Medicine and Health Sciences Commons^™

Preparedness Of School Psychologists To Provide Services For Students Diagnosed With Cancer, Lauren Mckenzie Blevins

Theses, Dissertations and Capstones

Children who survive cancer face many challenges when reintegrating into the school system. School psychologists are among the school support professionals who may aid in providing support and identifying appropriate interventions and accommodations for the academic and mental health needs of these students. This study identifies whether school psychologists in West Virginia perceive themselves to be adequately prepared to assist students who have survived cancer upon returning to school. A survey containing fourteen questions regarding the individual’s experience, training, and knowledge was distributed to school psychologists in attendance at the Fall 2016 West Virginia School Psychologists’ Association conference. Of the …

Exploring The Regulatory Mechanism Of The Notch Ligand Receptor Jagged1 Via The Aryl Hydrocarbon Receptor In Breast Cancer, Sean Alan Piwarski

Theses, Dissertations and Capstones

The aryl hydrocarbon receptor (AHR) is a ligand-activated transcription factor that binds pollutants, therapeutic drugs and endogenous ligands. AHR is of particular interest in cancer and has been shown to play roles in both tumor progression and tumor suppression. As a result, it has received growing attention as a possible chemotherapeutic target. AHR is expressed in all breast cancer subtypes and can promote or inhibit breast cancer depending on the ligand it binds. The Notch signaling pathway is a highly conserved evolutionary pathway that plays extremely vital roles during development by regulating cell fate and differentiation. Notch signaling has increasingly …

Novel Insights Into The Contribution Of Cellular Senescence To Cancer Therapy: Reversibility, Dormancy And Senolysis., Tareq Saleh

Theses and Dissertations

Cellular senescence a specialized form of growth arrest that contributes to the pathogenesis of several aging-related disorders including cancer. While by definition tumor cells are considered immortalized, they can undergo senescence when exposed to conventional and targeted cancer therapy. Therapy-Induced Senescence (TIS) represents a fundamental response to therapy and impacts its outcomes. However, TIS has been considered a positive therapeutic goal since senescent tumor cells are expected to enter a state of permanent growth abrogation. In this work we examined the hypothesis that a subpopulation of senescent cells can re-acquire proliferative potential after a state of senescent dormancy, indicating that …

Educating Oncology Nurses On The Benefits Of Patient Exercise, Roberta Anderson

Walden Dissertations and Doctoral Studies

Exercise benefits patients with cancer during and after treatments. A formalized educational program is lacking at the project's site for oncology nurses on the benefits of exercise for their patients during and after treatment. The purpose of the project was to address the identified gap in practice at the project's site by providing education to oncology nurses on the benefits of exercise for their patients during and after treatment. The ARCS model of motivational design was used as a theoretical foundation to develop and guide the educational program presented to the oncology nurses. The question addressed in the project was: …

Spiritual Care In Cancer Genetic Counseling: Patient Perceptions Of Methods, Christopher Michael Spencer

Theses and Dissertations

The integration of spirituality into medical care is a growing area of debate among professionals, involving a delicate balance between serving patients who may benefit from this without alienating those who would not. To date, little research has targeted spirituality in cancer genetic counseling, particularly concerning the various methods a genetic counselor can use to address spirituality with their patients. A paper questionnaire was created and distributed to patients following their cancer genetic counseling appointments to gain insight on their perception of these methods. Fifty-two participants completed this questionnaire. The eight different spiritual integration methods presented each showed positive responses …

Studies Of Norspermidine Uptake In Drosophila Suggest The Existence Of Multiple Polyamine Transport Pathways, Michael Dieffenbach

Honors Undergraduate Theses

Polyamines are a class of essential nutrients involved in many basic cellular processes such as gene expression, cell proliferation, and apoptosis. Without polyamines, cell growth is delayed or halted. Cancerous cells require an abundance of polyamines through a combination of synthesis and transport from the extracellular environment. An FDA-approved drug, D,L-α-difluoromethylornithine (DFMO), blocks polyamine synthesis but is ineffective at inhibiting cell growth due to polyamine transport. Thus, there is a need to develop drugs that inhibit polyamine transport to use in combination with DFMO. Surprisingly, little is known about the polyamine transport system in humans and other eukaryotes. Understanding the …

Mental Health Interventions For Adolescent Cancer Patients, Kelsey A. Faherty

Honors Undergraduate Theses

Background: According to the National Cancer Institute (2017) approximately 15,270 individuals’ ages 0 to 19 years would be diagnosed with cancer in 2017. Although pediatric cancer survival rates continue to rise, there are high rates of anxiety, fear, and depression amongst this population. The purpose of this literature review was to explore mental health interventions for adolescent cancer patients.

