Thinking Through the Chemo-Fog: Occupational Therapy’s Role in Promoting Participation in Adults with Breast Cancer

Breast cancer is currently the most common type of cancer in women (American Cancer Society, 2012). In 2012, 2,971,610 women in the United States were breast cancer survivors (American Cancer Society, 2012). Chemotherapy is often used to effectively treat breast cancer but can cause chemobrain, or chemotherapy-related cognitive impairments (CRCI), including decreased attention, concentration, memory, and difficulty learning new skills and completing routine tasks (American Cancer Society, 2013). CRCI can persist for years and may impact an individual’s occupational performance in daily activities and occupations. Occupational therapy practitioners currently work with this population in other areas including cancer-related fatigue management, lymphedema, physical limitations post-surgery, and psychosocial distress. However, the increasing number of breast cancer survivors and prevalence of CRCI highlight the importance for expanding and defining occupational therapy’s role with this population. The purpose of this presentation is to present the results of a systematic review on interventions within occupational therapy’s scope of practice that can be used to improve CRCI in adults with breast cancer, and to discuss the implications for clinical practice. A comprehensive literature review was performed to understand the role of occupational therapy in treating individuals with chemobrain. CINAHL, Medline and Cochrane databases were used to conduct the review following inclusion criteria (literature published after 2003, and adults with breast cancer who have received chemotherapy) and exclusion criteria. To minimize bias, all articles were critiqued by a primary and secondary reviewer. Thirteen articles were reviewed. The literature review determined health professionals tend to not acknowledge the presence of CRCI, and there is a need for health care professionals to address the symptoms of CRCI. Current interventions that fit within the scope of occupational therapy are being implemented primarily by other disciplines, such as memory strategies and training, and running support groups. The lack of high quality evidence supporting the role of occupational therapy highlights the need for further research and the development of evidence-based interventions that include using compensatory, remedial, psychosocial, and patient education interventions. References: American Cancer Society. (2012). Cancer treatment and survivorship facts & figures 2012-2013. Retrieved from http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-033876.pdf. American Cancer Society. (2013). Chemo brain. Retrieved from http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/chemotherapyeffects/chemo-brai

Evidence for shallow implantation during the growth of bismuth nanocrystals by pulsed laser deposition

The shallow implantation of Bi species was analyzed for energy densities above 2 Jcm-2. The implantation range was shown to depend on the energy density used for ablation, which was related to the velocity of the Bi atoms and ions in the plasma. The kinetic energy of the Bi species in the plume generated at laser energy densities above 2 J cm-2 was estimated to be around 200 eV.This work has been partially supported by project TIC99-0866, CICYT (Spain). One of the authors (J.-P.B.) acknowledges support by the EPSRC and a Marie Curie Fellowship of the EC under Contract No. HPMT-CT-2000-00064.Peer Reviewe

Study protocol: NITric oxide during cardiopulmonary bypass to improve Recovery in Infants with Congenital heart defects (NITRIC trial): a randomised controlled trial

Introduction Congenital heart disease (CHD) is a major cause of infant mortality. Many infants with CHD require corrective surgery with most operations requiring cardiopulmonary bypass (CPB). CPB triggers a systemic inflammatory response which is associated with low cardiac output syndrome (LCOS), postoperative morbidity and mortality. Delivery of nitric oxide (NO) into CPB circuits can provide myocardial protection and reduce bypass-induced inflammation, leading to less LCOS and improved recovery. We hypothesised that using NO during CPB increases ventilator-free days (VFD) (the number of days patients spend alive and free from invasive mechanical ventilation up until day 28) compared with standard care. Here, we describe the NITRIC trial protocol. Methods and analysis The NITRIC trial is a randomised, double-blind, controlled, parallel-group, two-sided superiority trial to be conducted in six paediatric cardiac surgical centres. One thousand three-hundred and twenty infants <2 years of age undergoing cardiac surgery with CPB will be randomly assigned to NO at 20 ppm administered into the CPB oxygenator for the duration of CPB or standard care (no NO) in a 1:1 ratio with stratification by age (<6 and ≥6 weeks), single ventricle physiology (Y/N) and study centre. The primary outcome will be VFD to day 28. Secondary outcomes include a composite of LCOS, need for extracorporeal membrane oxygenation or death within 28 days of surgery; length of stay in intensive care and in hospital; and, healthcare costs. Analyses will be conducted on an intention-to-treat basis. Preplanned secondary analyses will investigate the impact of NO on host inflammatory profiles postsurgery. Ethics and dissemination The study has ethical approval (HREC/17/QRCH/43, dated 26 April 2017), is registered in the Australian New Zealand Clinical Trials Registry (ACTRN12617000821392) and commenced recruitment in July 2017. The primary manuscript will be submitted for publication in a peer-reviewed journal. Trial registration number ACTRN12617000821392.</p

The Voltage–gated Proton Channel, Hv1, Enhances Brain Damage from Ischemic Stroke

