Scientific and Mathematical/Analytical Perspectives of Inquiry Paper

Working Title: STROKES, STEM CELLS, AND SCIENCE 1

A Study of the Problems with Strokes and a Potential Solution

Tye Arnett

West Coast University

STROKES, STEM CELLS, AND SCIENCE 2

Abstract

Strokes are a deadly and common disease for adults worldwide. The objective of this paper is to

give a brief explanation about the types of strokes, how the economic and social aspects affect a

person, and the statistics related to this condition. This analysis of the condition will show the

gravity of the situation and the significance of stem cell therapy used to treat neurological

damage should become clear. Stem cell therapy is still in the early stages of human testing but is

one of the only treatments shown to be effective in reversing neurological damage. Ethical

questions regarding human testing and stem cell research have played a part in slowing down

progress in finding a cure for strokes.

STROKES, STEM CELLS, AND SCIENCE 3

A Study of the Problems with Strokes and a Potential Solution

Strokes are a serious medical condition that has turned into a worldwide health concern.

Being one of the most common and fatal health problems in adults, it is a condition that needs to

receive more attention. The primary issue with strokes is that there is no way to treat the brain

damage it causes. The high mortality rate associated with strokes is in large part due to this

irreversible brain damage. With no real cure for this condition available, treatment focuses on

prevention and early detection which is not an ideal solution. More research needs to be done on

reversing the damage done by a stroke in order to reduce the risk associated with this disease.

Fortunately, stem cell treatment, an experimental treatment in the early stages of human trials,

has been shown to do just that. By making this experimental treatment more available to

volunteers, more data will be able to be gathered in a shorter amount of time leading to a cure

being found faster. Unfortunately, there are some ethical questions associated with loosening

regulations associated with human testing that may potentially delay the release of such a

revolutionary treatment.

An Overview of and Stem Cell Therapy

A stroke is a condition in which blood flow to part of the brain has been cut off or is

insufficient. This reduced blood flow is usually caused by a blockage or rupture of a blood vessel

in the brain and results in the death of brain cells due to lack of oxygen. Although the general

concept of a stroke is fairly simple, the pathophysiology of it is quite complex. The type of

stroke, the size of the affected area, and the location of the blockage all play a part in the

manifestation of the stroke and its treatability. Unfortunately, the brain damage resulting from a

stroke is always permanent. Some patients may be fortunate enough to recover without too many

lasting problems, others may be forever crippled. There is no cure available for stroke patients

STROKES, STEM CELLS, AND SCIENCE 4

and treatment focuses on prevention and minimization of damage. Although there is currently

no cure for brain damage, the experimental field of stem cell research has had promising results

in this area.

Strokes are categorized as either ischemic or hemorrhagic. Ischemic strokes are a result

of blockage of the blood supply to the brain. Ischemic strokes are by far the most common type

of stroke accounting for 87% of all stroke cases and is usually caused by a clot in an artery

(Benjamin et al., 2017, p. 159). The reduced blood flow causes a lack of oxygen in the brain

resulting in cell death. The blockage is usually located in the brain but can also be located

somewhere else in the body. Lack of oxygen quickly causes cell damage meaning that the

longer the blockage is in place, the more extensive the damage will become.

Hemorrhagic strokes are the result of a blood vessel rupture within the brain. According

to the American Heart Association, hemorrhagic strokes tend to be more fatal and severe than

their ischemic counterpart since the damage from a hemorrhagic stroke is threefold (p.280). In

addition to the rupture stopping the supply of blood to parts of the brain, the rupture causes blood

to spray out onto the surrounding brain tissue. Blood is toxic to brain tissue meaning that the

blood spilling out from the rupture kills the brain cells that come into contact with it. Thirdly,

the leaking of blood from a hemorrhagic stroke also leads to swelling inside the skull which puts

pressure on the brain resulting in further damage (Benjamin et al., 2017, p. 159).

While there is currently no cure or treatment for the brain damage resulting from a stroke,

studies in the stem cell field have had promising results in reversing the brain damage. Stem

cells are immature cells that have the ability to transform into different types of specialized cells.

This is significant since stem cells are able to transform into cells that do not normally regenerate

such as bone marrow, neurons, or brain cells. Stem cell therapy is still in the experimental stage

STROKES, STEM CELLS, AND SCIENCE 5

of development but the treatment usually involves a transplant of stem cells into the problem

area. Ischemic stroke patients have been shown to be particularly responsive to this

experimental form of treatment. The results from a clinical trial conducted in 2013 suggest that

the extra complications associated with the internal bleeding is the reason why this treatment is

less effective in subjects that experienced a hemorrhagic stroke (Bhasin et al., 2013). This

results from this trial supports evidence that this treatment can reverse some of the brain damage

by regenerating brain cells which was previously impossible to do (p.1007). Since the

disabilities associated with having a stroke are neurological in nature, the regeneration of the

damage areas of the brain allows for a faster and more complete recovery for the patient.

Analysis of Strokes and Stem Cell Treatment

Despite the staggering speed of advancement of medical technology, strokes continue to

be a problem for society. It is still a leading cause of death amongst adults and no treatment

exists for fixing the neurological damage caused by the stroke. Some affected patients may be

lucky and the damage causes minimal interference with day to day life, others will be

permanently disabled, having difficulty doing the simplest of tasks. The cost of living with such

a disability adds up further burdening these people. Swift administration of aid and early

detection can minimize or prevent the potential damage but too many factors exist when dealing

with a stroke and the chances of surviving one unscathed are less than ideal. Because of this, it

may be beneficial to look towards new and experimental treatment options. One particularly

promising solution is stem cell treatment. The ability to treat stroke-caused neurological damage

would help lower the increased cost of living and reduce the danger associated with having a

stroke.

STROKES, STEM CELLS, AND SCIENCE 6

Strokes are a significant cause of death and disability amongst adults worldwide. It is the

third most common cause of death and kills an estimated 160,000 people annually (Benjamin et

al., 2017, p. 160). This number does not take into account those who are permanently disabled

as a result of having a stroke. Stroke patients have extremely low chances of making a full

recovery and no current treatment exists that reverses the neurological damage resulting from the

stroke. The cost of treatment for an ischemic stroke can varies depending on the treatment

method. If the clot can be broken apart using medication, treatment costs roughly $6,000

however brain surgery to remove a brain embolism can cost anywhere between $11,000-$42,000

(Wang, et al., 2014). These prices do not account for the other additional cost associated with

the hospital visit. The cost of staying room (usually 8 days minimum), MRI and blood tests,

doctor examination, and drugs administered can easily cost as much as the actual brain surgery

(Wang, et al., 2014). If the patient survives and manages to pay almost $100,000 in medical

bills, they will likely still have to deal with the additional cost of living associated with living

with neurological damage. According to a study conducted in 2014, the cost of living for

permanently disabled stroke patients increases 20-fold when compared to the average US citizen

(Wang et al.).

