Cancer is one of the most prevalent and deadly diseases in the United States today. There are many approaches to treating cancer, but here we focus on biochemotherapy which is a combination of chemotherapy and immunotherapy. The intent of immunotherapy is to boost the body’s natural resistance to cancer which is often repressed by the regulatory branch of the immune system. Here we show that this repression may be overcome by chemotherapy followed closely by immunotherapy. However, giving immunotherapy at the wrong time can may actually promote tumor growth.

The purpose of the current study is to apply the delay and probability discounting in the areas of parent training and probability of success of treatment. There was a total of 31 participants that completed one demographic questionnaire and two probability and delay discounting surveys either via computer or with paper and pencil. Participants had two options in the surveys: one was an immediate reward, and one with a probability delay. The first survey gave scenarios of hours of parent training, the second was a monetary probability discounting survey.

The present study used a discounting task to evaluate how hypothetical treatment outcomes were discounter across successively greater probability values. Two discounting questionnaires were administered to thirty parents, half of which had a child with a disability. Delayed discounting of monetary rewards was assessed in relationship with probability discounting of hypothetical treatment outcomes. The questions on the probability discounting questionnaire consisted of asking participants to choose between a guaranteed percentage of symptom elimination or descending probability to eliminate all of their child’s symptoms. For example, “Which treatment outcome would you prefer for your child? (a) guaranteed elimination of 50% of symptoms or 30% chance to eliminate all symptoms.” Results showed a difference in the levels of discounting across the two groups of participants. Parents of children with disabilities discounted hypothetical monetary rewards more steeply while discounting hypothetical treatment outcomes less steeply compared to parents of children without disabilities. Exponential delay functions provided a strong fit for the monetary delayed function.

Thesis (M.Dev.) --University of Limpopo (Turfloop Campus), 2005 / The aim of this study was to investigate the socio-economic impact of interrupting TB treatment to the families of the TB sufferers and the reasons for patients interrupting treatment. The study was conducted at Mashishimale Village, Ba- Phalaborwa Municipality, Mopani District, Limpopo Province in South Africa. A sample of 35 tuberculosis patients and their family members was drawn from the Mashishimale population. The sample comprised of 17 (49%) males and 18 (51%) females. Self-administered questionnaires were distributed to the participants to complete. The questionnaire elicited demographic information; knowledge about TB, its causes, signs and symptoms, transmission, the reasons for interrupting treatment, and the patients’ coping and support structures. The findings of the study reported that 50% of TB patients are conversant with the signs, symptoms and mode of the spread of TB. However, 43% of the TB patients reported that there was a perception that TB patients are also HIV positive. A further 29% mentioned that there is stigma attached to TB disease. The lack of a Directly Observed Treatment Supporter, poverty and poor nutrition, side-effects of drugs, loss of disability grants, long clinic queues, and traditional healing were some of the reasons cited for the interruption of TB treatment. The interruption of TB treatment had an impact on the socio-economic situation of the family as they often relied on assistance from social grants, other family members and churches.

Estimates of the incidence of child abuse range from 200,000 to 500,000 (Light, 1973) to over one million children each year (O'Brien, 1980). Child abuse is a leading cause of childhood death and injury (Starr, 1979). Demographic studies (e.g., Steele & Pollock, 1968) suggest that parents who abuse their children were often abused or neglected themselves. Therefore, it is reasonable to expect that many of the present victims of abuse will become abusing parents in the future unless the cycle is broken. The need for effective interventions to reduce this pervasive social problem is obvious.

This study involved trialing an operant conditioning procedure known as time-out, as a treatment for adolescents and adults who stutter. Time-out requires individuals to pause briefly after stuttering and to resume talking after a pause in this case, of five seconds. A randomised control group design was used to evaluate the effectiveness of time-out treatment. Sixty participants were randomly assigned to either a time-out treatment or control group. The results demonstrated that individuals who stutter are highly responsive to time-out treatment. The impact of the severity of the stutter, a person's age, previous treatment, and the nature of the stutter on treatment outcome, were also investigated. Baseline severity was a strong predictor of treatment outcome, and to a lesser degree, previous treatment and speech rate were found to share some influence over treatment success. In addition, there was an unexpected change in the stuttering topography over the experiment conditions.

