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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
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
Culture is a living, dynamic concept that influences the lives of all human beings, making it one of the cornerstone building blocks of the human experience. However, there is a widespread assumption that culture matters more for some people than others. Recent studies have found evidence of a cultural (mis)attribution bias among psychologists, the tendency to exaggerate the role of cultural factors in the behavior of racial/ethnic minorities while simultaneously exaggerating the role of personal psychological factors in the behavior of the racial/ethnic majority (Causadias, Vitriol, & Atkins, 2018a; 2018b). This study aims to explore the cultural (mis)attribution bias, and how it manifests in the beliefs and attitudes of undergraduate students at ASU. Additionally, this paper will also explore the implications of those results and how to apply that knowledge to our daily interactions with the people around us.
ContributorsKwon, Woochan (Author) / Causadias, José (Thesis director) / Pedram, Christina (Committee member) / Korous, Kevin (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / Department of Psychology (Contributor) / College of Integrative Sciences and Arts (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Objective: This study examined how the belief (internalization) in the model minority myth of achievement orientation and of unrestricted mobility relates to one’s social awareness of racial inequity and inequality in society (critical consciousness) amongst Asian American college students. Methods: Participants (N = 275, 67.7% female, M_age = 22.35) were recruited from Asian American ethnic studies classes, clubs and organizations and completed an online cross-sectional survey. Results: Results indicated that internalization of achievement orientation significantly correlated with levels of racial critical consciousness while unrestricted mobility did not. Conclusion: These findings extend research exploring the correlates of critical consciousness on internalization of racial stereotypes for Asian Americans.
ContributorsMatriano, Ronae (Author) / Yoo, Hyung Chol (Thesis director) / Atkin, Annabelle (Committee member) / Li, Wei (Committee member) / School of Social Transformation (Contributor) / School of Life Sciences (Contributor) / Hugh Downs School of Human Communication (Contributor) / Sanford School of Social and Family Dynamics (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
Description
Prior research suggests that African American adults are more likely than White adults to experience negative alcohol use outcomes such as alcohol use disorder (AUD) despite reporting lower rates of alcohol consumption. Research also shows that African Americans experience higher rates of depression, which can increase risk for alcohol consumption and AUD through drinking to cope. The current study examined the role of depressive symptoms and drinking to cope in alcohol consumption and AUD symptoms among White and Black/African American college students. Participants completed an online survey during the fall (T1) and spring semester (T2) of their first year of college (N = 2,168, 62.8% female, 75.8% White). Path analyses were conducted to examine whether depressive symptoms and drinking to cope mediated the association between race/ethnicity and alcohol consumption and AUD symptoms, as well as whether race/ethnicity moderated the associations between depressive symptoms, drinking to cope, and alcohol use outcomes. Results indicated that White participants had higher levels of depressive symptoms and alcohol consumption than African American participants. Drinking to cope at T1 was also associated with more depressive symptoms at T1, higher levels of alcohol consumption at T2, and higher levels of AUD symptoms at T2. Also, there was an indirect effect of depressive symptoms on AUD symptoms via drinking to cope. Results from multigroup path analyses suggested that depressive symptoms were more strongly associated with drinking to cope for White students than African American students. There were no significant racial/ethnic differences in the associations between depressive symptoms or drinking to cope and alcohol use outcomes. Future research should examine the roles of race, depression, and drinking to cope in alcohol use outcomes for college students.
ContributorsTaylor, Nicole (Author) / Su, Jinni (Thesis director) / Corbin, William (Committee member) / Chassin, Laurie (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / Department of Psychology (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12
Description
The goal of this paper is to examine the relevance of ethnic identity in young Latinos and Whites in the Phoenix area. Based on interviews with 30 Latino and White young adults, I explore how “Zoomers” and millennials think about their ethnicity. I found that Whites’ ethnic identity tends to be symbolic or meaningless as they attribute less importance to ethnic identity because it has low personal significance and is inconsequential in their daily lives. Latinos, with their stronger connection to the ethnic core, tend to describe their ethnicity as consequential due to their experiences of discrimination that make their ethnic identity less optional. This research has implications for those looking to better understand how different groups think about their ethnicity.
ContributorsTorre, Samantha (Author) / Flores-González, Nilda (Thesis director) / Salgado, Casandra (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor) / Sanford School of Social and Family Dynamics (Contributor)
Created2022-05
Description
A case study using Bate Guide to Physical Examination and History Taking to look at gender and racial biases in medical school textbooks. 5 chapters were looked at specific based on their racial and gender themes present in the images in the chapters. Data from these chapters demonstrate the medical field as beneficial for white and male patients, while women and patients of racial minorities are underrepresented. This underrepresentation impacts future medical care, where these patients are dying as a result of this underdeveloped material.
ContributorsTrantina, Emily (Author) / Haskin, Jennifer (Thesis director) / Carlsen-Landy, Beverly (Committee member) / Barrett, The Honors College (Contributor) / Watts College of Public Service & Community Solut (Contributor) / Sanford School of Social and Family Dynamics (Contributor) / School of Molecular Sciences (Contributor)
Created2022-05