Medicine and Health Sciences Commons^™

Single Versus Multi-Center Surgeons' Risk-Adjusted Mitral Valve Repair Procedural Outcomes, Anne Bennett, Thomas Bogue, Samuel Greenberg, Joshua Zhu, Samantha Novotny, Joseph Pizzuti, Lee A. Santore, Robert H. Habib, Annie Laurie Laurie Shroyer, Jonathan Price, Henry Tannous, Thomas Bilfinger

Department of Surgery Faculty Publications

The purpose of this study is to explore strategies to improve mitral valve repair (MVr) outcomes. This research explores postoperative outcomes of patients undergoing MVr surgery by single center surgeons versus patients of multicenter surgeons. Specific outcomes of interest include 30-day operative mortality, major operative complications (e.g., deep sternal wound infection, permanent stroke, renal dysfunction requiring dialysis, reoperation, and prolonged ventilation), length of stay, and 30-day readmissions.

In brief, the serisk-adjusted outcome rates for surgeons that perform mitral valve repair procedures will be compared for surgeons that operate at a single center [i.e. SC surgeons] versus multiple centers [i.e. MC …

Downeast Maine Mat Expansion Project: Year 1 Data Summary, Mary Lindsey Smith Phd, Olivia Dooley Mpa, Evelyn Ali Bs

Substance Use Research & Evaluation

This report summarizes the Year 1 activities of the Healthy Acadia Downeast Maine MAT Expansion Project. Through a collaborative effort of Healthy Acadia, its providers, the Downeast Substance Treatment Network and Downeast Substance Use Response Coalition, the project utilized multiple evidence-based strategies to combat opioid use disorder (OUD) in Downeast Maine.

Key findings focused on:

• capacity building,
• stakeholder engagement,
• organizational and peer support,
• payment and reimbursement issues,
• the creation of low-barrier access to MAT,
• barriers, including stigma, to MAT
• patient-centered approaches
• auxiliary recovery supports

For more information, please contact M. LIndsey Smith, PhD at m.lindsey.smith@maine.edu

Rural Health Clinic Costs And Medicare Reimbursement, John A. Gale Ms, Zachariah T. Croll Mph, Andrew F. Coburn Phd

Rural Health Clinics

The Rural Health Clinic (RHC) Program is one of the nation’s oldest rural primary care programs. A key feature of the RHC Program is Medicare and Medicaid volume-appropriate, cost-based reimbursement, which is designed to sustain these vulnerable rural primary care providers. Medicare currently pays RHCs for the lesser of reasonable costs (expressed as an adjusted cost per visit) for a defined package of RHC services or a per-visit reimbursement cap, from which provider-based RHCs owned by hospitals with fewer than 50 beds are exempt. Although the per-visit cap is updated periodically, RHC administrators, policymakers, and stakeholders question whether the updates …

Marijuana Legalization: Beyond Yes Or No., Keith Humphreys

Center for Policy Research

This paper will first go over some basic terms and concepts, then discuss what’s going on in the world around cannabis with a focus on the United States. I will then offer some policy options to consider if New York chooses to legalize recreational cannabis.

Associations Among Knowledge, Attitudes, And Practices Toward Palliative Care Consultation Service In Healthcare Staffs: A Cross-Sectional Study, Li-Chun Huang, Ho-Jui Tung, Pei-Chao Lin

Department of Health Policy and Community Health Faculty Publications

Background

The palliative care consultation service (PCCS) of the National Health Insurance payments has been promoted in Taiwan since 2011, although few studies have been conducted on healthcare staffs’ knowledge, attitudes, and practices regarding PCCS in Taiwan; consequently, the main objective of this study was to explore any correlations regarding the above by cross-sectional design using convenience sampling.