When looking at the long-term effects of a stroke, the outcome is both positive and

negative. According to a study by Smajlović, Kojić, and Sinanović (2006), the survivability of a

stroke after 5 years was 31% for ischemic stroke patients and 24% for hemorrhagic stroke

patients. While it is true that this study is slightly dated, long-term case studies are not published

very often and this study serves as a good reference point for the long-term outlook for stroke

patients. According to a 2010 audit done by the Royal College of Physicians (2011), of the

patients that survive a stroke, 58% suffer some form of mental or physical disability, the most

STROKES, STEM CELLS, AND SCIENCE 7

common being some form of movement difficulty (Henssge et al., p.43). While these statistics

may seem bleak, both short-term and long-term survivability are significantly affected by the

amount of time between the manifestation of the first symptoms and the administration of

treatment. According to the American heart association (2017), patients who received treatment

within the first 3 hours of the onset of symptoms were much less likely to be disabled and more

likely to recover from their disabilities. Unfortunately, they also noted that only 38% of people

were aware of the symptoms and the proper action to take (Benjamin et al., 2017, p. 159).

Fortunately, experimental treatment using stem cells may potentially be the solution.

According to by Smajlović, Kojić, and Sinanović (2006), the high mortality rate in stroke

patients within the first 5 years of having a stroke is a result of medical and neurological

complications that occur as a result (p.20). It can be reasoned that some form of treatment that

could reverse the neurological damage caused by a stroke would not only have the potential to

reduce the severity of the related disabilities but also slower the mortality rate associated with

this disease. While stem cell treatment is still in the early stages of human testing, the results are

promising. A clinical trial conducted in 2013 studied the effect of stem cell transplant in

ischemic stroke patients (Bhasin et al.). This study observed a 33% increase in movement

functionality and recovery in the patients given the transplant (p.5). Additionally, various studies

have shown that this transplant is not only safe, it also had no observable adverse side effects

according to a meta-analysis done in 2017 (Nagpal et al.). It is too early to objectively say that

this can be a new form of stroke treatment; larger scale trials need to be conducted and more time

needs to pass to study potential long-term effects. However, stem cell implants could be the

solution to treating the neurological damage that makes a stroke so problematic.

STROKES, STEM CELLS, AND SCIENCE 8

Despite being such a common disease, strokes continue to be untreatable and deadly.

With no current cure for the neurological damage resulting from a stroke, little can be done for

those already affect. These individuals have a drastic increase in their cost of living from their

medical bills and from the added the cost that comes from living with a disability. Although still

in the early stages of human testing, stem cell therapy has been shown to reverse some to the

neurological damage. It is too early to objectively say how effective stem cell treatment will be

in treating stroke patients. Stem cell research is still a relatively new field and as a result, only a

handful of small scale clinical trials have been done over the past decade. That being said, this

type of treatment could potentially be used to treat a wide variety of neurological and muscular

diseases. Having a stroke will most likely never be risk-free but through the use of stem cell

treatment it may be possible to minimize the risk of having one.

Stroke Culture, Stem Cells, and Ethics

Strokes have become a global issue and part of the reason is due to the work and social

cultures of society. Although it is true that strokes become more common with age, there are

many risk factors that will increase the likeliness that a stroke will occur. Constant stress and

certain lifestyle choices such as lack of sleep, smoking, drinking and consuming unhealthy foods

drastically increase the risk of having a stroke. Unfortunately, in many cultures these risk factors

are just side effects of the cultural norms of that society.

The work culture in many countries, particularly in the U.S., leads individuals to fall into

a cycle of unhealthy lifestyle choices. According to the American Psychological Association,

62% of the U.S. work force experiences job-related stress at least once a week (Stress in

America, 2017). While a little stress is not harmful, excessive and extended periods of stress has

been linked to a number of health issues related to strokes including heart and lung disease as

STROKES, STEM CELLS, AND SCIENCE 9

well as hypertension (high blood pressure) (Booth et al., 2015). In addition to stress, the loss of

sleep due to work has become the norm in a variety of countries. A study conducted in 2014

concluded that 95% of the reported sleep problem in Britain stemmed from the conflicts with

balancing work and personal life (Lallukka, 2014). A study conducted by Pace, Adamantidis,

Facchin, and Bassetti (2017) concluded that chronic loss of REM sleep in adults contributes to a

slow increase in plaque buildup in arteries which increases the risk of an ischemic stroke later in

life.

Stress and sleep deprivation are not the only negative aspect of work culture, smoking is

another workplace practice that carries serious health concerns. While the popularity of smoking

has declined in recent years, it is still a common part of the work culture. Many jobs allow for

their employees to take smoke breaks and these smoke breaks have historically been integral in

the social part of work culture. Talking on smoke breaks is still a common way employees

socialize with each other. According to Weng, Ali, and Leonardi-Bee (2013), a quarter of blue

collar workers in the UK that smoke claimed to pick up the habit for their job so as to have extra

breaks in the day or to socialize. Smoking has been shown to be one of the leading causes of

strokes as well as heart and lung failure (Kwon et al., 2016). In fact, according to a study done

by Shah and Cole (2010), smokers are two to four times more likely suffer an ischemic stroke

than a nonsmoker.

Work culture isn’t all to blame, however; social expectations in many cultures also

promote stroke related risk factors. Social drinking is a deeply ingrained part of almost of almost

every culture and is another important risk factor. Drinking is universally seen as a form of

developing bonds and kinship. Drinking is can be a part of socialization, celebration, mourning,

competition, religion, and every other aspect of human interaction. Unfortunately, alcohol is a

STROKES, STEM CELLS, AND SCIENCE 10

risk factor for almost every progressive health problems. While alcohol in moderation is not

harmful, the importance of social drinking has been shown to encourage overconsumption and

misuse. According to a study conducted by Sudhinaraset, Wigglesworth, and Takeuchi (2016),

individuals who drink socially for their job are 30% more likely to binge drink.

Cultural and societal norms become a difficult problem when approached from a medical

perspective. While the latest trends may go in and out of style within a few days, the customs

and values of a society are slow to change. Unfortunately, many of the work and social culture

of many countries encourage unhealthy lifestyle choices for the individuals living in it. Strokes

are merely a side effect and reflection of these unhealthy lifestyle choices and will most likely

become more common as time goes on. The sad truth is that reducing these risk factors means

changing the cultural norms in these societies which is no easy feat. There are limits to the

effectiveness of preventative care epically when the societal expectation promote certain risk

factors. Because of this reason, it would be more beneficial to society if research begins to look

towards treatment rather than prevention.

Ethics and Experimental Treatments

Due to stroke damage stemming from areas of the brain being damaged, certain ethical

problems arise when looking at new forms of treatment. Currently, no treatment exists that fixes

the brain damage resulting from a stroke. As a result, the current medical approach to strokes is

to focus on prevention and early detection. While this may be enough for some individuals, it

does not help those already affected by strokes or those who will have one in the future.

Experimental forms of treatment to reverse brain damage may be a possible solution but the

ethics of such a treatment need to be addressed first.

STROKES, STEM CELLS, AND SCIENCE 11

The objectivity of science and the subjectivity morals are fundamental opposites but are

both necessary in order to properly conduct an experiment. Too much consideration for ethics

slows down progress but without an ethical guideline, experiments can quickly become

inhumane. Therefore, the question to be asked is where does the balance between science and

ethics lie? Recently, an argument has been made in favor of loosening human experimentation

regulations so that patients can have the freedom to volunteer for experimental treatments.