The problem investigated Four studies investigated the phenomenon of cancer-related fatigue (CRF) in women who had received adjuvant treatment for early-stage breast cancer, with a view to reducing the diagnostic uncertainty surrounding the syndrome and thus facilitating progress in both clinical management and aetiological research. Procedures and results A cross-sectional study of 109 women compared a ???cancer-specific??? self-report questionnaire (FACT-F) (canvassing fatigue symptoms) and a more generic questionnaire (SPHERE) (identifying depression and fatigue). Thirty-seven percent of women reported fatigue. Overall in 20%, fatigue was associated with psychological distress. Seventeen percent of women had fatigue but no depression. A qualitative study utilised focus groups to identify and compare the distinctive features of CRF with those of women with chronic fatigue syndrome (CFS). A similar set of symptoms was found in both groups, including overwhelming fatigue, un-refreshing sleep and subjective concentration problems. However, women with CFS also reported myalgia and arthralgia. Using the Structured Clinical Interview for Neurasthenia- SCIN, the third study compared the symptoms of three groups of women with fatigue: those with CRF, CFS or major depression. The detailed ???interviewer guide??? provided explicit directions for evaluating and classifying symptoms. This study confirmed the core symptom of ???profound fatigue unrelieved by rest???, and additional features that distinguished between the clinical diagnoses. The fourth study compared features of the evolution of clinically-identified fatigue syndromes in women from two prospective cohort studies; women with post-cancer fatigue (PCF) and women with post-infective fatigue syndrome (PIFS). Major conclusions A syndrome of PCF, present at least six months following adjuvant treatment and unexplained by medical or psychiatric disorder was investigated. The characteristics of PCF and those of CFS are very similar, with the fatigue state having indistinguishable descriptors. Longitudinal evaluation of the symptom complexes of PCF and PIFS suggests divergent pathways may be relevant. Co-morbid features like sleep disturbance; physical deconditioning and mood disturbance may be implicated as factors in the evolution and prolongation of PCF. These studies provide a basis for a more uniform and rigorous classification system - a necessary first step towards advancing the field both in investigating aetiology and new intervention strategies.

Methadone is the foremost, long-standing pharmacological treatment for opioid addiction. It has been shown to have considerable cost benefit to the community and to decrease mortality. Despite methadone's decades-long use, much is still unknown regarding its clinical pharmacology, particularly during the induction phase of Methadone Maintenance Treatment (MMT). Contrary to previous reports, I found systemic methadone clearance does not increase significantly between induction and steady state phases of MMT, and did not approach the previously reported 3-fold increase. Clinical dose prescription based on the premise of metabolism auto-induction could increase risk of respiratory depression. Significant differences between R- and S-methadone pharmacokinetics showed the importance of stereoselective measurement in a clinical situation and significant plasma concentration-effect relationships demonstrated their potential influence on induction pharmacodynamics. Small increases in CYP3A4 activity as measured by the Erythromycin Breath Test from Day 1 to Day 40 of MMT were not correlated with changes in methadone clearance. CYP3A4 activities were informative but would be insufficient for use as a sole predictor of methadone clearance during MMT. Clinically significant respiratory depression occurred in 20% of subjects, at times of peak plasma R-methadone concentrations, after reports of withdrawal symptoms at pre-dose sampling times, and irrespective of illicit opioid use. Utilisation of both respiratory rate and blood oxygen saturation measurements provided a good indication of respiratory risk for individuals. Although prior opioid use was a strong predictor of continued use during MMT, adoption of a new equation ("abc") and comprehensive documentation of each individual's MMT may increase prediction of MMT success. Even in light of recent advances in opioid substitution therapies, MMT's advantages ensure it is still at the forefront of addiction treatment. Careful choice of methodology enabled narrowing of this investigation to those factors most relevant in methadone pharmacology and most responsible for MMT success or failure, and therefore extending previous knowledge of this area. Such data might be utilised to develop a clinically applicable model for MMT, and help provide clients with a safe and uncomplicated transition from heroin use to methadone induction in the future. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1269301 / Thesis (Ph.D.) -- School of Medical Sciences, 2007

The aim of this study was to investigate COX-2 expression in squamous cell carcinoma of the oesophagus (SCC), and the potential of non-steroidal anti-inflammatory drugs, which inhibit the action of the enzyme, for chemoprevention of this cancer. The epidemiology of SCC and the outcome from surgery for this disease in Hebei Province, China, were reviewed. The rate of postoperative complications and deaths following oesophagectomy fell steadily over the last five decades, but the long-term survival remained disappointing. Improved survival is likely to be dependent on earlier diagnosis and better adjunctive therapies. Tissue was obtained from patients who had an oesophagectomy for SCC over 20 years earlier. The expression of COX-2 was elevated and correlated with TNM stage and lymph node metastases. Survival was longer in those patients whose tumours expressed lower levels of COX-2. The mechanism of action of aspirin, a non-selective COX inhibitor, and NS-398, a selective COX-2 inhibitor, was investigated in vitro. Both drugs inhibited the proliferation of and induced apoptosis in the SCC cell line TE-13. These changes correlated with a reduction in COX-2 mRNA and protein expression, prostaglandin synthesis, inhibition of NF-KappaB nuclear translocation and an increase in cytoplasmic IKappaB. Similar changes were seen in tumour tissue resected from patients given the selective COX-2 inhibitor Mobic daily for 14 days before surgery. These results suggested that aspirin and similar drugs might have value in cancer therapy. A clinical trial was established to determine if treatment with aspirin post-operatively would improve survival of patients who had had an oesophagectomy for SCC. Preliminary results suggested that treatment had no effect on survival in patients operated on for SCC. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1289296 / Thesis (Ph.D.) -- University of Adelaide, School of Medicine, 2007