Methodology: A total of 165 articles were found in a literature search. Databases used include: CINAHL Plus with Full Text, Cochrane Center Register of Controlled Trials, Cochrane Clinical Answers, MEDLINE, and PsycINFO. As results were further narrowed based on relevance and …

An Assessment Of The Effects Of Medical Marijuana On The Quality Of Patient Life, Kori L. Bullard

Honors Theses

America is known as the land of opportunity. People attempting to better their lives tend to see America as an opportunity to do so. This statement remains true for the American medical field. Americans are known as advanced in treatment options for various diseases. With this being said, there are few diseases that still bring forth complete fear in the minds of the people of America. In spite of this, "You have been diagnosed with cancer" is a statement that generates this fear. Cancer is one of the leading causes of death worldwide. Current treatments for cancer are invasive, expensive, …

Long-Term Health Impacts Of Cell Phone-Driven Radiofrequency Radiation Exposure In Humans, Ndukaku Omelu

Walden Dissertations and Doctoral Studies

Uncertainties still exist about the safety of cell phone use and the level of cell phone-driven radiation. The purpose of the current inquiry was to determine the long-term health impacts of cell phone-driven radiation via the use of cell phones. In this cross-sectional study, which was based on socio-ecological theory, secondary data from the 2012 National Health Interview Survey were analyzed to assess the difference in the prevalence of thyroid cancer, mouth/tongue/lip cancer, and heart disease between exposed and non-exposed/less exposed cell phone-driven radiation groups in the United States. Logistic regression was used to address three research questions. Findings initially …

Association Between Altitude And Bronchopulmonary Cancer, Hung Ching

Walden Dissertations and Doctoral Studies

As a validation study, this study addressed an under-researched area of bronchopulmonary cancer mortality and incidence. The association between altitude and bronchopulmonary cancer mortality and incidence was investigated using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research. The theoretical framework for my study was Bronfenbrenner's ecological model. This model emphasizes the relevance of social and physical environments that influence patterns of disease and injury and shape responses to these patterns of disease and injury. The age-adjusted bronchopulmonary cancer mortality and incidence rates per 100,000 people in the highest elevation and lowest elevation states …

Socioeconomic Status And Cancer Risks In Employer-Insured Cancer Survivors, Christine Clinton

Walden Dissertations and Doctoral Studies

Chronic illnesses such as cancer continue to be among the costliest for employers who provide health insurance to their employees. Despite efforts to incorporate health improvement programs in the workplace, there are concerns about the effectiveness of these programs that do not always deliver a positive return on investment. Little is known about the specific socioeconomic status of employees for whom these workplace health improvement programs are designed for. Guided by the social-ecological model, this study sought to understand the relationship between cancer health risks about socioeconomic factors among cancer survivors in the employer-insured population. Data were extracted from the …

Korean Immigrant Women's Perceptions Of Cervical Cancer Screening In Hawaii, Eurina Yujin Cha

Walden Dissertations and Doctoral Studies

Minority immigrant women are more likely to be diagnosed with and suffer from cervical cancer compared to other minority women in the United States. The purpose of this qualitative ethnographic study was to explore cultural health perceptions, behaviors, and barriers to cervical cancer prevention among Korean immigrant women (KIW) in Hawaii. The health belief model and the social-ecological model were used to guide the study. Data were collected using individual structured interviews with 20 KIW ages 21 to 65 who are first-generation KIW immigrant to Hawaii. Data were coded and analyzed to identify themes. Findings revealed that participants (a) prefer …

Evaluating The Effect Of A Nurse Navigator In Increasing Colorectal Screening, Christine Njogu

DNP Projects

PURPOSE: The purpose of this study is to evaluate the effectiveness of a nurse navigator in increasing colorectal (CRC) screening in primary care setting.

METHODS: This was a descriptive retrospective study of the effect of nurse navigators in increasing colorectal screening in primary care settings within Jefferson county and its surrounding counties. The sample consisted of 200 patient chart reviews for the period of September 1st through December 31st, 2017. Rates of colorectal screening were compared in those who received a nurse navigator call and those who did not.