Clinical trials for new treatments usually only take a small number of people however allowing

for a larger number of volunteers could help reduce the time it takes for a treatment to be

officially approved. Winter (2014) makes the point that given the proper protocol, allowing

patients to volunteer for experimental treatments would be mutually beneficial (para. 5). Winter

(2014) argues that assuming the patient is told about the inherent risks related to the treatment, it

is morally justified to allow them to participate if the treatment has the potential to help them

(para. 7). Such an arraignment would be mutually beneficial since the patient has a chance to

have access to a lifesaving drug while researchers are able to gather data about results in a

shorter amount of time. Winter (2014) goes so far as to argue that with serious or terminal

conditions like Ebola, not giving patients access to experimental medications that could

potentially save their life is unethical and similar to letting someone die without trying to save

them (para. 9).

The ethical issue with experimental stroke treatment is slightly more complicated since

the treatment involves stem cell injections. While stem cell research is still a fairly new area of

study, early tests have shown that it has a myriad of applications in treating neurological

disorders. Stem cell injections into a damaged part of the brain has been shown to repair or

regrow damaged brain cells. The ethical issue with stem cells is that it previously was only

STROKES, STEM CELLS, AND SCIENCE 12

possible to harvest them from live embryos, destroying the embryo in the process. However, it is

now possible to grow stem cells in vitro meaning they are grown outside the embryo (Longstaff,

Schuppli, Preto, Lafrenière, & Mcdonald, 2009). Despite stem cells now being harmless to

grow, opposition towards the continued research into this field remains. Farajkhoda (2017)

states that the main cause for concern with stem cell research is that there is too much potential

for ethically questionable experiments. Longstaff, Schuppli, Preto, Lafrenière, & Mcdonald

(2009), however, argue that stem cells harvested in vitro are fully ethical and the equivalent to

growing a bacteria culture in a petri dish. The progress in this area of study has been slow due to

the ethical issues weighing it down. However, the potential treatments from this field of study

are too promising to ignore.

The primary obstacle in treating stroke patients is that no treatment for brain damage

currently exists. Stem cell research has the potential to be the first true treatment for strokes as

well as other types of neurological disorders but is in the early stages of human testing. If the

regulations for human testing were loosened to allow a larger number of patients to volunteer to

undergo experimental treatment, the time it takes to find a true cure could be significantly

reduced.

Conclusion and Solution

Strokes continue to be a worldwide health concern despite the rate of medical

advancements. The underlining problem for this condition is simply how treatment is handled.

No treatment exists for reversing the brain damage caused by a stroke so treatment focuses on

early detection and prevention. While this is useful to an extent, it does not completely prevent

strokes from occurring nor does it help those who have already had a stroke. The only real

STROKES, STEM CELLS, AND SCIENCE 13

solution for helping stroke patients is to start researching and testing ways to reverse the brain

damage. Fortunately, stem cell treatment has had promising results in doing just that.

The gravity of strokes as a global health issue can be seen just by looking at its

commonality, survival rate, and the cost of treatment. In addition to being one of the most

common health problems for adults, the risk of one occurring increases with age. Furthermore,

the brain damage caused by the stroke plays a significant role in the low five year survival rate

after having a stroke. And finally, the cost of surgery that is necessary after a stroke is

astronomically high.

At this point in time, the most promising treatment for reversing is stem cell treatment

and it is still in the early stages of human trial. Stem cell injections to the damaged area of the

brain have been proven to reverse some of the brain damage. However, the availability of this

new treatment is still far away due to the restrictions related to human testing. While it is true

that these restrictions on human testing are in place in order to protect the test subjects, it is only

logical to put certain practices into place that would help reduce the time it takes for a new

treatment to be publicly available. Allowing patients to volunteer for these clinical trials and

increasing the size of such trials would give researchers more data from these tests and as a result

would require fewer clinical trials to prove that this experimental treatment is safe.

The main concern related to the loosening of regulations regarding human testing is that

these regulations are in place to protect the test subjects. History has shown that regulations on

human experimentation are necessary to prevent deplorable experiments from being conducted.

Stem cell research in particular has been met with serious resistance due to the ethically

questionable experiments that can be done in this field. Furthermore, some argue that a patient’s

ability to consent to testing is limited since they are unable to fully understand the potential

STROKES, STEM CELLS, AND SCIENCE 14

outcomes of the experiment. This argument is particularly against the use of vulnerable groups

such as children and the mentally disabled.

While there may be some valid concerns expressed in these arguments, having proper

procedures in place for increasing the availability of such experimental treatments would reduce

the risk of abuse. As long as the patient is properly informed of the potential risks or side effects

of the experimental treatment, the risk associated with loosening regulations would be effectively

eliminated. In addition to this, the ethical questions surrounding stem cell research are irrelevant

in regards to research in that field. The potential for abuse should not be reason to restrict an

entire field of research.

Unfortunately, the risk of having a stroke is just part of the aging process. Certain

lifestyle choices may increase or reduce the risk of having a stroke but time affects everyone. In

the end, prevention only goes so far, many people will still have strokes regardless of the effort

they make in preventing it. Because of this, the focus should be on treating the damage rather

than reducing risk factors. Treating and reversing the damage from a stroke is the most effective

way to reduce the risks associated with having a stroke. Therefore, the best solution for this

problem is to focus on finding a treatment as soon as we can.

STROKES, STEM CELLS, AND SCIENCE 15

References

Benjamin, E. J., Blaha, M. J., Chiuve, S. E., Cushman, M., Das, S. R., Deo, R., . . . Muntner, P.

(2017). Heart disease and stroke statistics-2017 update: A report from the American

Heart Association. Circulation, 135(10), 146-603.

Bhasin, A., Padma Srivastava, M., Mohanty, S., Bhatia, R., Kumaran, S. S., & Bose, S. (2013).

Stem cell therapy: A clinical trial of stroke. Clinical Neurology and Neurosurgery,

115(7), 1003-1008.

Wang, G., Zhang, Z., Ayala, C., Dunet, D. O., Fang, J., & George, M. G. (2014). Costs of

Hospitalization for Stroke Patients Aged 18-64 Years in the United States. Journal of

Stroke and Cerebrovascular Diseases : The Official Journal of National Stroke

Association, 23(5).

Smajlović, D., Kojić, B., & Sinanović, O. (2006). Five-year survival-after first-ever stroke.

Bosnian Journal of Basic Medical Sciences, 6(3), 17-22

Henssge, U., Hoffman, A., Kavanagh, S., Roughton, M., Rudd, A., &Cloud, G. (2011). The

national sentinel stroke audit 2010 round 7. Royal College of Physicians.

Wang, Q., Duan, F., Wang, M., Wang, X., Liu, P., & Ma, L. (2016). Effect of stem cell-based

therapy for ischemic stroke treatment: A meta-analysis. Clinical Neurology and

Neurosurgery, 146, 1-11.

Nagpal, A., Choy, F. C., Howell, S., Hillier, S., Chan, F., Hamilton-Bruce, M. A., & Koblar, S.

