Medicine and Health Sciences Commons^™

Diabetes Management In Adolescents: Insulin Pump Therapy Versus Insulin Injection Therapy, Candice J. Ryder, Chantal Connelly, Lindsay Clements, Keri Hebert

Non-Thesis Student Work

Understanding the compliance of different insulin delivery methods among adolescents with diabetes is crucial for bettering their outcomes as they grow into adulthood. Adherence to insulin regimens can be influenced by many factors, including education provided to the adolescent from caregivers and providers, utilization of diabetes educators, peer influence, and stereotyping. The two methods of insulin delivery focused on for this review are insulin pumps and daily insulin injections. These authors pose the question: in adolescents, aged 13-18 years with type 1 diabetes mellitus (T1DM), does the use of an insulin pump therapy compared to insulin injection therapy lead to …

A Quantitative Visualization Tool For The Assessment Of Mammographic Risky Dense Tissue Types, Margaret R. Mccarthy

Electronic Theses and Dissertations

Breast cancer is the second most occurring cancer type and is ranked fifth in terms of mortality. X-ray mammography is the most common methodology of breast imaging and can show radiographic signs of cancer, such as masses and calcifcations. From these mammograms, radiologists can also assess breast density, which is a known cancer risk factor. However, since not all dense tissue is cancer-prone, we hypothesize that dense tissue can be segregated into healthy vs. risky subtypes. We propose that risky dense tissue is associated with tissue microenvironment disorganization, which can be quantified via a computational characterization of the whole breast …

Improving Retention Rates Of New Graduate Nurses, Rebekah B. Littlefield, Courtney Kelsey, Sophia Howrey

Non-Thesis Student Work

The purpose of this project is to explore if pairing (P) new grad nurses (I) with a similar personality nurse preceptor (C) as compared to a randomly assigned nurse preceptor (O) improves retention rates (T) over a 24-month period? Nursing has been recognized as a highly stressful profession that can lead to early career burnout. New nurses have reported an intention to leave the profession due to high-stress levels from unrealistic career expectations. Studies have shown that having a supported, planned, and consistent residency program for new nurses will increase retention of the nurses at the beginning of their careers. …

Primary Cilia Of The Cardiac Neural Crest & Hedgehog-Mediated Mechanisms Of Congenital Heart Disease, Lindsey A. Fitzsimons

Electronic Theses and Dissertations

Elimination of primary cilia in cardiac neural crest cell (CNCC) progenitors is hypothesized to cause a variety of congenital heart defects (CHDs), including atrioventricular septal defects, and malformations of the developing cardiac outflow tract. We present an in vivo model of CHD resulting from the conditional elimination of primary cilia from CNCC using multiple, Wnt1:Cre-loxP, neural crest-specific systems, targeting two distinctive, but critical, primary cilia structural genes: Intraflagellar transport protein 88 (Ift88) or kinesin family member 3A (Kif3a). CNCC loss of primary cilia leads to widespread CHD, where homozygous mutant embryos (MUT) display a variety of outflow tract malformations, septation …

Social Isolation During The Covid-19 Pandemic And Its Impact On Maine's Nursing Homes, Tanya Roy

Honors College

The COVID-19 pandemic has created several challenges within the healthcare industry and has highlighted the impact of social isolation on older adults in Maine’s nursing homes. The older adult population, defined as individuals 65 years and older, has been identified with increased risk in contracting the SARS-CoV-2 virus during the COVID-19 pandemic. Therefore, older adults were placed on strict isolation precautions and confined within their nursing home setting, many residing only in their rooms. With Maine having the oldest population in the United States, this created a need for further investigation into how the COVID-19 pandemic has impacted the lived …

Advancing Anti-Racism, Diversity, Equity, And Inclusion In Older Adult Health Care, University Of Maine Center On Aging

Social Justice: Diversity, Equity, & Inclusion

Flyer advertising registration opportunities for the 16th Annual University of Maine Center on Aging Clinical Geriatrics Colloquium scheduled for October 25, 2021.

