Exploring Occupational Disruption in Newly Diagnosed Individuals with Cancer with Minor (Dependent) Children

Background: According to the American Cancer Society (2019), there were more than 1.7 million new cases of cancer in 2019 alone. Individuals are being diagnosed at a young age with 22.4% of cases occurring in individuals 22-55 years old and whom are childrearing age (Shah et al., 2017). There are an estimated 2.85 million children under the age of 18 who are living with a parent who has cancer (Shah et al., 2017). Newly diagnosed individuals face changes in daily life, the threat of possible death, and fear of dying (Compas et al., 1994). Changes in shared family roles can impact the entire family across many domains (Heiney et al., 1997; Helseth & Ulfsæt, 2005). Newly diagnosed individuals develop secondary psychosocial symptoms that impact the parenting roles and face challenges maintaining routines in the home (Kim et al., 2006; Smith et al., 2005). The purpose of this project is to further explore the impact of a cancer diagnosis and subsequent treatment on the individual and their family. This project also aims to investigate the role of occupational therapy in integrative therapy services. Methods: This project took place at the Knight Cancer Institute which is part of a large hospital: Oregon Health and Science University (OHSU) in Portland, Oregon. Needs assessment consisted of three parts: a survey to intended population, in-depth interviews with two participants using a modified version of the Occupational Circumstance Assessment and Rating Form (OCAIRS), and in-depth interviews with current instructors of the integrative therapy program. Results: Of the 10 survey respondents, eight were pre-treatment or in treatment. Of those participants, 87.5 reported their daily routine impacted by pain or fatigue. OCAIRS interviews revealed three common themes: Roles in the family became blended, independently sought additional care, and mindfulness as a strong coping tool. In-depth interviews with instructors developed common themes: Impact of cancer diagnosis and treatment, need to provide education on integrative therapies, programs typically accessed after treatment, and the value of in-home services. Discussion: Results from the survey suggest psychosocial symptoms develop at diagnosis and continue through treatment. There is a need to provide services in the home environment for parents to address psychosocial symptoms during their cancer treatment and additional resources to support their roles and responsibilities as parents of minor (dependent) children. Occupational therapists have an important role in integrative medicine within the home environment. To address psychosocial symptoms secondary to cancer, an occupation-based home program will be offered to the newly diagnosed parents at the Knight Cancer Institute. “Healing at Home” is a program guided by the occupational therapist in the natural setting of the family

Optovibrometry: tracking changes in the surface tension and viscosity of multicomponent droplets in real-time

An instrument was developed for measuring real time changes in the surface tension and viscosity of multicomponent droplets of miscible liquids and other soft materials. Droplets containing glycerol and water were supported on superamphiphobic surfaces and vibrated by applying a short mechanical impulse. Laser light was refracted through the droplets and allowed to fall on the surface of a photodiode. Time dependent variations in the intensity measured by the photodiode during vibration were used to monitor the decay of the droplet oscillations. The frequencies and spectral widths of the droplet vibrational resonances were then obtained from Fourier transforms of these time dependent intensity signals. A recently developed model of viscoelastic droplet vibration was used along with these values and measurements of the drop dimensions to extract the surface tension and viscosity of the drops as they evaporated. Collection of data was automated and values of frequency, spectral width, drop size, surface tension and viscosity were obtained with a time resolution of three seconds over a period of thirty minutes. The values of surface tension and viscosity obtained were shown to be in good agreement with literature values obtained from bulk glycerol/water solutions; thus validating the technique for wider application to other multicomponent liquids and soft matter systems

Differences in parental feeding styles and practices and toddler eating behaviour across complementary feeding methods: Managing expectations through consideration of effect size

Nutritional experiences during infancy and toddlerhood influence the development of healthy eating habits later in life. Interest into solid food introduction practices has experienced resurgence due to the popularization of the baby-led weaning (BLW) approach as an alternative to more traditional parent-led weaning (PLW) practices. Although the literature shows beneficial effects of BLW on eating behaviours, the magnitude of those effects is unknown making parental expectation management challenging. This study provides an estimation of the size of the difference between the solid feeding practices groups for a variety of practices consistent with the development of healthy food preferences and behaviours.565 participants with infants between 12 and 36 months old completed a survey concerning their preferred parental feeding styles, parental feeding practices, sources of information on feeding and toddler's eating behaviour. Participants were categorised to one of four groups reflecting the level of infant self-feeding level a month after the introduction of solid food (Strict PLW, Predominant PLW, Predominant BLW and Strict BLW).Estimated effect sizes of the observed significant differences showed that the magnitude of effects was modest to minimal. Moderate effect sizes were observed in comparisons regarding breastfeeding duration, maternal feeding practices, sources of information and types of first food given to the infants at the beginning of solid feeding introduction. When it comes to toddlers’ eating behaviour and the family food environment, although some differences were statistically significant, the effect sizes were very small. Considering the long-lasting impact of food preferences developed at this stage along with the stress surrounding infant feeding decisions, it is crucial that the complementary feeding advice parents receive reflects realistic expectations of the outcomes regarding the effects on eating behaviour

