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The purpose of this study was to examine swallowing patterns using ultrasound technology subsequent to the implementation of two therapeutic interventions. Baseline swallow patterns were compared to swallows after implementation of therapeutic interventions common in both feeding therapy (FT) and orofacial myofunctional therapy (OMT). The interventions consist of stimulation of the tongue by z-vibe and tongue pops. Changes in swallowing patterns are described, and similarities of interventions across the two professions are discussed. Ultrasound research in the realm of swallowing is sparse despite having potential clinical application in both professions. In using ultrasound, this study outlines a protocol for utilization of a hand-held probe and reinforces a particular protocol described in the literature. Real-time ultrasound recordings of swallows for 19 adult female subjects were made. Participants with orofacial myofunctional disorder are compared to a group with typical swallowing and differences in swallowing patterns are described. Three stages of the oral phase of the swallow were assigned based on ultrasonic observation of the tongue shape. Analysis involves total duration of the swallow, duration of the three stages in relation to the total duration of the swallow, and the number of swallows required for the bolus to be cleared from the oral cavity. No significant effects of either intervention were found. Swallowing patterns showed a general trend to become faster in total duration subsequent to each intervention. An unexpected finding showed significant changes in the relationship between the bolus preparation stage and the bolus transportation stage when comparing the group classified as having a single swallow and the group classified as having multiple swallows.
ContributorsMckay, Michelle Diane (Author) / Weinhold, Juliet (Thesis director) / Scherer, Nancy (Committee member) / Department of Speech and Hearing Science (Contributor) / Sanford School of Social and Family Dynamics (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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
The purpose of this project was to research the expression of Autism Spectrum Disorder in children and create a children’s book that can help the peers of individuals with a diagnosis to understand what the disorder entails and potentially gain a new sense of empathy for peers of all levels of physical and mental abilities. The research component includes interviews with individuals deemed knowledgeable about ASD, including occupational therapists, behavioral analysts, and parents, as well as a literature review of research studies on the expression of Autism in children. This written portion of the project may also serve as a manual for individuals who have little to no knowledge of ASD, as it dives deeper into the content of the book and research, while remaining easily understandable and clear to those without any prior knowledge or experience with ASD. It could prove especially useful for those in professions that come into contact with individuals with Autism, but do not necessarily require psychology courses or training as a prerequisite for the role, such as teachers and some health professionals.
ContributorsSigna, Hope (Author) / Nelson, Elizabeth (Thesis director) / Spinrad, Tracy (Committee member) / Department of Psychology (Contributor) / Sanford School of Social and Family Dynamics (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
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
Posttraumatic stress disorder is a psychiatric disorder that can develop after exposure to a traumatic event, and it can cause affected individuals to relive the associated event through flashbacks or nightmares. This project centers around the prevalence of PTSD in parents of infants admitted to the neonatal intensive care unit. Past research has shown that these parents are at increased risk of developing traumatic stress symptoms, with affliction rates as high as 53% in mothers and 33% in fathers (Hua et al., 2018). With this statistic as a catalyst, the present text has a variety of aims, all hinging on the goal of easing the NICU journey for parents. This thesis explores the different types of therapy used in the treatment of traumatic stress, with a focus on trauma-focused cognitive behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) as these were shown to be the most effective in past research. A compilation of resources was also gathered that can now be distributed to NICU parents, including information on PTSD, how to access a therapist, and other helpful articles. An additional component of this project included the administration of a survey to NICU parents to gain a better understanding of their stress levels, what resources were most helpful to them, what barriers limited their ability to seek help, and their thoughts on a text-messaging resource service. Institutional IRB approval was received for this survey. The survey indicated that parents were very stressed when admitted to the NICU, but their stress levels tend to decrease over time. Parents also faced a variety of barriers, with the need to return to work or maintain a busy schedule being the most pervasive. Additionally, an analysis was completed on federal legislation relating to healthcare and the NICU experience. Furthermore, special considerations for limited English proficient (LEP) families were also considered. The paper concludes with steps that should be taken, in both research and action, to improve on the NICU experience for at-risk parents. The implementation of a text-messaging resource service for NICU parents was desired by survey respondents and is a recommended next step. Changes in policy surrounding insurance reform and longer, paid family leave would also be beneficial. Training of NICU staff on how to provide resources and communicate sensitively and effectively with parents is also crucial if the current situation is to be improved. There are definitive steps that should be taken immediately to ease the journey and provide comfort for NICU parents.
ContributorsBryant, Tyler (Co-author) / Beck, Kelsey (Co-author) / Puruhito, Krista (Thesis director) / Visconti, Kari (Committee member) / Historical, Philosophical & Religious Studies (Contributor) / School of Politics and Global Studies (Contributor, Contributor) / Sanford School of Social and Family Dynamics (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05