Association Between Buprenorphine Use and Weight Gain in Pregnancy

Many pregnant women in the Appalachian Highlands region utilize buprenorphine as medication-assisted treatment (MAT) for opioid use disorder. This treatment is a tool used by medical teams to minimize patients’ drug cravings and optimize chances for a healthy pregnancy. Providers in our region have posited a relationship between MAT use and poor pregnancy weight gain based on clinical experience and observation. Appropriate weight gain in pregnancy is a critical determinant of pregnancy health; without it, pregnant mothers will possibly need nutritional supplementation. Therefore, understanding the association between buprenorphine use and weight gain may contribute to healthier pregnancies. In order to evaluate the association between buprenorphine use and weight gain in pregnant women using MAT, we conducted a retrospective chart review. A list of potential participants was generated by ETSU Population Health using ICD-10 codes. We enrolled patients who were cared for by ETSU Health and delivered babies between July 1, 2019 and June 30, 2021: a total of 504 patients. Of these, 96 were participants in the ETSU low-dose MAT clinic (Group 1), 109 were receiving MAT from other community clinics (Group 2), 97 were non-smoking women in the regular OB clinic (Group 3), and 202 were smoking women in the regular OB clinic (Group 4). Participants’ medical records were screened for inclusion and exclusion criteria. All patients were over age 18 with singleton pregnancies, had pregnancy care initiated in the first trimester, and delivered at or after 37 weeks’ gestation. Patients with confounding medical conditions including (but not limited to) Crohn’s disease, diabetes, heart disease, hypertension, fetal anomalies, or IUFD were excluded. In addition, patients were also excluded with BMI \u3e30 or undocumented BMI, prenatal care initiated after the first trimester, transfer to another practice or lost to follow up, or other documented drug abuse other than opiate use disorder. After consideration of the above criteria, 262 patients were excluded and 242 patients remained in the study. Of these, 53 were in Group 1, 53 in Group 2, 45 in Group 3, and 90 in Group 4. All protected health information was stored in the ETSU HIPAA-compliant REDCap server. At this time, the project is in the data analysis stage, with results expected by the end of March 2023. If an association between buprenorphine use and lower weight gain in pregnancy is discovered, these results can be used to recommend additional measures such as nutritional supplementation to optimize maternal and fetal health during pregnancy. Final conclusions will be drawn after data analysis is complete and associations, or lack thereof, can be fully evaluated. Based on observations of obstetric providers in the region, some association between lower weight gain and buprenorphine use is anticipated

Older Adults and Adults with Disabilities: Population and Service Use Trends in Maine, 2010 Edition

This chartbook is an update to the “Assessment of Maine’s Long-term Care Needs Baseline Report: Demographics and Use of Long Term Care Services in Maine” report that was produced in 2007. The Chartbook provides historical and projected trends in the demographics of Maine’s population. With the aging of Maine’s population and its status as the “oldest” state in the nation, the use of long term services and supports surfaces as a key issue of public policy. We hope that the information contained in this report will be useful to state policy makers, legislators, providers, advocates and others with an interest in this subject. The use and expenditure data show historical trends while the population data includes projections. Where possible, national comparisons are provided to show Maine relative to other states

Satisfaction Survey Results and Lessons Learned: Maine\u27s Aging & Disability Resource Center (ADRC) Project

The primary goal of Maine’s Aging and Disability Resource Center (ADRC) Project was to empower consumers to make informed decisions about long-term services and supports and to streamline access to existing services and supports through an integrated system. With funding from the Administration on Aging to strengthen and expand the number of Aging and Disability Resource Centers (ADRCs) in the state, all five of the Area Agencies on Aging were committed to becoming and/or strengthening their capacity to be fully functioning ADRCs. This report provides a summary of the results of consumer satisfaction surveys that were conducted for three years at all five ADRCs. The survey was designed to capture the consumer view of the ADRC services in key domain areas including: visibility/trust; efficiency; responsiveness and effectiveness. Also included is a summary of consumer comments that were shared by those responding to the survey and a summary of lessons learned from the administrators at the ADRCs. Significant accomplishments of the ADRCs were reported as training; providing information, resources, navigation assistance and options counseling to a broad spectrum of aging and disabled adults, along with their caregivers; the ability to expand the ARDC\u27s role into the disability community; and the connection with community providers. Challenges reported included the lack of resources and inability of the State Unit on Aging to be approved to apply for future funding; ongoing operations and expansion as a a fully functioning ADRC without the funding to support the additional work, and the need for updated on-line referral database and the staffing to maintain it

Caring for People with Alzheimer\u27s Disease or Dementia in Maine

It is clear that caring for people with Alzheimer’s disease and dementia is a growing public health issue. Alzheimer’s is a progressively deteriorating disease that can last anywhere from 1 to 15 years. Families are the primary caregivers and will continue to need support to manage the care of their loved ones, to coordinate services within the long term care system and to maintain their own health and well-being

Personal Experiences with MaineCare Services from People Who Use Elder and Adults with Disabilities Waiver and Private Duty Nursing/Personal Care Services.