Exploring Occupational Disruption in Newly Diagnosed Individuals with Cancer with Minor (Dependent) Children

Background: According to the American Cancer Society (2019), there were more than 1.7 million new cases of cancer in 2019 alone. Individuals are being diagnosed at a young age with 22.4% of cases occurring in individuals 22-55 years old and whom are childrearing age (Shah et al., 2017). There are an estimated 2.85 million children under the age of 18 who are living with a parent who has cancer (Shah et al., 2017). Newly diagnosed individuals face changes in daily life, the threat of possible death, and fear of dying (Compas et al., 1994). Changes in shared family roles can impact the entire family across many domains (Heiney et al., 1997; Helseth & Ulfsæt, 2005). Newly diagnosed individuals develop secondary psychosocial symptoms that impact the parenting roles and face challenges maintaining routines in the home (Kim et al., 2006; Smith et al., 2005). The purpose of this project is to further explore the impact of a cancer diagnosis and subsequent treatment on the individual and their family. This project also aims to investigate the role of occupational therapy in integrative therapy services. Methods: This project took place at the Knight Cancer Institute which is part of a large hospital: Oregon Health and Science University (OHSU) in Portland, Oregon. Needs assessment consisted of three parts: a survey to intended population, in-depth interviews with two participants using a modified version of the Occupational Circumstance Assessment and Rating Form (OCAIRS), and in-depth interviews with current instructors of the integrative therapy program. Results: Of the 10 survey respondents, eight were pre-treatment or in treatment. Of those participants, 87.5 reported their daily routine impacted by pain or fatigue. OCAIRS interviews revealed three common themes: Roles in the family became blended, independently sought additional care, and mindfulness as a strong coping tool. In-depth interviews with instructors developed common themes: Impact of cancer diagnosis and treatment, need to provide education on integrative therapies, programs typically accessed after treatment, and the value of in-home services. Discussion: Results from the survey suggest psychosocial symptoms develop at diagnosis and continue through treatment. There is a need to provide services in the home environment for parents to address psychosocial symptoms during their cancer treatment and additional resources to support their roles and responsibilities as parents of minor (dependent) children. Occupational therapists have an important role in integrative medicine within the home environment. To address psychosocial symptoms secondary to cancer, an occupation-based home program will be offered to the newly diagnosed parents at the Knight Cancer Institute. “Healing at Home” is a program guided by the occupational therapist in the natural setting of the family.https://soar.usa.edu/otdcapstonespring2020/1020/thumbnail.jp

The Emotional and Practical Experiences of Formula-Feeding Mothers

The majority of infant‐feeding research is focused on identifying mother's reasons for the cessation of breastfeeding. The experience of mothers who choose to use formula is largely overlooked in quantitative designs. This study aimed to describe the emotional and practical experiences of mothers who formula feed in any quantity, and examine whether these experiences would vary among different cohorts of formula‐feeding mothers according to prenatal feeding intention and postnatal feeding method. A total of 890 mothers of infants up to 26 weeks of age, who were currently formula feeding in any quantity, were recruited through relevant international social media sites via advertisements providing a link to an online survey. Predictors of emotional experiences included guilt, stigma, satisfaction, and defense as a result of their infant feeding choices. Practical predictor variables included support received from health professionals, respect displayed by their everyday environment, and main sources of infant feeding information. Descriptive findings from the overall sample highlighted a worryingly high percentage of mother's experienced negative emotions as a result of their decision to use formula. Multinomial logit models revealed that negative emotions such as guilt, dissatisfaction, and stigma were directly associated with feeding intention and method. The evidence suggests that the current approach to infant‐feeding promotion and support may be paradoxically related to significant issues with emotional well‐being. These findings support criticisms of how infant‐feeding recommendations are framed by health care professionals and policy makers, and highlight a need to address formula feeding in a more balanced, woman‐centered manner