A. (2017, August 30). Safety and effectiveness of stem cell therapies in early-phase

clinical trials in stroke: A systematic review and meta-analysis. Stem Cell Research &

Therapy, 8(191)

STROKES, STEM CELLS, AND SCIENCE 16

Stress in America: The State of Our Nation Survey. (2017). In American Psychological

Association. Retrieved from

https://www.apa.org/news/press/releases/stress/2017/state-nation.pdf

Booth, J., Connelly, L., Lawrence, M., Chalmers, C., Joice, S., Becker, C., & Dougall, N. (2015).

Evidence of perceived psychosocial stress as a risk factor for stroke in adults: a meta-

analysis. BMC Neurology, 15(1), 1-12

Lallukka, T., Ferrie, J. E., Kivimäki, M., Shipley, M. J., Sekine, M., Tatsuse, T., ... Lahelma, E.

(2014). Conflicts between work and family life and subsequent sleep problems among

employees from Finland, Britain, and Japan. International Journal of Behavioral

Medicine, 21(2), 310-8.

Pace, M., Adamantidis, A., Facchin, L., & Bassetti, C. (2017). Role of REM sleep, melanin

concentrating hormone and orexin/hypocretin systems in the sleep deprivation pre-

ischemia. Plos ONE, 12(1), 1-22

Weng, S. F., Ali, S., & Leonardi-Bee, J. (2013). Smoking and absence from work: systematic

review and meta-analysis of occupational studies. Addiction, 108(2), 307-319

Kwon, Y., Norby, F. L., Jensen, P. N., Agarwal, S. K., Soliman, E. Z., Lip, G. H., & ... Chen, L.

Y. (2016). Association of smoking, alcohol, and obesity with cardiovascular death and

ischemic stroke in atrial fibrillation: The Atherosclerosis Risk in Communities (ARIC)

Study and Cardiovascular Health Study (CHS). Plos ONE, 11(1), 1-13

Shah, R. S., & Cole, J. W. (2010). Smoking and stroke: the more you smoke the more you

stroke. Expert Review of Cardiovascular Therapy, 8(7), 917–932.

STROKES, STEM CELLS, AND SCIENCE 17

Sudhinaraset, M., Wigglesworth, C., & Takeuchi, D. T. (2016). Social and Cultural Contexts of

Alcohol Use: Influences in a Social–Ecological Framework. Alcohol Research : Current

Reviews, 38(1), 35–45.

Winter, G. (2014). Experimental treatment-do patients have a right to 'try anything'?. British

Journal of Neuroscience Nursing, 10(5), 258.

Longstaff, H., Schuppli, C. A., Preto, N., Lafrenière, D., & Mcdonald, M. (2009). Scientists'

perspectives on the ethical issues of stem cell research. Stem Cell Reviews, 5(2), 89-95.

Farajkhoda, T. (2017). An overview on ethical considerations in stem cell research in Iran and

ethical recommendations. Iranian Journal of Reproductive Medicine, 15(2), 67-74

Running head: CHILDHOOD OBESITY 1

Childhood Obesity

Margaret Webb

Westcoast University

CHILDHOOD OBESITY 2

Abstract

This essay will focus on the scientific, mathematical/analytic perspective, cultural and ethical

perspectives in relation to childhood obesity. This essay will also mention the ideal and reality

views of childhood obesity. It would be great if there was no child effected by childhood obesity,

however, the reality is that there are many children who are dealing with the issues and

complication in relation to childhood obesity. There are many consequences both good and bad

to consider regarding childhood obesity. The solution to childhood obesity is creating

preventative measures such as genetic testing and more resources.

CHILDHOOD OBESITY 3

Childhood Obesity

Ideally, there would be no child affect by childhood obesity. However, there are no

preventative measure set in place. Children are becoming less active outdoors due to other

hobbies that are not beneficial to their health, such as video games and other electronics. There is

a lack of education on the awareness of childhood obesity alongside poor nutrition. Although,

there are a few consequences good and bad to considered regarding childhood obesity. If the

issue of childhood obesity is not better control then that would potentially lead to the obesity rate

in children to increase, causing children to have lower self-esteem, which could result to

depression and suicide. If there is more awareness of childhood obesity, then there would show a

decrease in the rate of childhood obesity.

Resulting to children having self-awareness, parents could provide better eating habits for

their children so that when they become of age they would be able to make healthier choices

themselves. The solution to childhood obesity is creating preventative measures such as genetic

testing and providing resources for both parent and child to help better control their weight and

or diet to avoid obesity. This essay will focus on the scientific, mathematical/analytic

perspective, cultural and ethical perspectives in relation to childhood obesity.

Scientific, Mathematical/Analytic Perspective in Relation to Childhood Obesity

“In the United States, the percentage of children and adolescents affected by obesity has

more than tripled since the 1970s. Data from 2015-2016 show that nearly one and five school

age children and young adults ages six to nineteen years old, in the United States has obesity

(CDC, 2018). The definition of obesity, is having excess body fat. There is a specific tool known

as BMI (Body Mass Index), this tool can determine if a person within normal range, overweight,

or classified as obesity. BMI, is when you use a person’s weight which is measured in kilograms,

CHILDHOOD OBESITY 4

you then divide that number by square of a person’s height, this will be measured in meters.

According to the CDC (Centers of Disease Control and Prevention), obesity is determined in

children and young adults, as their BMI measuring above the 95th percentile for children and

young adults of the same age and gender.

Approximately 17 percent of United States, youth is classified as having obesity. Nearly

one in three children including adolescents are either overweight or have obesity. It is said that

obesity hits at a very early age estimating at a staggering 9.4 percent of children ages 2 to 5

already have obesity. The obesity rate for children ages 6 to 11 has also more than quadrupled

during the past 40 years, from 4.2 to 17.4 percent, as well as tripled for adolescents ages 12 to

19, climbing from 4.6 to 20.6 percent, according to the National Health and Nutrition

Examination Survey (NHANES, 2015). However, as children grow older and by having excess

weight can drastically cut short a child life expectancy. Unfortunately, weight-related health

issues can take a turn for the worse creating chronic conditions such as diabetes and heart

disease.

Childhood obesity over time has become a great concern in today society. The health

impact on African American children regarding obesity has created concerns about their future

health and well-being. However, there has been several literature studies reviewed that indicated

African American childhood obesity is impacted by several different factors including; the lack

of physical activities, their socioeconomic status, influences from the media and even their

parents. Currently, there are approximately 14 percent of African American children ages

ranging between 2 and 5 years, 19 percent ranges between 6 and 11 that are affected by

childhood obesity. Although, the causes of childhood obesity in relation to African American

children are considered very complexed and not easily considerable in nature, more research is

CHILDHOOD OBESITY 5

needed to get to a better understanding on the exact causes and or key factors within the African

American communities other than the obvious. According to Heathier America, in 2011 to 2014,

24.4 percent of African American adolescent girls were considered obese. African American and

Latino youths are much more at risk for being overweight or obese oppose to their Caucasian

peers. In 2011 and 2012, 22 percent of Latino children and 20 percent of African American

children had obesity in comparison to Caucasian children with only 14 percent had obesity

(CDC, 2018).

Obesity is a condition of increased adipose tissue mass. The accumulation of fat or

triacylglycerol, is primarily the only way that our body weigh can become excessive. Adipose

tissue is not purely s storage tissue for triacylglycerol, it also acts on an endocrine organ as well.