Methods

A total of 210 healthcare staff members were enrolled from a regional hospital from June 1, 2018, to September 30, 2018. Questionnaire items on the Palliative Care Consultation Service Inventory (KAP-PCCSI) were used to measure healthcare staff’s knowledge, attitudes, and practices …

Characteristics Of The Health Information Technology Workforce In Georgia, Imaobong Ekpo, Emmanuel Akowuah, Bettye Apenteng, Samuel T. Opoku

Department of Health Policy and Community Health Faculty Publications

Background: Advancement in medical technology, as well as the Health Information Technology for Economic and Clinical Health Act, has in part influenced the demand for health information technology (HIT) workers. While other sectors have experienced a tremendous increase in the information technology workforce, the health sector lags in this regard. The aim of this study was to describe the characteristics of the HIT workforce in Georgia, relative to surrounding states and the United States.

Methods: The supply of the HIT workforce in Georgia, surrounding states, and the United States was estimated using data from the 2014-2016 American Community Survey (ACS). …

La Comunicación Intercultural Entre Pacientes Bolivianos Y Trabajadores De Salud En Buenos Aires, Argentina / Intercultural Communication Between Bolivian Patients And Health-Care Workers In Buenos Aires, Argentina, Lilly Snellman

Independent Study Project (ISP) Collection

Según la Ley de Migraciones 25.871 de 2004, los inmigrantes en Argentina tienen el mismo derecho a la atención médica que los argentinos nativos. El sistema de salud argentina es uno de los más inclusivos en el mundo, pero todavía hay barreras al acceso para comunidades e individuos marginados. Muchas veces los migrantes bolivianos son discriminados en la sociedad argentina por sus rasgos raciales, bajo nivel socioeconómico y diferencias culturales. Tres clases importantes de barreras para el acceso a la atención médica para los migrantes son las económicas, estructurales y comunicativas. En este estudio, decidí enfocarme en las brechas de …

Long-Term Mental Health Support For Refugees After Resettlement: Assessment Of Mental Health And Psychosocial Support Services For Refugees In Switzerland, Courtney W. Chan

Independent Study Project (ISP) Collection

By definition, refugees are people forced to escape their home countries, often as a result of persecution, war, or disaster. While abundant literature exists on the psychological effects of trauma and corresponding psychological treatment during or immediately following crises, we know little about how post-migration factors affect refugees’ psychological well-being after resettlement. Few such longitudinal studies have been reported; moreover, evaluations of current long-term mental health and psychosocial services (MHPSS) and refugee access to MHPSS in host countries remain sparse. This study presents an evaluation of MHPSS services for refugees currently implemented around the world, with a focus on services …

La Ciudad Versus El Campo: La Calidad De Vida De Los Adultos Mayores Aymara Entre Arica Y Putre, Clare Rogowski

Independent Study Project (ISP) Collection

The elderly population in Chile is increasing rapidly. In indigenous villages in the interior of Chile, like Putre, the younger generation is leaving to pursue education and employment opportunities in cities, in this case Arica. In many cases no one stays to take care of the elders. As the elderly begin to grow older and require greater support, the younger generation seeks to move their family members to the city so that they can care for them. While this provides for greater connection to family and access to medical care for the elderly relatives, the elderly loses their connection to …

The Hapless State Of Amyotrophic Lateral Sclerosis In India: A Comprehensive Look At Life And Medical Services For Als Patients In Rural Himachal Pradesh, Carson J. Bergström

Independent Study Project (ISP) Collection

Amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease is a neurodegenerative disorder that leads to paralysis. The disease requires a high amount of medical intervention and interdisciplinary focus to achieve quality of life for patients. This study looks at ALS patient’s lifestyles, their access to these medical devices, Indian therapeutic approaches and policy that impacts patients in Shimla, Himachal Pradesh. As caretakers have a critical part in the care for this disease, their lives were also considered in the case studies. It was found that ALS patients are not experiencing access to medical devices necessary for life because of physical …

Syrian Refugee Mothers In Jordan: Perceived Social Support And Postpartum Depression, Marya Rana

Independent Study Project (ISP) Collection

Many women suffer from postpartum depression; migrant women experience postpartum depression at rates almost triple that of the general population. This study investigated the associations between perceived social support and postpartum depression among Syrian refugee mothers living in Amman, Jordan. Eleven mothers completed a sociodemographic questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), and the Interpersonal Support Evaluation List (ISEL) - Shortened Version. Four of those mothers also participated in individual interviews, and four others were included in a focus group. Multiple recurring themes were identified from the interviews and focus group, including: perceived differences in child and social support in …