Clinical review: Early patient mobilization in the ICU

Early mobilization (EM) of ICU patients is a physiologically logical intervention to attenuate critical illness-associated muscle weakness. However, its long-term value remains controversial. We performed a detailed analytical review of the literature using multiple relevant key terms in order to provide a comprehensive assessment of current knowledge on EM in critically ill patients. We found that the term EM remains undefined and encompasses a range of heterogeneous interventions that have been used alone or in combination. Nonetheless, several studies suggest that different forms of EM may be both safe and feasible in ICU patients, including those receiving mechanical ventilation. Unfortunately, these studies of EM are mostly single center in design, have limited external validity and have highly variable control treatments. In addition, new technology to facilitate EM such as cycle ergometry, transcutaneous electrical muscle stimulation and video therapy are increasingly being used to achieve such EM despite limited evidence of efficacy. We conclude that although preliminary low-level evidence suggests that EM in the ICU is safe, feasible and may yield clinical benefits, EM is also labor-intensive and requires appropriate staffing models and equipment. More research is thus required to identify current standard practice, optimal EM techniques and appropriate outcome measures before EM can be introduced into the routine care of critically ill patients

Measurements of tidal flow variability in Ramsey Sound, Pembrokeshire

The nature of the flow at in-stream tidal energy sites is particularly important for predicting array and device performance, and also for operations and maintenance planning. Previous developers have reported issues such as the choice of vessel, cost of operations, and the limits of operation of deployment vessels. The dynamics of the flow around slack water has been of particular interest at Ramsey Sound in Pembrokeshire (UK) for planning the recovery of an existing turbine, the Tidal Energy Limited ‘Deltastream’. This research presents flow characteristics of Ramsey Sound, based on analysis of Acoustic Doppler Current Profiler (ADCP) measurements and tide gauge data from the nearby Standard Port of Milford Haven. The ADCP was located approximately 300 m across the channel, at the northern end of the channel, where the channel width was 1200 m and the mean depth was approximately 33 m. The flow dynamics were examined specifically to look at times potentially suitable for offshore operations Two weeks of data were used in the analysis, spanning a complete spring-neap cycle. Results demonstrate that flow velocities exhibited clear asymmetry, with stronger flows on the northerly directed flood tide than on the ebb. There was considerable variation in the measured current speed around the time of the maximum, suggesting large scale bed feature generated turbulence. The flood (northerly) current maximum was approximately in phase with high water at Milford Haven. Cross correlation indicated that the flow generally led the elevation by 20 minutes. In contrast to the expected theory, the current strength at mid-depth was stronger than at the surface on the maximum flood tide. The maximum flow speed in the tide was reasonably predictable from the tide range at Milford. A threshold-based analysis of the ADCP measurements allowed the duration of slow-moving water to be identified for operation planning. Operations and planning in light of sound understanding of hydrodynamics at tidal energy sites is critical for future economic success of the tidal energy sector. The results shown here from an ADCP deployment in Ramsey Sound have shown the capability to give useful tools for planning recovery operations

Discovery of an ultramassive pulsating white dwarf

We announce the discovery of the most massive pulsating hydrogen-atmosphere (DA) white dwarf (WD) ever discovered, GD 518. Model atmosphere fits to the optical spectrum of this star show it is a 12,030 +/- 210 K WD with a log(g) = 9.08 +/- 0.06, which corresponds to a mass of 1.20 +/- 0.03 Msun. Stellar evolution models indicate that the progenitor of such a high-mass WD endured a stable carbon-burning phase, producing an oxygen-neon-core WD. The discovery of pulsations in GD 518 thus offers the first opportunity to probe the interior of a WD with a possible oxygen-neon core. Such a massive WD should also be significantly crystallized at this temperature. The star exhibits multi-periodic luminosity variations at timescales ranging from roughly 425-595 s and amplitudes up to 0.7%, consistent in period and amplitude with the observed variability of typical ZZ Ceti stars, which exhibit non-radial g-mode pulsations driven by a hydrogen partial ionization zone. Successfully unraveling both the total mass and core composition of GD 518 provides a unique opportunity to investigate intermediate-mass stellar evolution, and can possibly place an upper limit to the mass of a carbon-oxygen-core WD, which in turn constrains SNe Ia progenitor systems.Comment: 5 pages, 3 figures, Astrophysical Journal Letters, 771, L2 (2013