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Hope is significant to cancer patients in their struggle to find meaning in life as they adapt to the disease and its treatment. The purpose of this study was to test the effectiveness of a nurse telephone intervention to maintain hope and reduce symptom distress in chemotherapy patients. A conceptual framework, based on the hope models of Herth (1989) and Morse and Doberneck (1995), guided the study. Patient needs and resources were appraised using a Hope Assessment Guide (Penrod & Morse, 1997) that focused on behaviors related to coping with symptom distress, achieving goals, and mobilizing internal and external resources to maintain hope. A two-group randomized experimental design was used to test the effects of a nursing telephone intervention on hope and symptom distress in cancer patients (n = 100) receiving chemotherapy for the first time. Repeated measures of hope and symptom distress were made before the start of chemotherapy (baseline) and four times during the first two cycles of treatment. Mood states were measured at baseline and at expected nadir after the second cycle of chemotherapy. A total of three phone calls were made to each participant: those in the intervention group received a structured call from a nurse and those in the control group received brief reminder calls from a non-nurse. Hope was measured by the Herth Hope Index and Hope Visual Analog Scale, mood states by the brief Profile of Mood States, and symptom distress by the Symptom Distress Scale. Data were analyzed by descriptive statistics, t-test, Cronbach's alpha and analysis of variance. Patients in the telephone intervention group did not experience any statistically significant changes in either levels of hope or symptom distress compared to the control group. In addition, baseline measures of hope, symptom distress and positive mood states were significantly correlated in all subjects in the study. Because of study limitations, this correlation did not hold up over the course of treatment. A significant relationship was found between reduced symptom distress and positive mood states in all subjects of the study over two cycles of chemotherapy. These findings suggest that two measures of quality of life (mood state and symptom distress) were improved. Study results indicate a need to explore both hope-inspiring strategies and the management of symptom distress as mediators for enhancing quality of life in chemotherapy patients. Additional randomized testing in a larger sample of cancer patients is recommended. Further studies should also focus on the potential of meaningful nursing telephone interventions to improve health outcomes during chemotherapy treatment.

As the underlying cause of Glioblastoma Multiforme (GBM) is presently unclear, this research implements a new approach to identifying and segmenting plausible instances of GBM prior to critical mass. Grade-IV Astrocytoma, or GBM, is an aggressive and malignant cancer arising from star-shaped glial cells, or astrocytes, where the astrocytes, functionally, assist in the support and protection of neurons within the central nervous system and spinal cord. Subsequently, our motivation for researching the ability to recognize GBM is that the underlying cause of the mutation is presently unclear, leading to the operative that GBM is only detectable through a combination of MRI and CT brain scans, cooperatively, along with a resection biopsy. Since astrocytoma only becomes evident at critical mass, when the cellular structure of the neoplasm becomes visible within the image, this research seeks to achieve earlier identification and segmentation of the neoplasm by evaluating the malignant area via a volumetric voxel approach to removing noise artifacts and analyzing voxel differentials. In order to investigate neoplasm continuity, a differential approach has been implemented utilizing a multi-polynomial/multi-domain regression algorithm, thus, ultimately, providing a graphical and mathematical analysis of the differentials within critical mass and non-critical mass images. Given these augmentations to MRI and CT image rectifications, we theorize that our approach will improve on astrocytoma recognition and segmentation, along with achieving greater accuracy in diagnostic evaluations of the malignant area.

Prostate cancer is the second highest cause of cancer related deaths among men. According to the diagnostic pathway for prostate cancer, a prostate biopsy is performed if an individual showed signs of lesions through high prostate-specific antigen (PSA) concentration or suggestive digital rectal exam (DRE) results. The core biopsy mechanism involves inserting a beveled needle into the organ and removing a cylindrical fragment of tissue. Many factors affect the histological quality of the sample, including fragmentation, needle deflection, and needle insertion velocity. If a biopsy core is not clinically viable, an alternative core will need to be taken, resulting in increased patient trauma and potential risk of infection. Many of these relevant factors are impacted by sources of friction in the system. Prior studies have examined methods of decreasing the friction of the interactions between different components of the biopsy system to reduce the negative effects on histological sample quality. While scenarios have been explored that examine reducing the friction between the needle and tissue through sharpening and polishing techniques, the friction introduced by the needle guide in template guided core prostate biopsies has not been analyzed in the decades since its development. This study aims to introduce the biopsy guide as an additional source of friction which can be optimized to reduce friction force, while proposing and testing several configurations of the needle guide that would reduce the friction force of the system. A Finite Element Analysis (FEA) was conducted using SIMULA Abaqus modeling software, and the simulation was correlated with a derived equation that estimated friction force according to material properties. The study demonstrated that configurations for the internal surface of the needle guide which provided decreased contact surface compared to the control needle guide resulted in lower friction force between the needle and guide. Conditions which had contact points oriented parallel to the direction of insertion had the lowest recorded friction force. This suggests that the traditional biopsy needle guide may be optimized to introduce less friction force by reducing the contact area between the needle and guide inner surface. This has application in reducing the number of passes required to obtain a histologically viable core specimen, and therefore reducing the opportunity for patients to develop infection.