This then releases numerous chemical messengers known as adipokines, the communicate and

influences other tissues throughout the body. Beta-3 Adrenergic receptor gene, is expressed in

the adipose tissue, which is involved in the regulation of lipid metabolism and thermogenesis.

Other associated genes involved with obesity is Leptin. Leptin is secreted from

adipocytes into circulation, traverses into the central nervous system and the binds to leptin

receptors inside the hypothalamic arcuate nucleus. So how that works is if it appears genetically

that a lean individual may gain maybe an extra 7 to 8 kg before leptin increases sufficiently to

where it stops the weight gain. So, with that being the case individuals who ends up gaining

more maybe unresponsive to the hormone either because it just cannot enter the brain sufficiently

or maybe because there is a mutation in one of many steps associated with the Leptin action.

Lastly, polymorphisms of the adiponectin gene have also been associated with obesity.

The idea that some individuals are born with a tendency to obesity is not new. However,

there are individuals who believe that sudden death is more common in those who are considered

CHILDHOOD OBESITY 6

obese. There is a basic premise of the ‘thrifty gene’ hypothesis, is that certain populations may

have certain genes associated with the ability to allow your body to increase its fat storage. There

has been a genome-wide scan for obesity susceptibility genes have been performed in several

populations of diverse ethnic backgrounds. It is said that obesity is a highly heritable trait. The

heritable estimates for obesity are typically above 0.70, in comparison to other complexes,

polygenic diseases.

Although, there are several other pure forms of genes that influences the onset of obesity,

there is another gene that defected by appetite regulation and the disease is characterized by

severe early onsets obesity due to hyperphagia, syndromic forms have provided additional

insights into the mechanisms underlying obesity.

Cultural and Ethical Perspectives in Relation to Childhood Obesity

“Researchers have identified that disparities in obesity prevalence can be found just as

readily among children as among adults” (Mcintosh). For several individuals, culture has a large

influence than biology on eating habits and attitudes toward food and body weight which why

some of these differences can affect the way childhood obesity is being treated. An individual’s

social class will also influence treating childhood obesity. Poverty is another key factor in

relation to childhood obesity because poverty discourages physical activities and encourage

excess calorie consumption.

Several ethical issues emerge when discussing bariatric surgery within the pediatric

population. “Bariatric surgery for children and adolescents is becoming widespread. However,

the evidence is still scarce and of poor quality, and many of the patients are too young to consent

This poses a series of moral challenges” (Hofmann, 2013). There are several questions that may

arise when speaking in terms of considering bariatric surgery as a form of treatment for children.

CHILDHOOD OBESITY 7

Such as; How do bariatric surgery benefit children? Are there any long term affects?

“Knowledge from uncontrolled series from selected centers indicates that bariatric surgery may

be beneficial, but evidence on important outcome measures is lacking” (Hoffmann, 2013).

There are a few controversies over when the right timing for considering surgical

intervention regarding pediatric obesity. “Optimal timing often depends on the severity of the

patient’s obesity related comorbidities, whether the patient’s health is being compromised by

severe obesity, and whether the patient has failed more conservative options” (Taylor, 2009).

However, it could be unethical for a physician to deny a child because of their age, even though

bariatric surgery has been found to be successful within the adult population. There is current

literature that has suggested that childhood obesity is best addressed through preventative

measures, because it is better to prevent childhood obesity oppose to reversing it.

“Childhood obesity in the United States presents major health challenges, but neither the

medical industry, public health advocates, nor policy makers have identified effective ways of

reversing increasing rates of obesity among youth” (Kersh, 2011). There is an ethical concern

that raised by policy interventions is the association between and individual’s autonomy and the

state authority. “The libertarian perspective limits the authority of the state to ensure individual

freedom, whereas utilitarian and social-contract approaches allow individual interests to be

secondary to increases in overall welfare” (Kersh, 2011). However, because there has been an

increased concern regarding childhood obesity there has been policies set in place to intervene.

Such as; controlling certain conditions in relation to what schools can offer to children.

Restricting advertising of foods that are high in fats and low nutrients that targets children.

Introducing or substituting heathier alternatives that have higher calories. Finally placing a

restriction or banning certain ingredients that are harmful.

CHILDHOOD OBESITY 8

“Ethical interventions in the treatment of childhood obesity would be complete without

including the role of family, particularly parents, in influencing their child’s diet, and physical

activity. However, health experts have been hesitant to address this issue” (Perryman, 2011).

One theory that approaches the ethical concerns is that, “State intervention is justified when a

person’s actions affect others” (Kersh, 2011). There should be an attempt to reduce the risks that

are closely related to childhood obesity by promoting health information, programs and

emphasizes attention to the health of children. Parents act as the primary decision maker when it

comes to their children in several areas such as nutrition and their activity because children do

not yet possess the maturity that is needed to make health-related choices. However, parents are

biased and tend to make decisions that is beneficial to them. Family dynamics can play a major

role in childhood obesity, which is why family should be a part in ethical interventions

Solution to Childhood Obesity

The solution to childhood obesity is creating preventative measures such as

genetic testing. There is evidence that indicates a correlation between genetics and obesity. There

is a basic premise of the ‘thrifty gene’ hypothesis, is that certain populations may have certain

genes associated with the ability to allow your body to increase its fat storage. There has been a

genome-wide scan for obesity susceptibility genes have been performed in several populations of

diverse ethnic backgrounds. It is said that obesity is a highly heritable trait. The heritable

estimates for obesity are typically above 0.70, in comparison to other complexes, polygenic

diseases (Sikaris, 2004).

Others proposed different solutions regarding childhood obesity, such as providing

education, awareness to help influences healthier lifestyle. These solutions a great to consider,

however, the main focus is to prevent the issues at the genetic level before it becomes a more

CHILDHOOD OBESITY 9

complex issue that would be harder to control. There is no wrong or right way when it comes to

treating or creating suggestions for treatment in relation to childhood obesity. Choosing a

heathier diet, controlling weight, surgery or simply having the child be more active are all great

solutions to considered but genetic testing would be the most effective solution to the issues of

childhood obesity. Moving forward, creating research studies that are noninvasive to both parent

in fetus during 10-15 week of pregnancy. This study would involve a simple blood sample from

the mother to perform genetic testing.

This will help find a way to alter the gene or genes that has a major effect on

uncontrollable weight gain. There would also a family history questionnaire for both mom and

dad to complete, this would so the potential risk factors for this unborn child on their chances of

being obese as a child. If there is a very chance that the fetus will be affected by obesity than the

genetic testing would be considered medically necessary so that the family insurance would pay

or it as part of the mom complete OB care.