Critique Of Experimental Procedures Targeting Retinitis Pigmentosa, Jenna Goss

Honors College

Retinitis Pigmentosa (RP) is a group of hereditary genetic disorders, all causing degradation of the retina through loss of rod photoreceptor cells, ultimately causing loss of vision and in many cases complete blindness. Despite the prevalence o fRetinitis Pigmentosa disorders, safe and effective treatment methods have not yet been approved to stop or regain vision loss in patients diagnosed with RP. However, the ophthalmic field as a whole is working on several new technologies and procedures in order to both slow loss of vision as well as potentially regain lost sight. In this thesis, I describe the genetic causes and …

Health Insurance Plan Design And Chronic Disease Management, Daniel E. Feldman

Electronic Theses and Dissertations

Each year, Americans spend more money on health care than any other industrialized nation, despite comparable mortality rates for people with risk factors for heart disease. The reasons for this lack of health care value in the US are numerous and complex – including market distortions like supplier-inflated pricing and regulatory structures that enable consumers to utilize ubiquitous, high-cost medical technologies that yield uncertain benefits. Health insurance, once thought to be an insignificant contributor to rising health spending, has changed considerably in the past few decades in ways that make it more accessible and more generous in coverage. Health insurance …

Cpap-Compliance Of Aging Individuals With Obstructive Sleep Apnea With Or Without Mild Cognitive Impairment, Bailey Carter

Honors College

With approximately 20% of Americans affected by obstructive sleep apnea (OSA), and over 30% of sleep apneic patients non-compliant with the most common form of treatment, CPAP (Continuous Positive Airway Pressure), the proposed study looks to investigate the relationship between OSA, CPAP-compliance, and cognitive decline associated with many aging-related neurodegenerative diseases [1, 2]. Our group has performed in-home sleep studies using a patented, sensor mattress-sheet device, and standard actigraphy. Demographics including a questionnaire on OSA compliance and neurocognitive tests were administered to participants between 62 and 90 years of age. Cognitive decline meeting criteria for MCI (Mild Cognitive Impairment, the …

Impact Of Television On The Language Development Of Young Children, Courtney E. Daly

Honors College

Today, children are growing up immersed in television screen media, which has been shown to have both positive and negative effects on language development. Young children are considered developmentally vulnerable, and today, they are growing up highly immersed in digital media. Strict guidelines by the American Academy of Pediatrics (AAP) suggest that limiting the use of screen time. However, there is limited current research on the effect of coviewing while watching television programs on the language development of children. This investigation sought to contribute to efforts aimed at understanding the impact of coviewing on language output.

Blacklegged Tick (Ixodes Scapularis) Distribution In Maine, Usa, As Related To Climate Change, White-Tailed Deer, And The Landscape, Susan P. Elias

Electronic Theses and Dissertations

Lyme disease is caused by the bacterial spirochete Borrelia burgdorferi, which is transmitted through the bite of an infected blacklegged (deer) tick (Ixodes scapularis). Geographic invasion of I. scapularis in North America has been attributed to causes including 20th century reforestation and suburbanization, burgeoning populations of the white-tailed deer (Odocoileus virginianus) which is the primary reproductive host of I. scapularis, tick-associated non-native plant invasions, and climate change. Maine, USA, is a high Lyme disease incidence state, with a history of increasing I. scapularis abundance and northward range expansion. This thesis addresses the question: “To …

Incorporation Of Civilian Care In Emergency Medicine: Retainment Of Training And Familiarization Of Resources At The University Of Maine, Courtney Jurson

Honors College

According to statistics by the American Heart Association, there are 475,000 deaths from cardiac arrest every year with more than 350,000 of them happening outside of the hospital. The only chance of a victim of sudden cardiac arrest to survive is a bystander rapidly starting cardiopulmonary resuscitation (CPR), contacting emergency services for assistance, and acquiring an automated external defibrillator (AED).

This research recruited participants affiliated with the University of Maine campus and divided them into two groups: those who are required to have CPR/AED training for their affiliation and those who were not required these trainings. All participants then took …

Intergenerational Adult Day Services Needs Assessment Project Final Report, University Of Maine School Of Social Work, Eastern Area Agency On Aging, University Of Maine Center On Aging

Maine Center on Aging Research and Evaluation

Focus group research conducted in the Greater Bangor, Maine area in 2016 identified respite services and intergenerational programming as important factors for supporting a more livable community.