Logistic And Structural Considerations For The Use Of Psychological First Aid In Humanitarian Emergencies, Taylor Johnson

Independent Study Project (ISP) Collection

Following the IASC recommendations for implementation of psychological first aid (PFA) in 2007, providing PFA in humanitarian emergencies as a method of psychosocial support has become one of the standard interventions in the wake of crises. However, the impact of PFA on future mental health outcomes remains largely unstudied and many structural and logistic factors (e.g. training of PFA providers, reviewing evidence to inform practice, and policy considerations) must be managed in order to ensure appropriate, high-quality PFA in humanitarian emergencies. This research aims to synthesize both primary interview data and the existing literature surrounding PFA in humanitarian emergencies to …

Salud Mental Comunitaria: Implementación En Chile Actual, Emma Baker

Independent Study Project (ISP) Collection

This study explores how familiar community mental health organizations in Valparaíso follow an established model of community mental health, derived from a variety of essays, books, and reports on the topic. Additionally, it serves to present the effect of this relationship on the contemporary social revolution in Chile. The present social and political unrest, manifesting itself in massive protests throughout the country, presents a unique moment in which these themes can be examined. Additionally, Chile encounters high rates of psychological disorders among its population, a lack of protection for the mental health of children and adolescents, and a lack of …

Intersections Between Health And Disability: A Case Study At Disha Centre, Jaipur, Rajasthan, Finnian Brokaw

Independent Study Project (ISP) Collection

This study investigated intersections between health and disability by asking the question: how do community perceptions of disability at Disha: A Resource Centre for the Disabled in Jaipur, India relate to health and quality of life for a person with multiple disabilities? This study utilized a case study methodology. The researcher took qualitative interviews from six respondents in the immediate educational and familial support network of a 27-year-old man with multiple disabilities. An interview based, qualitative methodology was important for investigating the complexity of perceptions of multiple disabilities and health as intersecting identities. The responses were analyzed and reflected upon …

Pensaba Que Te Había Olvidado: El Daño Duradero De La Trauma Que Viene De Tortura En La Dictadura Chilena, Antonia Mcdonnell Capossela

Independent Study Project (ISP) Collection

Research question: Is there a more useful model to characterize the torture that was implemented in Chile using the context of theory and history to establish an in-depth understanding of the symptomology and effects of the experience of torture survivors?

Objective: The general objective of this study is to establish the origin of the methods of torture used during the Pinochet dictatorship and use these results to suggest a model of reparations that is more wholistic. The specific objectives are to understand the intervention and instruction by the CIA in Chile, to study the testimonies of torture during the dictatorship …

Adicción Como Un Hecho Político Económico: Un Análisis De Servicios De Atención De Abuso De Drogas Y Alcohol En Arica, Chile, Jack Steffy

Independent Study Project (ISP) Collection

Research question – What is the current landscape of drug abuse in Chile and how has the state attempted to address this problem?

Objectives – The objectives of the paper were to characterize drug use patterns in Chile since 1994, revise drug abuse services, and offer possible improvements for the system of drug abuse treatment.

Background – Chile, despite being one of the most well economically-developed countries in South America, has some of the worst mental health indicators, one of these being drug abuse. Since 1994, use of alcohol and marihuana has increased, while use of cocaine products has remained …

La Pertinencia Cultural De Los Proyectos Relacionados A La Planificación Familiar De Las Ongs En El Distrito De Acomayo, Sadie Traylor

Independent Study Project (ISP) Collection

Esta investigación identifica y analiza la pertinencia cultural de los esfuerzos de ayuda ambos de una ONG local (Kallpa) y de una ONG internacional (Plan International), examinando específicamente el proyecto de cada ONG vinculado al aumento del acceso y uso de la planificación familiar en el Distrito de Acomayo en la región de Cusco para evaluar cómo opera (o no opera) cada ONG con una pertinencia cultural. Además, esta investigación explora la forma en que las estrategias de cada ONG mantienen un enfoque intercultural, y también analiza las percepciones de los beneficiarios del proyecto como testimonios de cómo este método …