CHILDHOOD OBESITY 10

References

A Healthier America (2017). Facts About Childhood Obesity. Retrieved from

https://www.ahealthieramerica.org/articles/facts-about-childhood-obesity-102

Andrew J. W., Alexandra I.F. Blakemore, P. (2006). Genetics of Obesity and the Prediction of

Risk for Health, Human Molecular Genetics, (15) doi.org/10.1093/hmg/ddl215

Centers for Disease Control and Prevention (2018). Obesity facts. Retrieved from

https://www.cdc.gov/healthyschools/obesity/facts.htm

Hoffman, B. (2013). Bariatric Surgery for Obese Children and Adolescents: A review of the

moral challenges. BMC Med Ethics, 14 (18). Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655839

Karnik, S., & Kanekar, A. (2012). Childhood Obesity: A Global Public Health

Crisis. International Journal of Preventive Medicine, 3(1), 1–7. Retrieved from

https://www.ncbi.nlm.nih.gove/pmc/articles/PMC3278864

Kersh, R., Stroup, D. F., & Taylor, W. C. (2011). Childhood Obesity: A Framework for Policy

Approaches and Ethical Considerations. Preventing Chronic Disease, 8(5), A93.

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181193

Mcintosh, J. (2015). How do Race and Ethnicity Influence Childhood Obesity? Medical News

Today, Retrieved from Https://www.medicalnewstoday.com/articles/292913.php

Perryman, M. L. (2011). Ethical Family Interventions for Childhood Obesity. Preventing

Chronic Disease, 8(5), A99. Retrieved from

https://www.ncbi,nlm,nih.gov/pmc/aricles/PMC3181199

Sharpe, DK., Collins, J., Jones JW. (2016) Contributing

CHILDHOOD OBESITY 11

Factors to Obesity in African American Children within the United States. Epidemiology

(Sunnyvale) 6:277. doi: 10.4172/2161-1165.1000277

Sikaris, K. A. (2004). The Clinical Biochemistry of Obesity. The Clinical Biochemist Reviews,

25(3), 165–181.

Taylor, A.C. (2009). Legal and Ethical Considerations of Bariatric Surgery in Children and

Adolescents. Journal of Undergraduate Nursing Writing, 3, (1). Retrieved from

http://archie.kumc.edu/bitstream/handle/2271/750/STTTaylor.pdf?sequence=1

Running Head: MIGRAINES 1

The Ins and Outs of Migraines

Brianna Coats

West Coast University

MIGRAINES 2

Abstract

With millions of people suffering from migraines, the underlying cause of them still,

unfortunately, remain unknown. This paper explores the topic of migraines and has a primary

focus on the existing treatment options and preventative measures that can be taken to avoid

migraines. It also explores the history of migraine treatment, as well as, the origin of other

effective ways to relieve migraine pains. Treatment can range from prescribed to over the

counter medication and even piercings or Botox. However, with the excruciating migraine pain

and annoying symptoms, it is no surprise that when people get migraines in the United States

they often turn to prescription drugs or over the counter drugs like aspirin to relieve their pain.

These are quick, easily accessible, and “traditional” ways to relieve migraine pain and their

symptoms. However, there are many other ways to relieve pain. The information included in this

paper was revealed by conducting research using online databases and utilizing organization sites

that are devoted to migraine research in hopes of one day finding a cure. This cure not only leads

to a better quality of life for migraines sufferers, but can ultimately save the United States as a

country, billions of dollars that go toward treatment.

Keywords: migraines, treatment, prevention

MIGRAINES 3

The Ins and Outs of Migraines

In a perfect world, the human population would know the causes, preventative measures,

and not only treatment, but a cure for migraines. According to the Migraine Research Foundation

(n.d.), a “migraine is a neurological disorder involving nerve pathways and brain chemicals”

(para.1). Those that suffer from migraines may do so because of their genetics or lifestyle

factors. Migraines can last anywhere from four to seventy hours and some symptoms may

include “visual disturbances, nausea, vomiting. dizziness, extreme sensitivity to sound, light,

touch, and smell, and tingling or numbness in the extremities or face” and they vary from person

to person (Migraine Research Foundation, n.d. para.3). With research, the effects that migraines

have on the body systems is addressed as well as the various unique treatment options and

preventative measures that can be taken to avoid migraines.

The Science and Mathematics of Migraines

When most people think of a migraine, the brain or the nervous system is the first thing

that comes to mind when determining the area(s) of the body that is affected, hence the pounding

inside of their heads. However, they may not know that migraines can also be associated with the

respiratory, digestive, and reproductive systems. As stated earlier, nausea and vomiting are

symptoms of migraines, which would account for the association that migraines have with the

digestive system. Migraines can also have the potential to increase the risk for asthma and

cardiovascular disease, which is associated with the respiratory and cardiovascular systems.

Since the cause of migraines remains unknown, researchers are unsure of the cause for these

situations. One thing that may surprise some people is that some women suffer from menstrual

migraine. This is a migraine triggered by the menstrual cycle which means migraines can be

associated with the reproductive system. According to The Migraine Trust (2018), an

MIGRAINES 4

organization devoted to research and supporting those affected by migraines, two causes of

menstrual migraine include “the withdrawal of oestrogen as part of the normal menstrual cycle

and the normal release of prostaglandin during the first 48 hours of menstruation” (para.2).

Unfortunately, there aren’t any tests available to confirm the diagnosis so they “test” this by

keeping a diary for three months to record migraine attacks and menstruation days. These

associations prove that much more than the brain or the nervous system can be affected by

migraines.

As stated previously, genetics and/or lifestyle factors can also contribute to the suffering

of a migraine. Lifestyle factors like skipping meals, a sedentary lifestyle, irregular sleep, and

stress can very well trigger a migraine. In fact, there was a study done on the impact of some of

these factors in developing a migraine. In this study researchers found that having a consistent

sleep schedule, and engaging in daily aerobic exercise, and mealtime and hydration pattern

serves as protection against chronic migraines (Cowan and Woldeamanuel, 2016). This was

shown by studying 175 chronic migraine patients. The diagnosis of the chronic migraine cases

was confirmed by headache specialists from the Stanford Headache and Facial Pain Clinic. The

results of the study indicate that the number of migraine attacks decreased when the patients

engaged in daily exercise, regular sleep, and regular mealtime. Some medications can trigger

migraines as well. Some of these medications include oral contraceptives, postmenopausal

hormone therapy, nasal decongestant, selective serotonin-reuptake inhibitor antidepressants, and

proton-pump inhibitors (Charles, 2017). However, some individuals may be fortunate enough to

“cure” their migraines by simply avoiding their migraine triggers and engaging in healthy

lifestyle choices.

MIGRAINES 5

Although there are various preventative options, not everyone is aware of them. Fortunate

for them, there are several treatments available. Treatment medications can range from nasal

spray, to injections, to oral methods. An example of a treatment medication is a Botox injection

which has been recognized as a very effective treatment for those that suffer from chronic

migraines in particular. Chronic migraine is defined as those who experience migraine attacks on

15 or more days out of the month. How does this Botox injection work against migraines? The

American Migraine Foundation (2017) states that the Botox is injected around the pain fibers on

your face that are involved in headaches. They go on to say the “Botox enters the nerve endings

around where it is injected and blocks the release of chemicals involved in pain transmission.

This prevents activation of pain networks in the brain.” (The American Migraine Foundation,

2017, para. 4). One treatment typically lasts from ten to twelve weeks and those that received the

Botox treatment saw a fifty percent decrease in their number of headache days after getting two

treatments. Dr. Andrew Blumenfeld says that the benefits of Botox increase with the number of

treatments (The American Migraine Foundation, 2017).