This report provides the results from a survey and personal interviews that were conducted with MaineCare members who use long term services and supports -- specifically those who are on the Elder and Adults with Disabilities Waiver and those using Private Duty Nursing (PDN) Services. People who are eligible for these services generally need nursing care and assistance with a combination of activities of daily living (e.g. eating, toileting, mobility, transfer) and instrumental activities of daily living (e.g. meal preparation, grocery shopping, housework). People on the Waiver are medically eligible to be in a nursing home. The purpose of the survey and interviews was to provide information on the experience of members and their use of medical services; the coordination between the medical and home care systems; care transition services (e.g. from the hospital to home); home care services; and use of transportation services. The surveys also include information on the satisfaction of members with their workers, their use and need for assistive technology devices, and their access to other community resources

Assessment of Maine\u27s Long-Term Care Needs Baseline Report: Demographics and Use of Long Term Care Services in Maine

In 2006, the Office of Elder Services requested the assistance of the Muskie School in developing an assessment of long term care service use in Maine. This report provides baseline information on the demographic characteristics, participant characteristics and service use trends for people accessing long term care services in this State. For purposes of this report, we have excluded people with MR/DD. Long term care services do not include community support services for people with mental illness. In this report, long term care services include: Nursing Facility Services Private Non-medical Institutions Consumer Directed Attendant Services Day Health Services Elder and Adult Waiver Services Home Health Services Hospice Services Personal Care Services Physically Disabled Waiver Services Private Duty Nursing Facility Service

Older Adults and Adults with Disabilities: Population and Service Use Trends in Maine, 2012 Edition

This Chartbook is an update to the Chartbook: Older Adults and Adults with Physical Disabilities: Population and Service Use Trends in Maine 2010. With the aging of Maine’s population and its status as the “oldest” state in the nation, the use of long term services continues to be a critical public policy issue in the State and nationally. The information in this Chartbook is provided to help inform state policy makers, legislators, providers, advocates and others with an interest in this subject

Adults Using Long-term Services and Supports: Population and Service Use Trends in Maine, SFY 2014

Prepared by research staff at the University of Southern Maine\u27s Muskie School of Public Service for the Maine Office of Aging and Disability Services (the Office), this chartbook provides information on Maine adults who use long term services and supports. This is the first chartbook to reflect all the populations served by the Office: older adults; adults with physical disabilities; adults with intellectual disabilities/autism spectrum disorder or other related conditions; and adults with acquired brain injury. Long term services and supports are a vital lifeline for the thousands of Maine adults who need them, and they account for a significant portion of the state\u27s Medicaid (MaineCare) budget

Dementia in Maine: Characteristics, Care, and Cost Across Settings [CHARTBOOK]

This report provides a baseline picture of the current use of services by people with and without dementia in Maine

Competition-based model of pheromone component ratio detection in the moth

For some moth species, especially those closely interrelated and sympatric, recognizing a specific pheromone component concentration ratio is essential for males to successfully locate conspecific females. We propose and determine the properties of a minimalist competition-based feed-forward neuronal model capable of detecting a certain ratio of pheromone components independently of overall concentration. This model represents an elementary recognition unit for the ratio of binary mixtures which we propose is entirely contained in the macroglomerular complex (MGC) of the male moth. A set of such units, along with projection neurons (PNs), can provide the input to higher brain centres. We found that (1) accuracy is mainly achieved by maintaining a certain ratio of connection strengths between olfactory receptor neurons (ORN) and local neurons (LN), much less by properties of the interconnections between the competing LNs proper. An exception to this rule is that it is beneficial if connections between generalist LNs (i.e. excited by either pheromone component) and specialist LNs (i.e. excited by one component only) have the same strength as the reciprocal specialist to generalist connections. (2) successful ratio recognition is achieved using latency-to-first-spike in the LN populations which, in contrast to expectations with a population rate code, leads to a broadening of responses for higher overall concentrations consistent with experimental observations. (3) when longer durations of the competition between LNs were observed it did not lead to higher recognition accuracy