cancer patients who experience co-morbid mental health problems of depression and anxiety end up having a longer duration of recovery, as well as a worsened outcome than others with a single disorder (Massie, 2004). It was also shown that family members are affected emotionally and mentally from dealing with childhood cancer. Not only is the cancer patient at risk for PTSD during or after treatment, but also family members (National Cancer Institute, 2015). Siblings of the child with cancer may experience feelings of loneliness, fear, and anxiety, as the parent’s attention is focused on the child suffering with cancer. According to the National Cancer Institute (2015), familial problems can affect the child’s ability to adjust to the diagnosis and treatment in a positive way. However, children with strong familial and social support adjust easier to living with cancer. A common theme found in literature is that regular mental health checkups during and after cancer treatment is important for quality of life. Therefore, it is important for all childhood cancer patients and their families to receive information about mental health awareness, as well as therapeutic interventions that are developed for families caring for a child with cancer.
ContributorsBuchanan, Chantel Tatiana (Author) / Seeley, Bridget (Thesis director) / Bradley, Robert (Committee member) / Department of Psychology (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05