Digital Commons Network^™

Measuring Birth Trauma Rates In Maine Using Public Data, Mike Lapika

Thinking Matters Symposium Archive

An increasing number of states are creating databases that collect and organize health insurance claims from public and private health care payers. Since December 2016, at least 18 states have these “all-payer claims databases” (APCDs), including Maine. APCDs are intended to inform cost containment and quality improvement by increasing transparency and informing consumer choice. For this project, we assessed how Maine’s APCD data might be used to produce standardized quality measures across facilities in the state. Specifically, we tested a birth outcome quality measure developed by the Agency for Healthcare Research and Quality (AHRQ), Birth Trauma – Injury to Neonate …

Expanding International Health Curriculum For The Internal Medicine Residency At Mmc, Brian King, Hassan Mahmoud, Anthony Pastore

Thinking Matters Symposium Archive

While internal medicine residents at Maine Medical Center provide care for many refugees and immigrants, there is not a formal international health curriculum to equip residents to care for this vulnerable population. Since 2002, 3,793 refugees have arrived in Maine for resettlement. Our aim was to survey residents about their interest in added international health instruction and design an educational curriculum for these physicians.

Male Determining Gene Nix May Bring An End To Transmission Of Diseases Through Mosquitoes, Mohammed Mahdi

Thinking Matters Symposium Archive

Female mosquitoes take blood from humans to gain protein needed to produce eggs, and in the process they can transmit viruses, such as Zika, Dengue, and chikungunya, or parasites, such as malaria. Male mosquitoes do not transmit diseases. This literature review will examine what is known about how sex is determined in mosquitoes and how this can be used to manipulate the females that spread diseases to humans. Using CRISPR Cas9, the lab of Zhijian Tu removed the Nix gene from mosquito embryos; all of these were feminized. Ectopic overexpression of Nix gene product in mosquito embryos caused even genetically …

Benefits Of Onsite Health Programs In The Corporate Setting, Nathan Cook

Thinking Matters Symposium Archive

Worksite health care clinics and corporate wellness programs are becoming a staple of companies at all levels. Companies are finding that having onsite healthcare clinics as well as comprehensive wellness programs are not only good incentives for employees but actually able to save large amounts of money with injury prevention, decrease in lost productivity and a number of other factors. A 2010 meta- analysis looking at the Return-Of Investment (ROI) found that there was an average of $3.27 per dollar spent on wellness initiatives ROI. Yearly savings can be upwards of $225,000 in some cases as the Sygenta Crop Production …

Accuracy Of Self-Collected Vaginal Swabs In The Diagnosis Of Bacterial Vaginosis, Vaginal Candidiasis, And Trichomoniasis, Anna Chase

Thinking Matters Symposium Archive

Vaginitis is the most common gynecological problem seen in primary care. It is estimated to account for 10 million primary care visits each year. The most common causes of vaginitis - responsible for up to 90% of cases - are bacterial vaginosis (BV), vaginal candidiasis (“yeast infections”), and trichomoniasis. The purpose of this evidence-based project was to evaluate whether self-collected vaginal swabs are as accurate as those collected by a provider during a speculum exam in the diagnosis of BV, yeast infections, and trichomoniasis.

In order to appropriately diagnose and treat vaginitis, samples from a vaginal swab are often required. …

Lung Cancer Screening Provider Survey, Lindsay Mcfarren

Muskie School Capstones and Dissertations

The purpose of this capstone project is to evaluate provider knowledge, attitudes, and behaviors around lung cancer screening in Maine. To evaluate these elements, a survey will be developed and administered to primary care physicians in Maine through three physician specialty societies. The survey will be developed keeping existing literature and previous studies of a similar nature in mind. This survey is being developed in collaboration with the Center for Outcomes Research and Evaluation (CORE), a branch of Maine Medical Center Research Institute. The Evidence- Based Public Health Framework will be used to outline and ground this capstone project.

Effects Of Headgear On Concussions In Soccer Players, Bayley Pendleton

Thinking Matters Symposium Archive

Concussions have become a hot topic among athletic health care, but there is still a great deal to learn. One specific population has been studied and research produced showing the effects of wearing protective headgear. For some reason, adolescent soccer players are more apt to suffer a concussion. Taking steps to reduce recovery time and make concussions less common is something that should be addressed. The studies done showing the effects of headgear in adolescent soccer players is a topic that needs to be more widely known.

Assessing Dementia And Mild Cognitive Impairment Within The Home, Kate Sobanik, Melinda Blais

Thinking Matters Symposium Archive

What are useful assessments which can be administered by occupational therapists for homebound adults with dementia or mild cognitive impairment that will influence practice patterns?

Does The Application Of Kinesiology Tape Aid In Increasing Venous Flow, K. Fitzgerald, Victoria Saunders

Thinking Matters Symposium Archive

Kinesiology tape has become extremely popular among athletes of all ages. It’s bright colors and the unique patterns created by the tape have gained an astonishing amount of attention. KT tape is a highly elastic tape that is advertised to increase muscle proprioception, reduce pain, and increase the space between fascial layers for higher venous flow. There has been a large amount of controversy surrounding KT tape and the placebo effects its usage may have. The purpose of this study is to determine if kinesiology tape actually increases venous flow which will result in a reduction of edema and ecchymosis …

Occupational Therapy Led Handwriting Programs In General Education, Angela Hamel, Collin Skilling

Thinking Matters Symposium Archive

PIO: Does integrating occupational therapy led handwriting programs into a classroom’s curriculum improve overall handwriting in all children?

