Pertussis Vaccination in Pregnant Women at the EMMC Family Medicine Center

Pertussis, also known as whooping cough, primarily affects infants less than 12 months of age and frequently requires lengthy hospital stays. Maine has the 3rd highest rate of documented pertussis cases in the nation. Guidelines for prenatal vaccination recommend women receive pertussis vaccination during the third trimester of every pregnancy in order to protect the neonate. A small community project was designed to investigate adherence to prenatal vaccination guidelines. Rates of vaccination and electronic medical record (EMR) documentation for patient refusal were investigated for Jan. 1, 2016 - Aug. 1, 2016. Implementation of interventions focused on improving the rate of pertussis coverage in this population will require further follow up investigation to assess efficacy.https://scholarworks.uvm.edu/fmclerk/1230/thumbnail.jp

Paintings by Oscar Howe before the Annual National Indian Painting Competition at the Philbrook Museum of Art, 1958

ix, 68 p. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number.In 1958 Yanktonai Sioux painter Oscar Howe's (1915-1983) submission to the Annual National Indian Painting Competition at the Philbrook Museum of Art was rejected for deviating too far from the established conventions of "traditional Indian painting." Howe's innovative use of style and his subsequent declarations against the premises of his rejection established the artist as a major figure in the development of Native American painting in the twentieth century. The existing literature on Howe is predominantly biographical and lacks contextual or stylistic analysis. In particular, an under-analyzed relationship is prevalent between his mature style and his early works. This thesis aims to address the social, cultural, educational, political, and stylistic influences that prepared the artist to evolve the formal aspects of his painting. This discussion will expand the discourse on Howe by revealing trends of continuity in the artist's transition from his earlier style to an experimental style and showing that neither is without the influence of the other.Committee in Charge: Leland M. Roth, Chair; Joyce Cheng; Brian Klopote

Living in Recovery:Perceptions of Health Care and Comorbidities in Rural New England

Introduction: Alcohol and Drug Abuse: In the USA, abuse of tobacco, alcohol, and illicit drugs is costly, exacting more than $700 billion annually in costs related to crime, lost work productivity, and health care. 9% of Vermont residents and 8% of US residents report alcohol or illicit drug abuse, and 10% of US adults consider themselves to be in recovery from drugs or alcohol. Health Care and Recovery: Persons with drug addictions are approximately twice as likely to suffer from mood and anxiety disorders compared to the general population. Aside from mental health disorders, other common comorbidities include dental problems, insomnia, and migraines. The majority of people in recovery report having a primary care physician, but they receive fewer preventative health care interventions compared to the general population. The Turning Point Center of Chittenden County: The Turning Point Center is a non-profit organization that provides a safe, substance-free environment and peer-to-peer recovery activities to assist in recovery from addiction.https://scholarworks.uvm.edu/comphp_gallery/1231/thumbnail.jp

Design of a Curriculum-Spanning Mechanical Engineering Laboratory Experiment

This paper describes a laboratory experiment that was designed to facilitate education in material science, instrumentation and controls, and thermal sciences. The laboratory module is part of a broader effort to enhance mechanical engineering laboratory curriculum to incorporate modern pedagogical methods and to improve a defined set of student outcomes. The laboratory experiment focuses on a low-cost toaster oven that has been modified to allow students to control temperature and fan operation through either LabVIEW or Arduino systems. The oven experiment has been designed to facilitate long-term testing in the material science laboratory, sensing and control of the temperature in the oven during the mechanical systems laboratory, and precise heating of specimens during the senior level thermal systems laboratory. To assess the effectiveness of the laboratory experiment a student survey was administered and results indicate the new laboratory experiment has been successful in improving student engagement

Variation in the management of elderly patients in two neighboring breast units is due to preferences and attitudes of health professionals

Introduction: Elderly breast cancer patients have been shown to be managed less aggressively than younger patients. There is evidence that their management varies between institutions. We audited the management of elderly patients in two neighboring units in Glasgow and aimed to identify reasons for any differences in practice found. Methods: Patients aged ≥70 years, who were managed for a new diagnosis of breast cancer in the two units between 2009 and 2013, were identified from a prospectively maintained database. Tumor pathology, treatment details, postcode and consultant in charge of care were obtained from the same database. Comorbidities were obtained from each patient’s electronic clinical record. Questionnaires were distributed to members of each multidisciplinary teams. Results: 487 elderly patients in Unit 1 and 467 in Unit 2 were identified. 76.2% patients in Unit 1 were managed surgically compared to 63.7% in Unit 2 (p<0.0001). There was no difference between the two units in patient age, tumor pathology, deprivation or comorbidity. 16.2% patients managed surgically in Unit 1 had a comorbidity score of 6 and above compared to 11% of surgically managed patients in Unit 2 (p=0.036). Responses to questionnaires suggested that staff at Unit 1 were more confident of the safety of general anesthetic in elderly patients and were more willing to consider local anesthetic procedures. Conclusion: A higher proportion of patients aged >70 years with breast cancer were managed surgically in Unit 1 compared to Unit 2. Reasons for variation in practice seem to be related to attitudes of medical professionals toward surgery in the elderly, rather than patient or pathological factors

Design and Implementation of an Aspirational Ethics Laboratory Course

This paper describes a laboratory course designed to enhance education in a traditional mechanical engineering laboratory focused on controls and instrumentation. The laboratory course and specific modules are part of a broader effort to enhance the mechanical engineering laboratory curriculum with modern pedagogical methods, incorporate ethics through the curriculum, and improve student outcomes. The laboratory course was designed to inspire a heightened awareness of engineering ethics in addition to traditional controls.A new module has been added that applies the conventional topic of Programmable Logic Controllers in the context of controlling the breathing of an artificial lung. To assess the laboratory’s success a survey was developed for students interacting with the new module. Results indicate the new laboratory experiment has been very successful in improving student awareness of the ethical charge engineers have to perform quality work