This report outlines findings from a 2018 needs assessment of adult day services (ADS), funded by Maine Health Access Foundation. The needs assessment utilized a survey of local caregivers (N=84) and key informant interviews (N=10) with staff at Maine adult day service programs or service providers that could utilize adult day services for their clients.

Key survey findings indicate that lack of financial resources (identified by 20% of the survey sample), and lack …

The Effect Of Wild Blueberry Bioactives On Endothelial Cell Migration And Angiogenesis: An In Vitro Mechanistic, Genomic And Proteomic Approach, Panagiotis Tsakiroglou

Electronic Theses and Dissertations

The goal of this study is to investigate the effects of wild blueberry fractions (Anthocyanins and Phenolic acids) on vascular function and physiology. More specifically the potential effects of the above fractions and their combination in physiological concentrations on endothelial cell migration, angiogenesis, gene expression and proteins synthesis of markers related to the above processes. The objectives are to study whether anthocyanins, phenolic acids and their combinations (ACNs:PAs) affect: a) cell proliferation, b) speed of endothelial cell migration, c) angiogenesis, d) gene expression of genes critical for cell migration and angiogenesis such as RAC1, RHOA, AKT1, eNOS and VEGF and …

Genetic Modification Of Inherited Retinopathy In Mice, Yang Kong

Electronic Theses and Dissertations

The retina, as a critical component of the sensory system, consists of multiple cell types, of which, photoreceptors play a key role in receiving, integrating and transmitting light signals. The biofunctions of photoreceptors rely on their proper growth and development, which is predominantly governed by a cluster of molecules that comprise the transcriptional regulation for photoreceptor development. Any disruption of these molecules potentially incurs retinal pathologies.

It is known that deficiencies of nuclear receptor subfamily 2 group E member 3 (NR2E3) or neural retina leucine-zipper (NRL), two molecules in regulating photoreceptor cell development, cause photoreceptor dysplasia. In a sensitized chemical …

Basic Vision Research With Clinical Applications And Science Education Assessments, Andrew Wilson

Electronic Theses and Dissertations

Visual Acuity (VA) examinations are one of the most commonly conducted medical assessment throughout the world. Recent advances in computer technology allows for new forms of visual assessment to be conducted. In Part I of this thesis I demonstrate the capability of an automated computer program named VISION to assess human visual acuities. Different color combinations of an object against a background emitted from a computer screen are used to examine a variety of human color vision acuities. Results indicated a large difference in acuity scores between human subjects tested with these different color combinations. A single human subject exhibits …

Primary Care Transition Planning For Young Adults With Special Needs In Maine: A Preliminary Survey Of Pediatric Providers, Clelia Sigaud

Poster Presentations

Research suggests that less than half of young adults with special health care needs are prepared for the transition to an adult primary care provider at the age-appropriate time (McManus et al., 2013). Prior research also indicates that having a “usual source of care” and routinized medical services creates a higher likelihood of adult patients receiving preventative and screening health services (Blewett et al., 2008).

Dynamic Host-Pathogen Interactions Result In Fungal Epitope Unmasking, Alex Hopke

Electronic Theses and Dissertations

Molecular camouflage is used by a diverse set of pathogens to disguise their identity and avoid recognition by protective host receptors. The opportunistic fungal pathogen Candida albicans is a good example, as it masks the inflammatory component β-glucan in its cell wall to evade detection by the immune receptor Dectin-1. Interestingly, it has been seen that β-glucan becomes unmasked during infection in vivo, though the underlying mechanisms remained unclear. Exposure levels of this epitope may be important, as Dectin-1 mediates protection from some strains of C. albicans and alterations in the organization and composition of the Candida cell wall …

Daily Chocolate Consumption Is Inversely Associated With Insulin Resistance And Liver Enzymes In The Observation Of Cardiovascular Risk Factors Study, Ala’A Alkerwi, Nicolas Sauvegeot, Georgina E. Crichton, Merrill F. Elias, Saverio Stranges

