Biomedical subjects

Karen Moody

Publications and source records attributed to Karen Moody.

7 recordsLinked to original sources

PubMed2006

Exploring concerns of children with cancer.

BACKGROUND: Aggressive treatment protocols in pediatric oncology have major effects on the lives of children with cancer. The effects of lifestyle changes such as hospitalization and home schooling on quality of life have not been investigated. This study explores lifestyle effects of cancer therapy on the quality of life of children with cancer. The goals of this study were to identify important quality-of-life issues from the perspectives of children with cancer and to identify how they think their experience with cancer treatment could be improved. MATERIALS AND METHODS: Pediatric oncology patients age 5-21 were interviewed individually. Sample questions included, "Ever since you got sick, what has bothered you the most?" and "How has having this illness affected your life?" Responses were analyzed using standard qualitative techniques. RESULTS: Thirty-one patients were interviewed in depth. Four major themes emerged including (1) loneliness and isolation: the loss of a normal childhood, (2) decreased pleasure from food, (3) physical discomfort and disability, and (4) emotional responses to cancer, specifically anger and fear. Their suggestions for improvement included better-tasting food, more comfortable hospital décor, and social activities with children their own age. CONCLUSIONS: Children cited concerns regarding pleasures taken away as well as pain inflicted due to cancer treatment. In addition to traditionally mentioned side effects, children complained of difficulty enjoying food and restricted social activity. To improve the quality of life of children with cancer, healthcare providers should focus on potentially modifiable variables including food-related pleasure, hospital aesthetics, and social activity.

Adolescent↗

PubMed2006

Maternal residential proximity to waste sites and industrial facilities and oral clefts in offspring.

OBJECTIVE: This study examined the association between oral clefts and maternal residential proximity to waste sites or industries. METHODS: In a case-control study, maternal residences at birth of 1781 births with oral clefts and 4368 comparison births were related to locations of waste sites and industrial facilities in Texas through geographic information systems. RESULTS: Compared with women who lived farther, women who lived within a mile of these sites or facilities were not more likely to have offspring with oral clefts. Among women > or =35 years, oral clefts in offspring were associated with living within a mile of industrial facilities (odds ratio [OR] = 2.4, 95% confidence interval [CI] = 1.3-4.2), especially smelters (OR = 15.0, 95% CI = 2.8-151). CONCLUSION: These findings suggest that maternal residential proximity to industries might be associated with oral clefts in births to older mothers.

Case-Control Studies↗

PubMed2006

Feasibility and safety of a pilot randomized trial of infection rate: neutropenic diet versus standard food safety guidelines.

The neutropenic diet is an intervention that excludes certain foods, especially fresh fruits and vegetables, from the diets of pediatric oncology patients to reduce infection rate. The purpose of this study was to demonstrate a safe and feasible methodology to evaluate the infection rate in pediatric cancer patients randomized to the neutropenic diet or to Food and Drug Administration (FDA)-approved food safety guidelines. Pediatric oncology patients receiving myelosuppressive chemotherapy were randomized to the neutropenic diet or to FDA food safety guidelines and followed through one chemotherapy cycle. The primary outcome was febrile neutropenia. Secondary outcomes were adherence and diet tolerability. Nineteen patients were enrolled. Four patients on each diet arm developed febrile neutropenia. The adherence rate was 94% for the neutropenic diet and 100% for the food safety guidelines. Although patients were able to tolerate both diets, there was more reported difficulty adhering to the neutropenic diet. Infection rates for children with cancer on the neutropenic diet were similar to those for patients following food safety guidelines. The results of this study suggest that a larger randomized trial to determine the effectiveness of food safety guidelines in minimizing the risk of food borne infection is safe and feasible in children with cancer.

Adolescent↗

PubMed2005

Maternal exposure to arsenic, cadmium, lead, and mercury and neural tube defects in offspring.

Arsenic, cadmium, lead, and mercury are neurotoxins, and some studies suggest that these elements might also be teratogens. Using a case-control study design, we investigated the relation between exposure to these heavy metals and neural tube defects (NTDs) in offspring of Mexican-American women living in 1 of the 14 Texas counties bordering Mexico. A total of 184 case-women with NTD-affected pregnancies and 225 control-women with normal live births were interviewed about their environmental and occupational exposures during the periconceptional period. Biologic samples for blood lead and urinary arsenic, cadmium, and mercury were also obtained for a subset of these women. Overall, the median levels of these biomarkers for heavy metal exposure did not differ significantly (P > 0.05) between case- and control-women. However, among women in the highest income group, case-women were nine times more likely (95% confidence interval (CI) 1.4-57) than control-women to have a urinary mercury 5.62 microg/L. Case-women were 4.2 times more likely (95% CI 1.1-16) to report burning treated wood during the periconceptional period than control-women. Elevated odds ratios (ORs) were observed for maternal and paternal occupational exposures to arsenic and mercury, but the 95% CIs were consistent with unity. The 95% CIs of the ORs were also consistent with unity for higher levels of arsenic, cadmium, lead, and mercury in drinking water and among women who lived within 2 miles at the time of conception to industrial facilities with reported emissions of any of these heavy metals. Our findings suggest that maternal exposures to arsenic, cadmium, or lead are probably not significant risk factors for NTDs in offspring. However, the elevated urinary mercury levels found in this population and exposures to the combustion of treated wood may warrant further investigation.

Adult↗

PubMed2002

The neutropenic diet: what's the evidence?

Despite improved survival of children with cancer, opportunistic infections remain a significant cause of morbidity and mortality in this population. Several interventions have been tried to decrease the incidence of infection by reducing patients' exposure to bacteria during neutropenia. The neutropenic diet is one such intervention that was intended to limit the introduction of bacteria into the host's gastrointestinal tract. The only studies evaluating this diet have used this strategy in combination with multiple other interventions, and the independent effect of this diet remains unknown. More research about the neutropenic diet is needed to establish its effectiveness in clinical practice.

Bacterial Translocation↗

PubMedDate not supplied

The public good: regulation of nursing students.

The last decade has seen a number of trends effecting both the quality and quantity of the registered nursing workforce nationwide. Among these are a nursing shortage due to the aging of the nursing workforce and the general population, the resultant increase in the number of nursing students, and an increase in the number of problems with initial licensure based on criminal background checks. State boards of nursing protect citizens by regulating the education, licensure, and practice of registered nurses and licensed practical nurses. Although most jurisdictions conduct a criminal records search for initial licensure and ask candidates about their mental and physical fitness to safely practice the profession, Louisiana has drafted regulations to extend this authority to students upon entry to clinical nursing courses as well as at graduation and application for licensure. This article discusses the need for such regulation and the Louisiana State Board of Nursing initiative to address an increasingly more critical component of licensure, the criminal background check.

Crime↗

PubMedDate not supplied

Linking environmental hazards and birth defects data.

The authors describe methods for linking birth certificate and birth defect registry data to potential environmental hazards and assess potential confounding factors. Cases of selected birth defects from the Texas Birth Defects Registry were linked to their respective birth/ fetal death records. Comparison births were randomly selected from the 1996-2000 Texas birth records. Maternal addresses were related through a geographic information system to boundaries of hazardous waste sites and point locations of industries. Approximately 89% of maternal addresses of case births and 88% of comparison births were successfully related in distance to these sites and industries. Maternal characteristics associated with living within one mile of these sites included belonging to any group besides non-Hispanic white and having lower education attainment (< 16 years) or a residence within the city limits. In linking environmental and health outcome databases, researchers should be aware of factors that may confound associations between exposure and outcomes.

Adult↗