Quality improvement in provider attitudes towards adherence to comprehensive diabetic care HEDIS standards

Healthcare Effectiveness Data and Information Set (HEDIS) is a quality measurement for standard of care used to rate a health plan or provider\u27s ability to demonstrate clinical effectiveness. Medicare Advantage healthcare plan utilizes HEDIS as a guide for standard of care. Adherence to HEDIS is useful in decreasing chronic disease burden through preventative measures. Diabetes, a disease with high burden, has Comprehensive Diabetes Care HEDIS standards that specifically target providers. Increasing adherence to HEDIS measures is shown to significantly improve health outcomes when used with evidence-based guidelines. The literature shows having high HEDIS scores are not an incentive to adhere to the measures for providers. Furthermore, financial incentives are often not enough of a motivating factor. This project assessed current attitudes, beliefs, and behaviors of primary care providers that service Medicare Advantage patients, implemented a Practice Improvement Module (PIM) intervention and evaluated its effectiveness. With the PIM, there was positive movement in categories relating to relevance, awareness and understanding, behavior control, and impact related to use of HEDIS

The Effects of Literature on Childhood Anxiety and Attachment Issues

The purpose of the present study was to determine whether children’s literature that targets issues related to anxiety and attachment has any effect on preschoolers, specifically at the beginning of a new school year. A sample of 12 children aged 2 to 4 years who attended a university-based preschool was examined with two parental and teacher questionnaires that assessed childhood anxiety and attachment-related issues. These measures were administered before and after the treatment. The participants were split into three groups: control, reading, and reading with discussion, and then were read two books that focused on the theme of coping with anxiety. Although there were no group differences after the treatment, a main effect for time was found for parent-rated attachment, teacher-rated attachment, and teacher-rated anxiety. Despite the fact that no evidence was found for the treatment playing a role in the change in anxiety and attachment, the passage of time did seem to play a role. Further studies, especially those with larger sample sizes that also involve more extensive interventions are needed in order to more fully examine the potential for positive effects of bibliotherapy on preschool-aged children

A Concept OST

A Concept OST was developed during my final year at the University of Maine at Farmington. This collection of original music represents the skills I have learned while studying composition and music theory. Some of the inspirations that helped me shape the sonic world I created include Nobuo Uematsu (Final Fantasy), Yoko Shimomura (Kingdom Hearts), Junichi Masuda (Pokemon) Jake Kaufman (Shovel Knight), and Toby Fox (Undertale). These composers are known for their narrative-driven compositional work for video games that fit into the Role-Playing-Game playstyle. My primary mode of research was listening to these game tracks and playing the video games each song lives in to see how they function in-game. My goal was to compose a selection of music that would emphasize characters, plot points, and game mechanics for a conceptual video game. This means rather than illustrating existing characters and stories through music, I composed the soundscape first and will use the soundscape to inspire a potential plot for a future game project. I’ve come to learn that the most unique thing about video game music is that each track needs to be able to smoothly repeat infinitely. This means that I had to plan how my music would establish a theme, but keep it interesting and engaging enough to be played over and over again. To time my repeats just right, I worked alongside my Faculty Sponsor Aaron Wyanski to find the best way to make my compositions play forever. In the end, I have developed ten video game songs that each represent different necessities in a video game including the title track, battle music, character music, and more. I have also included the sheet music I used to convert each composition into synthesized music for those who enjoy reading the music while they listen. I am excited to have generated so much material that might just make its way into an entire video game in the future