Phagocytic cell NADPH oxidase (NOX) generates reactive oxygen species (ROS) as part of innate immunity. Unfortunately, ischemia can also induce this pathway and inflict damage on native cells. Here we show that NOX–mediated damage can be inhibited by suppression of the voltage-gated proton channel, Hv1. Hv1 is required for full NOX activity since it compensates for loss of NOX–exported charge. We show that Hv1 is required for NOX–dependent ROS generation in brain microglia in situ and in vivo. Mouse and human brain microglia, but not neurons or astrocytes, express large Hv1-mediated currents. Mice lacking Hv1 were protected from NOX–mediated neuronal death and brain damage 24 hours after stroke. These results demonstrate that Hv1–dependent ROS production is responsible for a significant fraction of brain damage at early time points after ischemic stroke and provide a rationale for Hv1 as a therapeutic target for the treatment of ischemic stroke

Autism Resources in Rural America

The topic of this final project centers around the lack of services that are available to autistic children and adults in rural America and the steps that should be taken the ensure services are available as the growing population of children grow older and need full-time care. Our modern society as well as the current healthcare system are not prepared for the growing need of an ageing disabled population. Will these disabled children and young adults flood the current long-term care facilities that are already established? Will the already stretched thin Medicare and Medicaid system cover the costs associated with the permanent placement of this growing population? This project will also fully explain and compare the seemingly endless options that are in more urban areas that may or may not have years long waiting lists. This project will also provide an overview of the definitions of autism and the challenges that can present itself with a diagnosis and the overwhelming need for early intervention which is becoming increasingly difficult to obtain with the growing numbers of diagnosis. The present number of children diagnosed in the year 2023 with the same age groups 30 years ago will be compared to highlight the growing number of children and adults being diagnosed with this life altering diagnosis. Many practitioners in a clinic setting are getting limited training on the treatment of autistic patients in their formal education and are ill-equipped to deal with challenging patients, this is even more so attributed to children and adults with an autism diagnosis. After this final project the reader should have a better understanding of the challenges facing the Healthcare system relating to autism

Involve Me: Using the Orff Approach within the Elementary Classroom

Musical independence, improvisation, and composition are important skills that teachers should include within an elementary music curriculum. The musical concepts that accompany these skills can be difficult for teachers to convey and for students to understand due to the difficulty and complexity of teaching musical independence. This study consists of a literature review pertaining to the history and development of the Orff Approach, application of Orff concepts to the creation of lesson plans and classroom activities, action research with elementary students, and conclusions. Three different lesson plans were created implementing Orff techniques specific to the following grade ranges: two-four, four-six, five-eight. Two lessons were taught to students in a local public school and were video-taped for later reflection and analysis. Participants consisted of students in two elementary general music classes, grades four and six. The students and the classroom teacher responded positively to the activities designed using the Orff Approach. Every student successfully participated in the rhythmic and melodic musical opportunities, learning and demonstrating musical independence. Being directly involved with the creative musical process at an elementary level helps foster the musical learning process. When developed at a young age, creativity and musical independence are very helpful skills to utilize during musical performing in later musical training. The Orff Approach naturally fosters musical creativity and independence and highlights individual student success. The Orff Approach is a beneficial teaching methodology that helps to successfully implement improvisation and better teach composition. It also promotes active participation in musical activities that will aid students in applying the skills in later musical experiences

Structural studies of various β-aluminas

This thesis describes results obtained using high resolution electron microscopy, acoustic microscopy and chemical analysis to study the structure and properties of the superionic β-aluminas.The acoustic microscopy and chemical analysis results relate solely to sodium β- and β" -alumina, which are used as the solid state electrolyte in the sodium/sulphur cell. The high resolution electron microscopy results cover sodium β- and β"-alumina as well as a number of ion-exchanged β"-aluminas.The β-alumina structure consists of spinel-like blocks separated by the so-called conduction planes. The conduction planes have a low density, and contain all the mobile cations. Lattice images of sodium β- and β"-alumina, silver β-alumina, ammonium/hydronium β"-alumina, gadolinium β" -alumina and divalent and trivalent europium β" -alumina are presented and discussed.A hitherto unreported long-period structure in sodium β-alumina is shown, as is superlattice ordering in the divalent and trivalent β"-aluminas.Defects in these materials are also discussed. The most common damage mode in the β" -aluminas, due to electron beam irradiation, is the loss of the mobile-ion containing planes, and the subsequent collapse and shear of the structure to form broad defect spinel blocks. It is shown that collapse vectors determined for sodium β"-alumina can also be applied to ammonium/hydronium β"-alumina. Two further damage modes observed in this β"-alumina are also discussed. A damage mode has been observed in sodium B-alumina and silver β-alumina which involves the extrusion of material to the crystal surface. Electron diffraction patterns from the extruded material have been indexed.The acoustic microscope has been used to examine bulk sodium β/β"-alumina electrolyte tube specimens. Images of rectangular features present in the tubes (approximately 40um in length) are presented and the possible nature of the features is discussed