Maine-Syracuse Longitudinal Papers

This study examined the association of chocolate consumption with insulin resistance and serum liver enzymes in a national sample of adults in Luxembourg. A random sample of 1153 individuals, aged 18–69 years, was recruited to participate in the cross-sectional Observation of Cardiovascular Risk Factors in Luxembourg study. Chocolate consumption (g/d) was obtained from a semi-quantitative FFQ. Blood glucose and insulin levels were used for the homoeostasis model assessment of insulin resistance (HOMA-IR). Hepatic biomarkers such as serum γ-glutamyl-transpeptidase (γ-GT), serum aspartate transaminase and serum alanine transaminase (ALT) (mg/l) were assessed using standard laboratory assays. Chocolate consumers (81·8 %) were more …

Nurses' Perceptions Of Barriers To Pediatric Patient Advocacy In End-Of-Life Care, Layla J. Eaton

Honors College

Nurses responsible for caring for pediatric patients during end-of-life care find themselves in any number of ethical dilemmas as they attempt to balance providing care, educating family and patients spanning a large developmental spectrum, working collaboratively with extensive medical teams, ensuring proper therapy and bereavement services for parents and siblings, as well as advocating for the voices of their patients who do not yet have legal authority to make decisions regarding their care. These issues are multifaceted and require considerations from multiple disciplines if proper assessment of potential barriers to patient advocacy is desired. This thesis explored the barriers perceived …

Maine’S Initiatives In Geriatric Medical Care: Commentary From The Front Lines, Cliff Singer, Roger Renfrew

Maine Policy Review

Cliff Singer and Roger Renfrew write from their perspectives as medical practitioners and leaders in geriatric medi­cine to examine issues affecting health care and outcomes for older adults in Maine. Focusing on the acute and primary care systems, they highlight issues and policy recommendations they think are most urgent or helpful.

Accessing Healthcare: The Experience Of Individuals With Autism Spectrum Disorders In Maine, Alan Kurtz, Angie Schickle, Margaret Carr, Marnie Bragdon-Morneault, Susan Russell, Debra Rainey, Jill Downs, Nancy Cronin

Health and Well-Being

Previous research has revealed that children and adults with autism spectrum disorders (ASD) are significantly more likely to have both unmet healthcare needs than those with other disabilities. In addition, they are more likely to have difficulty accessing primary or specialized medical care. Minority status, living in a rural location, and low income can exacerbate these disparities. Other obstacles to effective healthcare for individuals with ASD include the following: (1) severity of symptoms associated with ASD; (2) lack of knowledge or skill by medical practitioners; (3) lack of access to comprehensive healthcare supports or a medical home; and (4) lack …

Combating Autism Reauthorization Act Of 2014, Kassandra Mores

Policy Analysis

On May 9, 2014, Representative Smith (R-NJ) and Representative Doyle (D-PA) introduced a bill to reauthorize the Combating Autism Act (H.R. 4631) for five years. Senator Menendez (D-NJ) and Senator Enzi (R-WY) are planning to introduce a Senate bill of the Combating Autism Reauthorization Act. The Combating Autism Act of 2011, due to sunset September 30, 2014, provides federal funding for autism research, public education, and early detection and intervention in Maine. We are hoping that you will consider voting in support of the Combating Autism Reauthorization Act.

A Novel Mechanism For Mechanosensing By Endothelial Cells, Jennifer Macdowell

Honors College

The formation of new vasculature is an essential process, but can also be utilized by cancerous cells. Angiogenesis requires the directed migration of the endothelial cells lining the nascent blood vessels. This process is largely mediated by integrin, which plays a key role in the interplay between sensing a force in the extracellular matrix (ECM) and transducing this signal, a process termed mechanotransduction. Through cell-ECM focal adhesions, integrin mediates the signaling both into and out of the cell, promoting growth of focal adhesions and subsequent cell spreading and migration. In order to study focal adhesion dynamics related to force, we …

Development Of Porous Polymeric Implants For Use In Orthopedic Research And Development Applications, Alexander Caddell