An Analysis Of The Rajasthan Public Health System’S Response To The 2019 Dengue Insurgence, Luke Bryan

Independent Study Project (ISP) Collection

Dengue virus is in a pandemic status and is a major public health issue in the modern world. The mosquito-borne disease is largely prevalent in Asia and specifically India, where more than half of the states are considered to have complete presence of the dengue virus. The intricate infrastructure of the Indian public health system looks for dengue cases at all levels and reports to the integrated disease surveillance programme (IDSP).

Analyses of the IDSP and trends of dengue cases was done in response to dengue outbreaks throughout the state. Geographic information system (GIS) maps were created to evaluate a …

Sociodemographic And Health Status Characteristics Of Maine's Newly Eligible Medicaid Beneficiaries [Data Brief], Zachariah T. Croll Mph, Erika C. Ziller Phd, Barbara Leonard Mph

Medicaid

This data brief identifies key characteristics of groups who will gain access through MaineCare expansion. Researchers Croll and Ziller at the University of Southern Maine, along with Leonardson of the Maine Health Access Foundation present a statistical analysis of uninsured non-elderly adults age 18 – 64 with no children and lower incomes, the population newly eligible for MaineCare through expansion. Drawing from five years of data from Maine’s Behavioral Risk Factor Surveillance System, the report addresses sociodemographic characteristics, health status, and access to care. The survey indicates that those who are likely eligible for expanded MaineCare coverage are twice as …

Adolescent And Young Adult Mental Health Is Better In States That Mandate More School Mental Health Policies, Stephanie Spera, Shannon M. Monnat

Population Health Research Brief Series

Mental health problems and suicide rates have increased among adolescents and young adults over the past several years. This research brief shows that adolescent and young adult mental health is better in states that mandate more school mental health policies, including school-based mental health centers, professional development in suicide prevention, and social-emotional curricula.

Black Women’S Wellbeing: The Intersections Of Race, Immigrant Status, And Mental Health Among African Diasporan Women In Houston, Texas, Sianneh Vesslee

African American and Africana Studies Summer Fellows

My central research question is: how has white supremacy impacted African Diaspora women’s mental health, access to mental healthcare, and identities as mental health patients in the United States as discernible in advertisements and state policies for psychological wellness? More specifically, I will investigate whether and/or how white supremacy shapes the ways in which advertising and state policies for mental healthcare address the particular needs of black women who immigrate to Houston, Texas from Lagos, Nigeria and Coahuila, Mexico. I choose those geographies because Houston is a U.S. city with one of the highest populations of black immigrants from Nigeria …

Dissociation Between The Growing Opioid Demands And Drug Policy Directions Among The U.S. Older Adults With Degenerative Joint Diseases, Pearl Kim Phd, Takashi Yamashita Phd, Mph, Ma, Jay J. Shen Phd, Seong-Min Park Phd, Sung-Youn Chun Phd, Sun Jung Kim Phd, Mhsa, Jinwook Hwang Md, Phd, Se Won Lee Md, Georgia Dounis Dds, Ms, Hee-Taik Kang Md, Phd, Yong-Jae Lee Md, Phd, Dong-Hun Han Dds, Phd, Ji Eun Kim Phd, Hyeyoung Yeom Md, David Byun Do, Tsigab Bahta Md, Ji Won Yoo Md

Public Health Faculty Publications

We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others. As aging society advances in the United States (U.S.), orthopedic operations and opioid-related hospital stays among seniors increase in the nation. A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from 2006 through 2015 measured annual rate per 100,000 populations of orthopedic operations by age groups (45–64 vs 65 and older) as well as annual rate per 100,000 populations of opioid-related hospital …

The Interface Between Invasive Species And The Increased Incidence Of Tick-Borne Diseases, And The Implications For Federal Land Managers, Ed Clark, Janis Mcfarland, Blaine Parker, Slade Franklin

National Invasive Species Council

Includes information on the dynamics of tick-borne disease, factors affecting the occurrence and density of ticks, matrices of ties between habitat, human activities, invasive plants, and ticks, federal resources and programs related to ticks and vector-borne disease in the United States, with references and an annotated bibliography of literature on ticks, vector-borne diseases, and invasive species.