Phylogenetic Analysis of Blacknose Dace (Rhinichthys) in West Virginia Streams

Blacknose dace (Rhinichthys) are one of the most common cyprinid fishes in eastern North America. They also have been a topic of debate for over 30 years because morphology-based systematics has failed to clearly define their taxa. Taxonomists classify the complex into two species and one subspecies: the eastern form, R. atratulus atratulus; and the western form R. obtusus obtusus, and southern form R. obtusus meleagris. This research uses the mitochondrial cytochrome b gene and genomic RAG 2 gene in a phylogenetic analysis to help clarify species relations according to differences between each current species. Maps have been created to give a visual representation of how these fish may have evolved from one another in their respective stream locations in West Virginia, both by morphological and genetic characteristics. Current results with the mitochondrial cytochrome b gene indicates that there is a distinct separation between R. atratulus atratulus and R. obtusus obtusus,R.atratlus atratulus having 51-58 site changes compared to the R. obtusus obtusus reference. The difference between R. obtusus obtusus and R. obtusus meleagris is not as direct. In the collection of R. obtusus obtusus two groupings were recorded. The first group had 0–5 differences; the second grouping had 10–19 base pair changes. The R. obtusus meleagris species group had 19–21 changes. The RAG2 genetic tree was composed of two branches, one mixed with R. obtusus obtusus and R.obtusus meleagris and a second composed of R. atratulus atratulus. Even though there are strong indications that these fish have been separated long enough to begin to look different through there mitochondrial lineage, there is evidence that the groups are interbreeding

Technology Application for Freight Data Collection

This paper looks at the application of GPS, GIS, wireless communication networks and Personal Digital Assistant (PDA) technology to freight data collection. The Transport Research Centre (in Melbourne) is undertaking a Freight Activity and Commercial Travel Survey (FACTS) which aims to use this technology to collect metropolitan road based freight data in Melbourne. FACTS is currently at the prototype development stage and consists of a GPS based tool to automatically collect location and route choice information, and an electronic touch screen questionnaire to collect data on vehicle stops, the driver and the vehicle. This paper explains the prototype development

A Comparative Study of America\u27s Entries into World War I and World War II.

This thesis studies events that preceded America\u27s entries into the First and Second World Wars to discover similarities and dissimilarities. Comparing America\u27s entries into the World Wars provides an insight into major events that influenced future ones and changed America. Research was conducted from primary sources of Presidents Woodrow Wilson and Franklin D. Roosevelt. In addition, secondary sources were used that study the events preceding America\u27s entries into World War I and World War II. Research was also conducted on public opinion. In World War I, German actions angered Wilson and segments of the American public, persuading Wilson to ask for a declaration of war. While German aggression shaped American opinion in World War II, Japanese action forced the United States to enter the war. In both cases, the tone of aggression that molded the foreign policy of Presidents Wilson and Roosevelt and shaped American public opinion originated from Germany

“Gosh I Miss the Cold War”: Post-Cold War Foreign Policy Making In The United States, 1989-1995

The end of the Cold War created a dilemma for American foreign policymakers as the strategy to contain the spread of communism became obsolete. The presidencies of George H. W. Bush and William “Bill” Jefferson Clinton were forced to create grand strategies for American national security and foreign policy to replace the forty-plus year strategy of containment that continued to rely on traditional themes and principles of US foreign policy. Both men had to overcome lingering Cold War attitudes about the United States role in the world and its national security interests. As they struggled to do this, they faced an American public that was supportive of and reluctant of American participation in conflict resolution around the world. This dissertation argues that even hat even as the international context changed following the end of the Cold War and during the early post-Cold War period, presidents George H. W. Bush and William “Bill” Clinton relied on pre-Cold War US foreign policy and national security strategies from the early twentieth century to devise a non-containment grand strategy. Clinton’s and Bush’s national security strategy and foreign policies returned to cooperative security arrangements that relied on international and regional institutions to respond to international and intranational conflicts that threatened to world security and stability and American interests. Their efforts occurred as post-Cold War technological advances in satellite transmissions, the growth of the internet, and electronic email increased public opinion’s and the mass media’s ability to influence foreign policy decisions. This dissertation focuses on the intranational or intra-state conflicts the United States intervened in between 1989 and 1995. Using Bush and Clinton’s national security strategies, presidential documents, documents from the National Security Council, US State Department, and Central Intelligence Agency this dissertation examines the development and execution of Bush and Clinton’s grand strategies. The dissertation also uses public opinion polls, newspaper editorials, and archived television news reports understand public opinion and its responses to mass media and presidential framing and agenda setting