Select TWO of the SDGs that resonates most powerfully with your individual vision and passion? Answer the specific questions for ongoing reflection as
outlined in the chapter 30. For example: SDG1 No poverty the questions for ongoing reflection includes the following:
How do I feel about the poor and economically disadvantaged?
What assumptions and judgments do I make about the poor that will prevent
me from being an effective global nurse?
What are my fears related to poor people?
Which implications of poverty can I alleviate with a nursing sensibility?
Is it my responsibility to address and work for no poverty for all?
What is the first step I can take toward realizing the SDG most important to me? With whom can I partner? When will I do this? How will I evaluate myself?
However, it is important to recognize the potential biases that may hinder my ability to effectively care for patients from different economic backgrounds. Through reflection and self-awareness, I must work hard to challenge any assumptions or judgments about individuals living in poverty that can prevent me from being an effective global nurse. This includes recognizing how privilege has shaped my perspectives on poverty as well as avoiding making generalizations about the individual based on their economic situation.
Rather than viewing those who are economically disadvantaged through broad strokes – such as labeling them ‘poor’ – it is important to take time to get to know each patient individually while taking into consideration their unique cultural backgrounds and personal experiences when providing care. For example, rather than assuming a patient will not be able to afford certain treatments or medications due solely to financial constraints; It is important that nurses become knowledgeable regarding what resources are available (such health insurance options) and make sure they have done all they can do in order to ensure access to quality healthcare services without discriminating against any patient regardless of their socio-economic status (Organization for Economic Co-operation and Development,[OECD], 2019). Furthermore, understanding root causes of poverty such as gender inequality or lack of access to educational opportunities also enables nurses move beyond simply dealing with symptoms towards developing lasting solutions which improve lives directly affected by poverty (World Health Organization [WHO], 2020).
In conclusion, it is essential that global nurses develop empathy while working with those living in poverty while also challenging any existing biases preventing us from providing holistic care which values every individual regardless of their socio-economic background. By drawing upon our own experiences combined with research knowledge we can create meaningful programs which empower communities towards progress instead merely treating symptoms associated with poverty.
How can I use my talents, skills and knowledge to support this SDG?
I can volunteer my time at a local food bank or soup kitchen to help provide meals for those in need. Additionally, I can donate money to organizations that focus on poverty relief.
• What would it look like if everyone was successful in achieving this goal?
If everyone was successful in achieving the goal of ending poverty, then there would be a big decrease in inequality across the world. People who live in poverty would be able to access resources such as education, healthcare, and food which will all contribute towards improving their standard of living. There would also be increased opportunities for employment which could further reduce global poverty rates.
The basic aim of the personalized medicine is applying right therapy to the right population of people by defining disease at the moecular level. So, identifying differences among the individuals support the new treatment methods and pharmaceutical companies to develop new cancer drugs. Patients who have similar clinical outcome and histological tumor type can give different response to the same drug(17). Prediction of who will be a nonresponders reduces the harmfull effect of drug on nonresponders like a potential toxic effect of drug and cost effect. Also when drug companies develop new drug, they focus on the patient population that benefit from drug to increase positive responds(17).
U.S. Food and Drug Administration bringed development about targeted therapy. For example, to treat chronic myeloid leukemia and gastrointestinal stromal tumor(18) ,imatinib mesylate is used and to treat breast cancer(19), trastuzumab (Herceptin) is used. Molecular characteristics of these cancer types that are abnormal protein tyrosine kinase activity in chronic myeloid leukemia and gastrointestinal stromal tumor and HER-2 receptor in breastcancer is used as a predictive biomarker. By using these markers only individuals which have these molecular alteration is selected and it means they are favorable for the treatment. Using this way some cancer types’ survival rate is shifted from 0 to 70%(17).
This application is used in non-small cell lung cancer treatment with using of mutations screeing. In this cancer type mutation occurs in kinase domain of EGFR. Gefitinib (Iressa) and erlotinib are tyrosine kinase inhibitors drug are used to treat and patients give a higher response to the treatment(20). Also if patient that is never smoked Asian females have adenocarcinomas, these drugs efficient on them(21). On the other hand, if the mutatuions occur at downstream effector KRAS, patient is resistant to to erlotinib(22). Also mutations that is at KRAS have a resistance to cetuximab (Erbitux) and panitumumab (Vectibix) drugs in colon cancer patients. If the KRAS is wild type, these these drugs is effective on the patients(23). These responses that are specific and different are based on molecular profile. Some molecular test are done before the using of cetuximab or panitumumab to a colon cancer patient. Lung and colon cancer is concerned with targeted therapy that is guide to patient about treatment by understanding the structure of cancer(24).
Pharmacogenomics and treatment safety
Genes that have genetical variation encode enzymes which metobolize drug, drug transporters, or drug targets. Variation in genes that can predict dose and safety of treatment for different types of cancer patient can have harmful influence on these patients’ treatment(25). For instance, polymorphism where in cytochrome P450 enzymes could cause to metabolite to drug slowly or very fast. So patient give an overdose symptoms or no response to drug by changing the pharmacokinetics of drug metabolism, also it may cause an adverse drug reaction(26). Thereby , forecasting optimal dose of drug , inducing the harmful side effects can be provided by using polymorphism(27). In familial breast cancer, patients shows low survival rate to treatment with tamoxifen that is chemotherapeutic drug because of genetic variation in CYP2D6 that is seen as a poor metabolizer (28). There are some studies abour genetic testing on drug label including test for CYP450 polymorphisms.
Prognosis
Insteaf of using clinicopathologic parameters as a biomarker in biochemical testing for prognosis and selection of therapatic way for cancer patient , Genotyping or gene expression profiling by microarray and protein analysis by mass spectrometry is used for prognostic biomarkers with the understanding of the molecular mechanism of cancer subtypes(29).
Biomarkers can be used alone or with combination of other parameters for classify subgroups according to their risk rate and for leading to therapy decision. For example, tissue microarray analysis with combining molecular and clinical biomarker is more efficient than the clasical cl