Honors College

Current orthopedic implants comprised of plastic, ceramic, or metal alloys are susceptible to surface degradation at the implant-implant interface. The resulting microscopic fragments cause tissue irritation that can lead to osteolysis. In addition, existing percutaneous implants, such as pins used to stabilize fractures, are prone to bacterial infections due to the inability of the surrounding soft tissue to adhere to the implant and form a biologic seal. The goal of this Honors Thesis was to develop porous polymeric implants for orthopedic research and development applications that improve upon current designs in an attempt to remedy the issues detailed above. A …

Fingering A Murderer: A Successful Anthropological And Radiological Collaboration, B. G. Brogdon, Marcella H. Sorg, Kerriann Marden

Anthropology Faculty Scholarship

We illustrate an interdisciplinary approach to identify a victim in a case with complex taphonomic and procedural issues. Burning, fragmentation, species commingling, and examination by multiple experts required anthropological preparation and analysis combined with radio- graphic adaptations to image and match trabecular patterns in unusually small, burned specimens. A missing person was last seen in the company of a reclusive female on a remote rural property. A warranted search found several burn sites containing human and animal bones. Fragment prepara- tion, analysis, and development of a biological profile by anthropologists enabled examination by the odontologist, molecular biologist, and radiolo- gist, …

Elder Abuse Screening Protocol For Physicians: Lessons Learned From The Maine Partners For Elder Protection Pilot Project, University Of Maine Center On Aging

Maine Center on Aging Research and Evaluation

This manual was designed to assist physicians, nurses, and medical office managers become aware on means to incorporate screening processes in regard to elder abuse. The United States Senate Special Committee on Aging has reported that as many as five million elderly persons are abuses each year in the United States. By implementing proper screening procedures, disclosure will be made easier, thus protecting patients from harm. The screening procedure involves evaluating for mistreatment among patients 60 years or older, at least once per year. The protocol has been tested in 16 healthcare facilities with a total of 2,082 patients being …

Caregiving Resources: Primary Care Practice Fact Sheet #7, Eastern Agency On Aging, University Of Maine Center On Aging, Aroostook Area Agency On Aging, Senior Spectrum, Rosscare, Norumbega Medical, Horizons Health Services, Indian Township Tribal Health Center, Bucksport Regional Health Center

Maine Center on Aging Service and Consultation

It is important to remember that not all resources are dependent upon income. Health care professionals should remind patients to ask about options that they have. Local resources for caregivers include the Local Area Agency on Aging, the Maine Alzheimer’s Association Helpline, and the Bureau of Elder and Adult Services. Nationwide resources for professionals in regard to caregiving include the Family Caregiver Alliance, the US Administration on Aging, and the American Medical Association. By keeping these resources in mind and utilizing them when available, caregivers will be better prepared before a crisis occurs.

Men Provide Care To Relatives Also: Primary Care Practice Sheet #6, Eastern Agency On Aging, University Of Maine Center On Aging, Aroostook Area Agency On Aging, Senior Spectrum, Rosscare, Norumbega Medical, Horizons Health Services, Indian Township Tribal Health Center, Bucksport Regional Health Center

Maine Center on Aging Service and Consultation

Male caregivers in modern society often are overlooked or face discrimination. Due to the belief systems in our society, many men fell as though they should not seek outside help with their caregiving, and often experience health problems. Thus, it is important for healthcare professionals to ask questions to ensure that the male caregivers are maintaining their wellbeing. Encouraging discussions can assist in this as well as identifying if they need help from outside resources.

Elder Abuse, Neglect, And Exploitation: Primary Care Practice Fact Sheet #5, Eastern Agency On Aging, University Of Maine Center On Aging, Aroostook Area Agency On Aging, Senior Spectrum, Rosscare, Norumbega Medical, Horizons Health Services, Indian Township Tribal Health Center, Bucksport Regional Health Center

Maine Center on Aging Service and Consultation

Elder abuse often occurs in the home by family members, and often goes unreported due to isolation and dependency on these individuals. The term elder abuse encompasses physical abuse, sexual abuse, emotional abuse or psychological abuse, or neglect. It is important for healthcare professionals to ask older individuals questions in regard to safety and fears. By knowing the signs of abuse, physicians will be able to discuss and document potential dangers.