RESULTS: Overall screening rates were 44.6%. A distinct increase in screening …

Evaluation And Adaptation Of Live-Cell Interferometry For Applications In Basic, Translational, And Clinical Research, Kevin A. Leslie

Theses and Dissertations

Cell mass is an important indicator of cell health and status. A diverse set of techniques have been developed to precisely measure the masses of single cells, with varying degrees of technical complexity and throughput. Here, the development of a non-invasive, label-free optical technique, termed Live-Cell Interferometry (LCI), is described. Several applications are presented, including an evaluation of LCI’s utility for assessing drug response heterogeneity in patient-derived melanoma lines and the measurement of CD3+ T cell kinetics during hematopoietic stem cell transplantation. The characterization of mast cells during degranulation, the measurement of viral reactivation kinetics in Kaposi’s Sarcoma, and drug …

Educating Oncology Nurses About The Emotional Impact Of Cancer Diagnosis, Jonnell Ortiz Zayas

Walden Dissertations and Doctoral Studies

Anxiety and depression are common mood disorders in cancer patients, regardless of mental state prior to diagnosis. A gap in the education of oncology nurses in an eastern Caribbean island was discovered regarding their ability to identify anxiety and depression symptoms and to help patients who suffered from these disorders. The purpose of this project was to improve oncology nurses' assessment skills by reviewing appropriate use of the Hospital Anxiety and Depression Scale (HADS) tool and familiarizing nurses with resources to help patients who score high on the HADS. The Levine conservation model was the theoretical framework for this project. …

Exploring The Effect Of Chronic Inflammation On Response To Immune Checkpoint Inhibitors In Cancer, Sherif M. El-Refai

Theses and Dissertations--Pharmacy

Precision medicine has allowed for the development of monoclonal antibodies that unmask the anti-tumor immune response. These agents have provided some patients durable clinical benefit. However, PD-1 and PD-L1 inhibitor therapies are effective in a small group (10-20%) of non-small cell lung cancer (NSCLC) patients when used as single-agent therapy. The approved companion diagnostic is expression of the immune cell surface molecule, programmed death ligand 1 (PD-L1), on tumors measured by immunohistochemistry (IHC). Studies in tumor biology and immune surveillance dictate that PD-1 inhibitor efficacy should depend on the level of PD-L1 expression; however, the literature has not followed with …

A Program Evaluation Of A Colon Cancer Screening Program Using At-Home Fecal Immunochemical Tests With Certified Patient Navigators, Candace E. H. Brunk

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Colorectal cancer is the second leading cause of cancer-related death in this country, but 33% of these deaths could be prevented by screening. While colonoscopy is an effective screening tool, it is expensive, invasive, and prone to encounter considerable patient resistance. An alternative is to first screen those at-risk using at-home fecal immunochemical test (FIT) kits. This study determined factors associated with the return of these kits distributed by Kentucky CancerLink, a non-profit organization, and its affiliates to participants in a colon cancer prevention program.

Objectives: To identify factors associated with: completing a FIT kit, completing the kit with minimal …

Elevated Blood Lead Levels, Cancer Incidence, And All-Cause Mortality In Adults, Sherri L. Davidson

All ETDs from UAB

Epidemiologic studies have indicated an association between lead exposure and cancer. Although lead exposure has declined in recent decades, from removal of lead in gasoline and paint, lead exposure remains a health concern from environmental and occupational sources including aging water systems. In a retrospective cohort study, Adult Blood Lead Epidemiology and Surveillance (ABLES) records in Alabama were linked to cancer incidence data in the Alabama Statewide Cancer Registry and mortality data from the Alabama Center for Health Statistics, using a probabilistic linkage program. Blood lead level (BLL) measurements were used to categorize exposure levels. Odds ratios approximated relative risks. …

Investigating The Role Of Nicotinic Acetylcholine Receptor Agonists In Lung Cancer Progression And Chemosensitivity In The Context Of Treating Chemotherapy-Induced Peripheral Neuropathy, Sarah L. Kyte

Theses and Dissertations

While cancer chemotherapy continues to significantly contribute to the number of cancer survivors, exposure to these drugs can often result in chemotherapy-induced peripheral neuropathy (CIPN), a consequence of peripheral nerve fiber dysfunction or degeneration. CIPN is characterized by sensory symptoms in the hands and feet, such as numbness, burning, and allodynia, resulting in an overall decrease in quality of life. Paclitaxel (Taxol), a microtubule poison that is commonly used to treat breast, lung, and ovarian cancers, has been found to cause CIPN in 59-78% of cancer patients. There is currently no effective preventative or therapeutic treatment for this side effect, …

The Future Of 5-Fluorouracil Treatment Of Colorectal Cancer: Translating A Better Understanding Into Improved Patient Care, Nathan Smits

Theses and Graduate Projects

5-fluorouracil (5-FU) is a pyrimidine analog that has been successfully employed in anticancer therapy for over forty years. Over the past several decades, researchers have characterized its cellular and clinical pharmacology and uncovered multiple mechanisms of action, which include the inhibition of thymidylate synthase (TS) and incorporation of its metabolites into DNA and RNA. The purpose of this quantitative systemic review was to summarize and evaluate what is known of these mechanisms to determine which are of most significance in the anticancer effects of 5-FU in metastatic colorectal cancer (mCRC) patients. A literature search of peer-reviewed articles dating back to …