Another way to effectively treat migraine is by consuming magnesium sulfate.

Magnesium is a very important mineral that the human body produces. Low levels of magnesium

have been associated with several inflammatory diseases, including migraines. In a study

performed on magnesium in prevention and therapy, researchers found that when migraine

sufferers consumed magnesium, the migraine attack frequency reduced by 41.6 % (Grober,

Kisters, & Schmidt, 2015). They also found that “the number of days with migraine and the drug

consumption for symptomatic treatment per patient” had decreased tremendously. Overall, these

researchers concluded that magnesium sulfate is as “effective and fast-acting” as medication for

the treatment of migraines (Grober, Kisters, & Schmidt, 2015).

MIGRAINES 6

Recent research has also focused on the calcitonin gene-related principle (CGRP)

because they are convinced that it plays a role in pain transmission during a migraine. Hunter

(2016) mentions that it does so by “activating one nerve cell and triggering its own release so

that it is passed on to the next neuron in line” (p. 798). Because of this, researchers have targeted

CGRP as a preventative therapy. There are clinical trials that prove “CGRP-based” drugs have

the potential to reduce the impact and severity of migraines preventatively (Hunter, 2016).

Although they have found this to be true, Silberstein, former president of the American

Headache Society, still believes that discovering this information isn’t necessarily a cure but it

has been proven to better relieve the symptoms. This is a step in the right direction to find a cure

for migraines.

The 14 million people in the United States suffer from migraines causes about 113

million lost workdays which costs employers an astounding $13 billion. In addition to this,

migraine treatment has an annual cost of $50 billion. How effective are some of the existing

treatments though? A lot of migraine treatments simply get rid of the migraine symptoms which

doesn’t get to the root of the problem. Therefore, the migraine will eventually reappear. Phillip

Hunter, says “a new generation of drugs could avert migraine attacks rather than merely relieve

symptoms.”, which is exactly what migraine sufferers need (Hunter, P., 2016). Researchers think

they’re on the verge of putting migraine sufferers out of their misery. This could not only

improve quality of life for millions, but it can also save the U.S. billions of dollars.

The Culture and Ethics of Migraine Treatment

In today’s American society, many people experience migraine pain and immediately

turn to aspirin or other medicinal options to relieve their pain. However, there are several other

ways to relieve migraine pain which can vary by cultures. According to the Merriam-Webster

MIGRAINES 7

dictionary, culture is defined as “the customary beliefs, social forms, and material traits of a

racial, religious or social group”. In addition to preventative measures and migraine treatment

options, there are also unique migraine treatments that vary by culture.

Recently, it has been discovered that the daith ear piercing could be a potential treatment

for migraines. A visual of this ear piercing provided by the

American Migraine Foundation is shown in Figure 1. There

was a study done on a 54-year-old male that suffered from

chronic migraines, which is defined by experiencing 15 or

more headache days each month, due to a head injury that

occurred when he was 3 years old. In the past, he was

prescribed preventative therapies like topiramate, sodium valproate, propranolol, flunarizine, and

flunarizine, in which he benefitted from these medications (Altamura, Altavilla, Assenza, et al.,

2017). However, they only lasted for a few months. For years, he continued to seek effective

solutions that would last for more than a few months. Finally, he decided to take matters into his

own hands and get a daith piercing. At this time, he still suffered from the chronic migraines.

Fortunate for him, the daith piercing was a very effective and long-lasting treatment. Months

after getting the piercing, he noticed a reduction in migraine attacks. He continued to experience

headaches, but they were much less intense, less frequent, and less disabling than before. He

suffered from a headache only 13 days within the last 3 months, compared to 15 or more days a

month (pg. 2). In addition to this, he only felt the need to take a single painkiller compared to

several types of medication. Finally, after a year and a half of having the piercing, his previous

triggers of alcohol and traveling, no longer trigger headaches. He also found that his migraine

Figure 1. This figure is a visual of a daith piercing. American Migraine Foundation

(2017). Daith piercing.

MIGRAINES 8

attacks were very rare, having none in the last 2 months. His painkiller consumption decreased

tremendously as a result of this.

The success of the daith ear piercing could be due to the fact that the piercing resembles

the Chinese technique, acupuncture, where a needle is placed at specific pressure points to slow

pain transmission. In the case of the daith piercing, wearing the erring in that specific location

provides constant pressure on that pressure point, which can relieve pain (American Migraine

Foundation, 2017, para 3). According to the Chinese culture, pain or illness occurred because of

a disturbance of energy in the body (American Migraine Foundation, 2017, para 1). In addition

to this, the American Migraine Foundation conducted a clinical trial that studied 4985 people. In

this study they found this technique reduced the frequencies of headaches in those that suffer

from migraines (para 1). The research showed a 50% reduction or more “in up to 59% of

individuals receiving acupuncture and this effect can persist for more than 6 months” (para. 2). It

is believed that the acupuncture technique stimulates pathways in the brain that are in control of

turning pain off.

On another note, trepanation was used thousands of years ago to treat migraines or any

other form of cranial trauma. This technique requires cutting, drilling, or scraping a small hole in

the skull. This was a very common technique used in Peru during the Inca period and ancient

Greece. Forming a hole in the skull released the accumulation of fluids or took pressure off of

the skull (Ultimate History Project, para 7). After investigation, researchers have found evidence

that have led them to believe the survival rate for this procedure was about 50% (para 9).

Trepanned skulls dated to the late Middle Ages in the Czech Republic “show evidence of both a

tumor which would have caused headaches and the trepanation which was performed in the

hopes of curing the patient.” (para 11). Some skulls were even trepanned for spiritual reasons in

MIGRAINES 9

which the procedure was done to release demons. Fortunately, by the nineteenth century, doctors

became more knowledgeable on the structure of the brain and began performing brain surgeries

that allowed them to remove tumors. This led to a major declination of the trepanation

procedure. However, the brain surgeries cured those that suffered from migraines due to the

pressure of a tumor. Those that did not have tumors, only found relief with the consumption of

pain medication.

A less drastic migraine relief option that does not involve needles or trephines drilling

through the skull, are remedies that can be taken at home. Remedies like lavender oil have

proven to be effective in migraine treatment. This may be ideal for individuals that prefer not to

consume medicine or put needles inside of their bodies. A study was done to determine the

effects that essential lavender oil has on migraines. Lavender is a plant native to the

Mediterranean mountains, the Arabian Peninsula and Russia. The lavender essential oil is

attained by steam distillation from the flower heads and the aerial foliage (Abbasi, Gorji., Saeedi,

et al., 2012). This study was performed by having the patients rub 2-3 drops of lavender oil onto

their upper lip and inhale it for fifteen minutes. At thirty minutes they were asked to record the

severity and symptoms of their migraine. This cycle continued for a total of two hours. At the

end of the study, the researcher found that of 129 migraine attacks, 92 attacks responded totally

or partially to the lavender (p. 290). This study proved that lavender oil is an effective alternative

to reducing migraine symptoms such as nausea and vomiting, as well as prevent the migraine

from spreading from its primary location (p. 290).