The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd

Disability & Aging

This study sought to determine the Medicare and Medicaid costs experienced by dual eligible older adults in Maine for whom Maine Adult Protective Services (APS) substantiated allegations of elder financial exploitation and to compare them to those of Maine’s general older population. The analysis is an important step forward in estimating the medical costs associated with elder abuse.

Elder financial exploitation may result in significant public burden on Medicare and Medicaid, shouldered by taxpayers. Efforts to detect, investigate, prosecute, and mitigate this abuse will benefit not only the victims, but also the financial stewardship of these public programs.

The Patient-Physician Relationship: Overcoming Language And Cultural Barriers, Corrilynn Lynch

Senior Honors Theses

The patient-physician relationship governs the field of medicine, forming the basis for all relationships, interactions, and procedures in medicine. The degree to which a patient trusts his physician and thus is willing to be receptive to medical advice and adhere to assigned treatment is dependent on the quality of his relationship with his physician. The method of relationship chosen will dictate how the patient feels he is perceived and thus to what extend he will participate in his healthcare. A patient-centered approach to medicine will increase this confidence and lead to improved clinical results. Additionally, the rise of physician burnout …

Preventive Health Service Use Among Rural Women, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Nathan Paluso Mph, Jaclyn Janis Bsn, Rn

Access / Insurance

Preventive health services and screenings are an important component in the continuum of care provided to individuals across all ages. Yet, research has shown that rural residents generally use fewer preventive health services and screenings. This study used the National Health Interview Survey to examine receipt of preventive health services (cholesterol check, fasting blood sugar test, mammogram, pap smear, and receipt of the HPV vaccine) by rural and urban women over the age of 18. Findings indicate that rural women were less likely than their urban peers to receive preventive health services, and that some of the differences may be …

Digital Information Technology Use And Patient Preferences For Internet-Based Health Education Modalities: Cross-Sectional Survey Study Of Middle-Aged And Older Adults With Chronic Health Conditions, Nancy P. Gordon, Elizabeth L. Crouch

Faculty Publications

Background: Health information, patient education, and self-management (health information and advice, HIA) tools are increasingly being made available to adults with chronic health conditions through internet-based health and mobile health (mHealth) digital information technologies. However, there is limited information about patient preferences for using specific types of health information and advice resources and how preferences and usage differ by age group and education.

Objective: The objective of this study was to examine how use of digital information technologies and preferred methods for obtaining health information and advice varies by age group and education among middle-aged and older adults with chronic …

It Takes A Village To Uplift A Population: Addressing The Homeless In District 16 Of Virginia, Chloe Allen

Student Writing

Homelessness is a community issue which affects every country. My research group and I decided to look into the causes of homelessness in our community. We interviewed the Fredericksburg Regional Continuum of Care (FRCoC), The Brisben Center (TBC), and Micah Ecumenical Ministries (MEM) to better understand the situation in District 16 of Virginia. This paper discusses the actions already in place in the district as well as our proposed solutions to help the homeless population. We propose acting on minimum wage, petitioning and revising a budget proposed by the FRCoC, and opening a new shelter to serve the chronically homeless. …

Activating Nursing To Address Unmet Needs In The 21st Century, Patricia Pittman

Health Policy and Management Faculty Publications

No abstract provided.

A Collaborative Perspectives Approach For Understanding Effective Care Coordination In Autism Spectrum Disorder, Rachel Severs

Dissertations

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that causes significant impairment in social and communication areas. The severity of the disorder can often result in a substantial degree and amount of service access and expenditures relating to a child’s needs. This study examined the experiences of how family caregivers and service providers of children with ASD view service delivery using a basic qualitative research design. For the study, 10 participants (five family caregivers and five service providers) were enrolled and interviewed. Interview data were collected and coded to produce a qualitative analysis of the experiences of these individuals who …