“Older Adults And Their Experiences With Home Care And Assisted Living”, Faith Robinson

Thinking Matters Symposium Archive

As the state of Maine and the U.S. population at large continues to age, discussion about future care and living arrangements for older adults has become an increasingly relevant issue. Older adults are often faced with a range of options for housing, including staying in their home in their community while receiving home care services, or moving to an assisted living facility.

Currently a gap in the research exists as to the attitudes, perceptions, and lived experiences of the older adults themselves around these decisions, experiences, and the meaning of “home” in our older years. This study aims to provide …

Meditation As A Tool For Blood Pressure Management, Maggie Ray

Thinking Matters Symposium Archive

PURPOSE: Appraise existing evidence about meditation and blood pressure in persons with cardiac risk factors and offer evidence-based recommendations about the use of meditation in management of blood pressure

Palliative Players: Project Development And Initial Implementation, Eliza Eager

Muskie School Capstones and Dissertations

The Palliative Players are screened and trained hospice volunteers who provide a low-cost, sustainable, role-playing resource for use teaching communication skills to healthcare workers who discuss serious illness with patients and their families. The Palliative Players project was conceived and developed in early 2017 by Dr. Lauren Michalakes, Medical Director of Palliative Care at Coastal Healthcare Alliance (CHA); Sarah Dwelley, RN; Flic Shooter, Director of Hospice Volunteers of Waldo County (HVOWC); and Eliza Eager, Project Coordinator; to provide believable, emotive simulated patients (SPs) for role-play in workshops teaching healthcare workers communication tools and skills for use in conversations with patients …

Physical Activity Levels & Successful Aging, Ryan R. Bourque

Thinking Matters Symposium Archive

Hypothesis: Greater levels of physical activity have a positive correlation with greater levels of independence as well as better outcomes with respect to self-perceived health-related quality of life for elderly individuals (65+ years of age).

Rehabilitation Of A Post-Surgical Ulnar Collateral Ligament Repair, Emily Nicholson, L Webber

Thinking Matters Symposium Archive

The purpose of this literature review is to demonstrate a plan for the rehabilitation of ulnar collateral ligament tear post-surgery and return to play quickly and safely. This poster will demonstrate a protocol to follow for an athlete post reconstruction of their UCL to regain range of motion, to strengthen, to stabilize and to prepare the shoulder joint to return the athlete to an overhead throwing sport.

Metabolic Costs Of Blood Flow Restriction Training Under Moderate Load To Failure, Ian Byron, Chris Chessie, Matthew Smith, Logan Carman

Thinking Matters Symposium Archive

This research focused on the metabolic costs associated with squatting to failure and squatting to failure with blood flow restriction cuffs. Each individual training program lasted a total of three weeks; consisting of two training days per week. Two groups were used for this study; proximal occlusion of legs and non-occluded legs. The occlusion group left the cuffs on until their final set was complete and pressure was maintained at 140 mmHg. The final session was monitored by a metabolic cart which recorded oxygen consumption levels throughout the workout. Oxygen consumption levels can be used to estimate aerobic costs, which …

Conservative Treatment For An Achilles Rupture, Krystyn Keating, Braden Heal, R Ingram

Thinking Matters Symposium Archive

The aim of this research is to illustrate a protocol of non-operative treatment of an Achilles rupture and discover the best practices for the rehabilitation process. The sources of the literature search included the following databases: SAGE and BioMed Central A complete Achilles rupture is a condition that may affect athletes as well as the general population. A majority of these injuries occur during a combination of exaggerated dorsiflexion of the ankle and forceful plantarflexion. Evidence has shown that overuse injuries such as chronic inflammation or other tendinopathies correlate to this injury. It’s common to get the Achilles tendon surgically …

Post-Surgical Rehabilitation For The Anterior Cruciate Ligament, Daniel Webb, S Dibiase, T Grant

Thinking Matters Symposium Archive

The purpose of this project was to construct a rehabilitation protocol using therapeutic exercises carried out to return to play. The protocol was for a soccer player in the college setting who has sustained a torn ACL. The sources that we use include databases from EBSCO, physiopedia, hindawi and google scholar. ACL injuries are common in soccer players. It is important that the sports medical field has a good understanding on how to preform a rehabilitation protocol for athletes that are recovering from ACL reconstruction. Injuries to the ACL can occur with direct contact or non-contact. A cut-or-plant movement is …

The Effects Of Blood Flow Restriction Training On Strength And Hypertrophy; Is It Worth It?, David Donovan, Clarissa El-Hajj, Ryan Koenig, Seth Wing

Thinking Matters Symposium Archive

We examined the effects of Blood Flow Restriction Training on Strength and Hypertrophy involving 3 female and 5 male subjects. Participants came in to train twice a week for 3 weeks and were randomly assigned to either the BFR or non-BFR group. Resistance exercise included lifting a weight to muscular fatigue or wearing blood flow restriction cuffs during resistance training to muscular fatigue performed on the smith machine. Squat exercises were performed on different days, lifting a weight at 50% of a 1 repetition maximum for a total of 3 sets with a 90 second recovery after the 1st and …

Perceptions Of Successful Aging Among Maine Elders With Physical Limitations: Insights From Qualitative Interviews, Madeline Minor, Rebecca Knight

Thinking Matters Symposium Archive

Research Question: How do elders living with a disability perceive the aging process?