When dealing with the health of others, or in this case migraines specifically, physicians

also have a duty to do what is ethically right. According to the Merriam-Webster dictionary,

ethics can be defined as “the discipline dealing with what is good and bad and with moral

MIGRAINES 10

obligation”. The ethical theory, egoism, has a focus of self-interest of person doing, considering,

or affected by the action. It is also said that “one should choose the action which most realizes or

conduces to one’s own self-interest” (Walter, 2018). This approach is taken when patients seek

different cultural treatments for their migraines. Some migraine treatments like the daith piercing

or the lavender essential oil may work for some, but not others. These are things that should be

considered when seeking any form of treatment. In fact, every treatment included in this research

paper can be viewed from the ethical theory, egoism.

For the first explanation of the egoism approach, the daith piercing previously mentioned

will be used. In the study of the 54-year-old male, he was not advised to get the piercing to help

with migraines. After his constant search of a long-term migraine preventative measure, he took

a leap of faith and got the daith piercing on his own, without doctors advising him to do so.

Although the piercing helped him tremendously, it doesn’t have the same effect on everyone.

The Daily Migraine Website, a site that strives to help migraine sufferers reduce or eliminate

their daily migraines, was visited to get feedback from those that got the daith piercing in hopes

of making their migraines a thing of the past. There were a few people that said the daith

piercing did not help with their migraines. On the other hand, there were tons of people that said

they noticed a dramatic difference. In fact, there were multiple people that said they went to get

the piercing while they had a migraine and immediately started to feel relief after getting the

piercing (Jacobson, 2016). There tends to be much success with the piercing for most, however,

a daith piercing may not be appealing to a very conservative person. This is a perfect example of

choosing the action that appeals to your own self-interest.

Another example would be the use of lavender essential oil mentioned earlier. Although

the study showed proof of the lavender essential oil’s effectiveness for migraine sufferers, it

MIGRAINES 11

unfortunately did not work for every single person included in the study. However, on the bright

side, it did totally or partially relieve the migraine and its symptoms of 92 of the 129 participants,

or about 71% of the patients. This goes to show that not every treatment works on everyone.

Individuals must explore their options and find a treatment that is tailored toward them, or in

other words, choose the action which most realizes one’s self-interest.

Conclusion

Organizations like the Migraine Research Foundation, American Migraine Foundation,

and the Migraine Trust are all organizations that are devoted to the research of migraines that

will hopefully one-day lead to a cure for this disabling disease. There are so many unknown

factors that go into the understanding of migraines. Understanding the underlying cause could

ultimately lead to a cure. There is still plenty of research that needs to be done to reach this goal

and not settle for only a treatment for migraines. In the meanwhile, there are several treatments

and preventative measures that can be taken to avoid migraines.

Although some like to focus on the medications for migraine treatment, I think the

prevention of migraines should be the primary focus which would ultimately avoid the need for a

treatment. Knowing your migraine triggers can help with this. Taking care of your body by

making healthy lifestyle choices like having regular meals, a consistent sleep schedule, and

engaging in aerobic physical activity can prevent some migraine attacks. In addition to these

preventative measures, daith piercings and Botox are also proven preventive measures that have

worked for many migraine sufferers. Of course these are only a few ways to avoid dreadful

migraines and they vary by person.

MIGRAINES 12

It is amazing how treatments vary across the world. From typical over the counter or

prescription drugs to piercings and essential oil, researchers have discovered traditional as well

as untraditional effective and efficient ways to relieve migraine pains and their symptoms. The

research conducted has made it clear how far migraine treatment options have come and what

efforts have been taken to determine the cause. Although there is no definite cure currently

available to those suffering from migraines, the continuous innovations in our society give

promise that migraines will one day be history.

MIGRAINES 13

References

Abbasi, M, Gorji, A., Saeedi, M, et al., (2012). Lavender essential oil in the treatment of

migraine headache: A placebo-controlled clinical trial. European Neurology, 67, 288-

291. doi: 10.1159/000335249

Altamura, C., Altavilla, R., Assenza, F., et al. (2017). Daith piercing in a case of chronic

migraine: A possible vegal modulation. Frontiers in Neurology, 8, 624.

http://doi.org/10.3389/fneur.2017.00624

American Migraine Foundation (2017). Acupuncture and migraine: Finding a combination that

sticks. Retrieved from https://americanmigrainefoundation.org/understanding-

migraine/acupuncture-and-migraine-finding-a-combination-that-sticks/

American Migraine Foundation (2017). Botox for migraine. Retrieved from

https://americanmigrainefoundation.org/understanding-migraine/botox-for-migraine/

American Migraine Foundation (2017). Daith Piercings 101. Retrieved from

https://americanmigrainefoundation.org/understanding-migraine/daith-piercings-101/

American Migraine Foundation (2017, August 3). Daith piercing [Photograph]. Retrieved from

https://americanmigrainefoundation.org/understanding-migraine/daith-piercings-101/

MIGRAINES 14

Charles, A. (2017). Migraine. The New England Journal of Medicine, 366, 553-561.

Cowan, R. and Woldeamanuel, Y. (2016). The impact of regular lifestyle behavior in migraine:

A prevalence case-referent study. Journal of Neurology, 263(4), 669-676.

Culture. (n.d.). In Merriam-Webster online. Retrieved from https://www.merriam-

webster.com/dictionary/culture

Culture. (n.d.). In Merriam-Webster online. Retrieved from https://www.merriam-

webster.com/dictionary/culture

Girardi, P., Lionetto, L., Marsibilio, F., et al. (2014). Treatment of menstrual migraine: Utility of

control of related mood disturbances. Expert Review of Neurotherapeutics, 14(5), 493-

502.

Grober, U., Kisters, K., & Schmidt, J. (2015). Magnesium in prevention and therapy. Nutrients,

7(15). 8214. doi:10.3390/nu7095388

Hunter, P. (2016). New migraine therapies promise prevention: A new generation of drugs could

avert migraine attacks rather than merely relieve symptoms. EMBO Reports, 17(6), 797-

799.

Jacobson, L. (2016). Does daith piercing really work?: First anecdotal study of its kind.

Retrieved from http://www.thedailymigraine.com/blog/2016/3/1/does-daith-piercing-

really-work-first-anecdotal-study-of-its-kind

Migraine Research Foundation (n.d.). What is migraine? Retrieved from

http://migraineresearchfoundation.org/about-migraine/what-is-migraine/

MIGRAINES 15

Migraine.com (n.d.). Nausea with or without vomiting. Retrieved from

https://migraine.com/migraine-symptoms/nausea-with-or-without-vomiting/

The Migraine Trust (n.d.). Menstrual migraine. Retrieved from

https://www.migrainetrust.org/about-migraine/types-of-migraine/menstrual-migraine/

The Ultimate History Project (n.d.). You need this like you need a hole in your head. Retrieved

from http://ultimatehistoryproject.com/trephination.html

Walter, J. (2018). Approaches to the ethical perspective of inquiry paper [PowerPoint slides].

Retrieved from https://learn.westcoastuniversity.edu/bbcswebdav/pid-148947-dt-

announcement-rid-23969817_1/courses/DA_CAPS401_201801SPI_BL-TU_PM/06-

Weekly%20Onsite%20Presentations/CAPS401-EthicalTheoriesApproaches.pdf