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- All Subjects: Cancer
- Creators: Blattman, Joseph
Adaptive therapy utilizes competitive interactions between resistant and sensitive cells by keeping some sensitive cells to control tumor burden with the aim of increasing overall survival and time to progression. The use of adaptive therapy to treat breast cancer, ovarian cancer, and pancreatic cancer in preclinical models has shown significant results in controlling tumor growth. The purpose of this thesis is to draft a protocol to study adaptive therapy in a preclinical model of breast cancer on MCF7, estrogen receptor-positive, cells that have evolved resistance to fulvestrant and palbociclib (MCF7 R). In this study, we used two protocols: drug dose adjustment and intermittent therapy. The MCF7 R cell lines were injected into the mammary fat pads of 11-month-old NOD/SCID gamma (NSG) mice (18 mice) which were then treated with gemcitabine.<br/>The results of this experiment did not provide complete information because of the short-term treatments. In addition, we saw an increase in the tumor size of a few of the treated mice, which could be due to the metabolism of the drug at that age, or because of the difference in injection times. Therefore, these adaptive therapy protocols on hormone-refractory breast cancer cell lines will be repeated on young, 6-week old mice by injecting the cell lines at the same time for all mice, which helps the results to be more consistent and accurate.
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.