Anthropogenic supply of nutrients in a wildlife reserve may compromise conservation success

In nutrient-poor wildlife reserves it has become common-practice to provide supplemental mineral resources for wildlife. Yet, the impacts of anthropogenic mineral supplementation on large herbivore nutrition, behaviour, and subsequent impact on ecosystem processes have received little attention. Here, we examine the contribution of anthropogenic mineral lick provision to wildlife nutrient intake across a community of mammalian herbivores (>10 kg) in the southern Kalahari Desert. Based on predicted daily nutrient intake and a faecal nutrient assessment, many large herbivore species appear deficient in phosphorus (P), sodium (Na), or zinc (Zn). For these nutrients, anthropogenic salt and mineral licks constitute an important source of nutrient intake helping to reduce or overcome requirement deficits. Larger-bodied species disproportionately consumed licks, acquiring more nutritional benefits. A comprehensive assessment of animal body condition indicated that, in general, large herbivores display good health. However, bulk grazers, non-ruminants and females displayed poorer body condition. We discuss how provisioning of anthropogenic mineral licks may inflate large herbivore populations beyond the long-term carrying capacity of the reserve by decoupling wildlife fecundity from nutrient-related feedbacks on population growth. Over time, this could compromise ecosystem integrity through habitat degradation, modified species interactions and trophic cascades. Based on results presented here, it is clear that anthropogenic provisioning of mineral licks should be considered cautiously by wildlife managers aiming to conserve natural processes in landscapes

Increasing Engagement in Materials Laboratory with Backward Design and Quadcopters

This paper describes a laboratory experiment that was designed to increase student engagement and enhance student development in a materials laboratory. The laboratory module described is part of a broader effort to enhance the mechanical engineering laboratory curriculum to incorporate modern pedagogical methods and to improve student outcomes using backward design. The new laboratory modules encourage students to work in small groups, develop team skills, and learn about basic measurement methods. The first module is a simple cantilever beam mounted with a strain gage. Students develop an understanding of the correlation between bending stress and strain. While doing so, they also determine a calibration factor for the beam in order to use the beam as a load cell to measure the weight of an object. For the second module, students are provided an instrumented beam with a known calibration factor and are asked to determine the amount of lift produced by a small quadcopter. To assess the effectiveness of the laboratory experiment, a student survey was designed and the experiments were observed by an education expert. The results indicate the new laboratory modules have been successful in increasing student engagement and meeting learning objectives

A population-based audit of surgical practice and outcomes of oncoplastic breast conservations in Scotland – an analysis of 589 patients

Introduction: Current evidence for oncoplastic breast conservation (OBC) is based on single institutional series. Therefore, we carried out a population-based audit of OBC practice and outcomes in Scotland. Methods: A predefined database of patients treated with OBC was completed retrospectively in all breast units practicing OBC in Scotland. Results: 589 patients were included from 11 units. Patients were diagnosed between September 2005 and March 2017. High volume units performed a mean of 19.3 OBCs per year vs. low volume units who did 11.1 (p = 0.012). 23 different surgical techniques were used. High volume units offered a wider range of techniques (8–14) than low volume units (3–6) (p = 0.004). OBC was carried out as a joint operation involving a breast and a plastic surgeon in 389 patients. Immediate contralateral symmetrisation rate was significantly higher when OBC was performed as a joint operation (70.7% vs. not joint operations: 29.8%; p < 0.001). The incomplete excision rate was 10.4% and was significantly higher after surgery for invasive lobular carcinoma (18.9%; p = 0.0292), but was significantly lower after neoadjuvant chemotherapy (3%; p = 0.031). 9.2% of patients developed major complications requiring hospital admission. Overall the complication rate was significantly lower after neoadjuvant chemotherapy (p = 0.035). The 5 year local recurrence rate was 2.7%, which was higher after OBC for DCIS (8.3%) than invasive ductal cancer (1.6%; p = 0.026). 5-year disease-free survival was 91.7%, overall survival was 93.8%, and cancer-specific survival was 96.1%. Conclusion: This study demonstrated that measured outcomes of OBC in a population-based multi-centre setting can be comparable to the outcomes of large volume single centre series

Predicting tropical tree mortality with leaf spectroscopy

Do tropical trees close to death have a distinct change to their leaf spectral signature? Tree mortality rates have been increasing in tropical forests, reducing the global carbon sink. Upcoming hyperspectral satellites could be used to predict regions close to experiencing extensive tree mortality during periods of stress, such as drought. Here we show, for a tropical rainforest in Borneo, how imminent tropical tree mortality impacts leaf physiological traits and reflectance. We measured leaf reflectance (400–2500 nm), light-saturated photosynthesis (Asat), leaf dark respiration (Rdark), leaf mass area (LMA), and % leaf water across five campaigns in a six-month period during which there were two causes of tree mortality: a major natural drought and a co-incident tree stem girdling treatment. We find that prior to mortality, there were significant (p < 0.05) leaf spectral changes in the red (650–700 nm), the NIR (1,000–1,400 nm), and SWIR bands (2,000–2,400 nm) and significant reductions in the potential carbon balance of the leaves (increased Rdark and reduced Asat). We show that the partial least squares regression technique can predict mortality in tropical trees across different species and functional groups with medium precision but low accuracy (r2 of .65 and RMSE/mean of 0.58). However, most tree death in our study was due to girdling, which is not a natural form of death. More research is needed to determine if this spectroscopy technique can be applied to tropical forests in general