Analysis Of The Efforts Of Urban And Rural Health Systems To Achieve Accountable Care Organization Target Goals For Dilated Eye Exams In Individuals With Diabetes, Michele Gilliam

Muskie School Capstones and Dissertations

This capstone project was designed to understand and analyze the completion rates for diabetic dilated eye exams within four different health systems participating in the MaineHealth Accountable Care Organizations (ACO). This research is valuable within the current US health care climate as health care providers have sought to evaluate the cost of care in terms of their value to payers. Moreover, many providers have elected to join the ACO in order to demonstrate better outcomes, improve the cost of care and to share programmatic content and tools to standardized care. Within this capstone, system level workflows and processes were evaluated …

Implementing A Good Catch Program In Nursing Homes, Leigh Raposo

Muskie School Capstones and Dissertations

Rationale and processes for reporting near misses and evidence-based tools were collected by a literature search, seminal works by Sidney Dekker and James Reason, and websites for the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and the Centers for Medicare and Medicaid Services (CMS). Tools, information, and strategies found in this research were evaluated for implementation in Maine nursing homes. The tools provide a communication vehicle for nursing home staff to safely report to management near misses, or mistakes that do not harm residents. To emphasize a positive approach, the project replaces the term …

Maine's Breastfeeding Gap: How Initiation And Duration Differ By Socioeconomic Status, Zoe Miller

Thinking Matters Symposium Archive

The preventive health benefits of breastfeeding for both mothers and children are widely recognized. Leading health authorities recommend exclusive breastfeeding for the first six months of life.

Though breastfeeding rates in the United States have been increasing for the past decade, significant disparities continue across race and socioeconomic status.

Utilization Of An Electronic Best Practice Advisory Decreases Brain Computed Tomography In An Academic Emergency Department Setting, Donald Szlosek

Thinking Matters Symposium Archive

More than 1.3 million people seek emergency care following a mild traumatic brain injury (MTBI) each year. While most MTBI patients are safely discharged, a small proportion experience serious intracranial processes. The wide availability of computed tomography (CT) has generated a dramatic increase in the number of CTs performed to identify those patients with clinically important traumatic brain injury (ciTBI), generating expense and radiation exposure risks for patients. To address unwarranted variation in practice, we implemented an electronic best practice advisory (eBPA) based upon a validated clinical prediction rule that appears when emergency department (ED) clinicians order CT following MTBI.

Inhibition Mechanisms Of Type 2 Diabetes, Jalise Maree Cotton

Thinking Matters Symposium Archive

Type 2 Diabetes (T2D) is the most common form of diabetes mellitus which affects approximately 8.3% of the popula@on (diabetes.org 2013). T2D is most oDen brought on by reduced sensi@vity to insulin receptors. This is thought to be caused by a muta@on in the gene Insulin Receptor Substrate-­‐ 1 (IRS-­‐1). It is the suppression of IRS-­‐1 that leads to inac@va@on of signaling molecules insulin signaling pathways causing insulin resistance (Victor D. H. et al). This literature review will focus on the major mechanisms of inhibi@on of the insulin signaling pathways.

Pillow Talk: The Epigenetic And Physiological Effects Of Sleep Deprivation, Jennifer D. Cotter

Thinking Matters Symposium Archive

Circadian rhythms, or the 24-hour biological cycles of living cells, function as the body’s internal clock. Although circadian rhythms and sleep are very different processes, they are closely related to one another as these cycles play an important role in sleeping and waking patterns. Recent studies have shown that lack of sleep or sleep of poor quality can disrupt circadian rhythms and may actually cause cognitive disorders and memory loss, facilitate false memory production, and even alter gene expression in humans. This literature review is focused on identifying the epigenetic and physiological effects of disruptions and desynchronization in circadian rhythms …

Habilitation Training Curriculum: Is It Useful?, Ryan K. Cole, Christine Wyman

Thinking Matters Symposium Archive

Alzheimer’s disease is the most common form of dementia, affecting approximately five million Americans. Paul Raia, PhD, Vice President, Clinical Services at the Alzheimer’s Association, MA/NH Chapters, developed a training curriculum called Caring for People with Alzheimer’s Disease: A Habilitation Training Curriculum. The Alzheimer’s Association’s Maine Chapter has been implementing this training in care facilities across Maine. The purpose of this project was to evaluate if this training is perceived as useful in direct care settings.A secondary goal of the project was to determine if this training should be adapted for use in other settings in which professionals of varying …