Electrocoagulation is an empirical (and largely heuristic) water treatment technology that has had many different applications over the last century. It has proven its viability by removing a wide range of pollutants. The approach to reactor design has been haphazard, however, with little or no reference to previous designs or underlying principles. This thesis reviewed these reactor designs, identifying key commonalities and synthesising a new design hierarchy, summarised by three main decisions: 1. Batch or continuous operation; 2. Coagulation only or coagulation plus flotation reactors, and; 3. Associated separation process if required. This design decision hierarchy thereby provides a consistent basis for future electrocoagulation reactor designs. Electrochemistry, coagulation, and flotation are identified as the key foundation sciences for electrocoagulation, and the relevant mechanisms (and their interactions) are extracted and applied in an electrocoagulation context. This innovative approach was applied to a 7 L batch electrocoagulation reactor treating clay-polluted water. Structured macroscopic experiments identified current (density), time, and mixing as the key operating parameters for electrocoagulation. A dynamic mass balance was conducted over the batch reactor, for the first time, thereby enabling the extraction of a concentration profile. For this batch system, three operating stages were then identifiable: lag, reactive, and stable stages. Each stage was systematically investigated (in contrast to the previous ad hoc approach) with reference to each of the foundation sciences and the key parameters of current and time. Electrochemical behaviour characterised both coagulant and bubble generation. Polarisation experiments were used to determine the rate-limiting step at each electrode�s surface. Consequently the appropriate Tafel parameters were extracted and hence the cell potential. At low currents both electrodes (anode and cathode) operated in the charge-transfer region. As the current increased, the mechanism shifted towards the diffusion-limited region, which increased the required potential. Polarisation experiments also define the operating potential at each electrode thereby enabling aluminium�s dissolution behaviour to be thermodynamically characterised on potential-pH (Pourbaix) diagrams. Active and passive regions were defined and hence the aluminium�s behaviour in an aqueous environment can now be predicted for electrocoagulation. Novel and detailed solution chemistry modelling of the metastable and stable aluminium species revealed the importance of oligomer formation and their rates in electrocoagulation. In particular, formation of the positively trimeric aluminium species increased solution pH (to pH 10.6), beyond the experimentally observed operable pH of 9. Thereby signifying the importance of the formation kinetics to the trimer as the active coagulant specie in electrocoagulation. Further leading insights to the changing coagulation mechanism in electrocoagulation were possible by comparison and contrast with the conventional coagulation method of alum dosing. Initially in the lag stage, little aggregation is observed until the coagulant concentration reaches a critical level. Simultaneously, the measured zeta potential increases with coagulant addition and the isoelectric point is attained in the reactive stage. Here a sorption coagulation mechanism is postulated; probably charge neutralisation, that quickly aggregates pollutant particles forming open structured aggregates as indicated by the low fractal dimension. As time progresses, pollutant concentration decreases and aluminium addition continues hence aluminium hydroxide/oxide precipitates. The bubbles gently sweep the precipitate through the solution, resulting in coagulation by an enmeshment mechanism (sweep coagulation). Consequently compact aggregates are formed, indicating by the high fractal dimension. Flotation is an inherent aspect of the batch electrocoagulation reactor via the production of electrolytic gases. In the reactor, pollutant separation occurs in situ, either by flotation or settling. From the concentration profiles extracted, original kinetic expressions were formulated to quantify these competing removal processes. As current increases, both settling and flotation rate constants increased due to the additional coagulant generation. This faster removal was offset by a decrease in the coagulant efficiency. Consequently a trade-off exists between removal time and coagulant efficiency that can be evaluated economically. A conceptual framework of electrocoagulation is developed from the synthesis of the systematic study to enable a priori prediction. This framework creates predictability for electrocoagulation, which is innovative and original for the technology. Predictability provides insights to knowledge transfer (between batch and continuous), efficient coagulant and separation path, to name just a few examples. This predictability demystifies electrocoagulation by providing a powerful design tool for the future development of scaleable, industrial electrocoagulation water treatment design and operation process.