The Development Of Novel Non-Peptide Proteasome Inhibitors For The Treatment Of Solid Tumors, Zachary C. Miller

Theses and Dissertations--Pharmacy

The proteasome is a large protein complex which is responsible for the majority of protein degradation in eukaryotes. Following FDA approval of the first proteasome inhibitor bortezomib for the treatment of multiple myeloma (MM) in 2003, there has been an increasing awareness of the significant therapeutic potential of proteasome inhibitors in the treatment of cancer. As of 2017, three proteasome inhibitors are approved for the treatment of MM but in clinical trials with patients bearing solid tumors these existing proteasome inhibitors have demonstrated poor results. Notably, all three FDA-approved proteasome inhibitors rely on the combination a peptide backbone and reactive …

Analysis Of The Gtp Cyclohydrolase I/Tetrahydrobiopterin Pathway In Glioblastoma Biology, Anh Tran

All ETDs from UAB

Glioblastomas (GBMs) are the most common primary malignant brain tumors in adults and one of the most aggressive cancers with high rates of recurrence and therapeutic resistance. In GBMs, subpopulations of highly tumorigenic cells called brain tumor initiating cells (BTICs) have the unique capacity to promote tumor maintenance, therapeutic resistance, and angiogenesis. Depending on the level, differentiation state, and tumor stage, reactive nitrogen and oxygen species inhibit or increase cancer growth and BTIC maintenance. GTP cyclohydrolase 1 (GCH1) is the rate limiting enzyme in a pathway that can regulate reactive species production but has not been thoroughly investigated in GBM. …

Overcoming Obesity-Induced Immunotherapeutic Impairment, Shannon Boi

All ETDs from UAB

Obesity affects ~40% of United States adults and is linked to the development of multiple health-related complications. Obesity is a major risk factor for developing renal cell carcinoma (RCC), the most common type of renal cancer. Metastatic RCC has poor five-year survivals, therefore, new, efficacious therapeutics are needed. One avenue is immunomodulation to generate tumor-specific, systemic anti-tumor responses that are long-lasting against local, metastatic, and recurrent tumors. Despite encouraging results, immunotherapeutic treatment of RCC is underwhelming. Cytokine therapies are largely toxic, while newly FDA-approved ‘checkpoint blockade’ (CB) antibodies have responses <50%. Here, we present a strategy employing a T cell priming therapy (AdTR/CpG) upstream of CB administration. Combinatorial use resulted in improved anti-tumoral immune responses, significantly reduced tumor burdens, and extended overall survival in pre-clinical RCC. Importantly, this approach was more efficacious than either single agent(s). Pre-clinical therapy development is often accomplished using lean, healthy animals–thus, to improve translatability we examined immune responses in the context of obesity as a major patient comorbidity. Subsequently, we investigated AdTR/CpG/CB in diet-induced obese (DIO) mice. Tumor/treatment-naïve DIO mice exhibited obesity-associated features; i.e., increased leptin/insulin and serum cytokines. These effects were not dependent on high-fat diet administration as mice resistant to weight gain had minimal alterations in these factors, and were similar to mice maintained on standard chow. As previously identified, 80% of DIO mice bearing renal tumors failed to respond to AdTR/CpG. AdTR/CpG/CB-treatment dramatically improved response rates against DIO tumors, however, decreased obese responder percentages were observed in both combinatorial therapies and was independent of high fat diet administration alone. Impaired response rates were not model or immunotherapy-specific as similar reductions in tumor clearance were seen in models of melanoma and sarcoma. Furthermore, responses were not due to initial T cell priming or unequal precursor CD8+ T cell frequencies. Detrimental changes in the tumor microenvironment underscored failure in obese mice and revealed therapeutic success was defined by a T cell-myeloid cell-inversion profile, supported by immunogenetic and flow cytometric analyses. Thus, we demonstrate a novel combinatorial approach for improving checkpoint-based outcomes, and identify the ability of host obesity to impede therapy-induced anti-tumor immunity.

Pain Management, Gender, And Quality Of Life In Cancer Patients, John Robert Buhmeyer

Walden Dissertations and Doctoral Studies

The type of cancer pain management used may have an effect on the quality of life (QOL) of cancer patients. Researchers have determined that cancer patients are inadequately treated for pain and pain management is an essential determinant of patient survivability and QOL. Numerous clinical studies have been accomplished concerning opioid administration and noncancer and cancer pain management exist. Previous studies have examined the relationship between cannabinoid products, noncancer pain, cancer pain, and related QOL for patients but have not focused on the QOL of cancer patients while also moderating for gender. These relationships were investigated using the health belief …